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As older adults continue to contribute to the labor force, it is critical that perceptions of them reflect these contributions. We explore whether portraying older adults based on their occupational roles instead of their age is linked to more positive sentiments and test the possibility of an age premium. We created the largest historical corpus of American English—a 600-million-word dataset with over 150,000 texts—spanning 210 years (1810–2019). Top descriptors ( N = 675,213) of nouns related to age, occupation, and age × occupation over 21 decades were compiled and rated for valence (negative-positive) on a 5-point scale. Occupational role-based framing was associated with more positive portrayals than age-based framing. Positive portrayals of older lawyers increased by 22.6% over 210 years. Older doctors (−1.4%) and older soldiers (−10.7%) experienced a decline in positive portrayals, though sentiments toward older doctors, lawyers, and soldiers remained more positive than those toward older adults.

Central to raising awareness of ageism are advocacy organizations dedicated to serving the needs and interests of older adults. Although many of these organizations have cultivated an online presence, inquiry into the effectiveness of age advocacy work on social media remains an untapped area. Our foray into this topic explores how different tweet features predict the level of engagement of posts uploaded by age advocacy organizations on Twitter.Tweets (N = 403,426) were collected from 53 accounts and spanned 12 years from July 2009 to October 2021. After applying our exclusion criteria, 204,905 tweets were retained for analysis. We analyzed the tweet features (predictors) and engagement level (outcome variable) using a linear mixed-effects model.Tweets with higher engagement are those with a URL, with at least three hashtags, with visuals (GIF, photo, or video), which are quote tweets, and which are posted in the evening or at night Central Standard Time (CST), adjusting for account-level variables (e.g., follower count). Conversely, tweets with more than one mention, which are replies and which are uploaded in the morning are associated with lower engagement.The rise of digital media means that advocates have the opportunity to communicate their messages to reach a critical mass. This is the first known study to offer an evidence-informed playbook for age advocacy organizations to optimize outreach efforts by maximizing online engagement. These results represent a crucial step in ongoing efforts to tackle ageism, an issue that has long been under-discussed.

Background and ObjectivesAlthough reputed for being the virtual playground of teenagers, TikTok has since made its way to older adults, some of whom have become content creators with millions of followers. Despite their immense sway over audiences, as well as their potential to reconfigure socially constructed notions of aging, these older TikTok personalities have been given scant attention in gerontological literature. We fill this gap by exploring how older adults use TikTok to engage in discourses on old age.Research Design and MethodsWe compiled the most viewed videos of users aged 60 and older with at least 100,000 followers, generating 1,382 videos with over 3.5 billion views. Videos that did not feature older adults engaging in discourses on aging were excluded, resulting in 348 videos for content analysis. Both inductive and deductive approaches guided the qualitative analysis.ResultsThree themes emerged: Nearly 3 in 4 videos featured older adults “Defying Age Stereotypes” (71%; Theme 1), 18% featured them “Making Light of Age-Related Vulnerabilities” (Theme 2), and 11% involved older adults “Calling out Ageism” (Theme 3).Discussion and ImplicationsThis is the first known study exploring how older adults consciously engage in discourses of aging through their participation on TikTok. Our findings highlight the potential for older adults to be put at the vanguard of a movement aimed at challenging socially constructed notions of old age.

Background and Objectives The recent entry of the hashtag #OkBoomer into social media vernacular underscores the collective frustration of younger people with a group whose views they find increasingly incompatible with theirs. Most social media analyses in gerontology focus on the content on Twitter and Facebook, with content on TikTok virtually unexplored. Given the burgeoning popularity of TikTok among younger people, we assess the content of TikTok videos with the hashtags #OkBoomer or #Boomer to distill the undercurrents of hostility expressed by younger people toward Baby Boomers. Research Design and Methods We collated TikTok videos (N = 332) with the hashtags #OkBoomer or #Boomer, which received over 5.4 billion views. Both inductive and deductive approaches guided the qualitative content analysis of the videos. Results Five themes emerged. Most videos (79%) described “Negative Encounters with Baby Boomers” (Theme 1); 58% were about “Conflicting Values/Beliefs between Baby Boomers and Younger People” (Theme 2); 39% were about “Baby Boomers Antagonizing Younger Generations” (Theme 3); 22% of the videos made references to the “Karen Meme” (Theme 4); and 7% bemoaned the existence of a “Wealth Gap” between Baby Boomers and younger people (Theme 5). Discussion and Implications Findings reveal that the usage of the hashtags #OkBoomer and #Boomer is highly nuanced, at times explicitly ageist, and at others, emblematic of a phenomenon far more complex than ageism. There is a need to leverage social media as a space to foster interaction between older and younger people. Society is ultimately well served by intergenerational interaction.

Background and ObjectivesWhile studies have researched ageism in public policy, few investigated the impact of aging policy on ageism—typically, an unintended consequence. Ageism is linked to $63 billion in health care costs, so its antecedents are of interest. We test the association between Aging Policy Agenda Setting and Societal Age Stereotypes and hypothesize a mediating pathway via Medicalization of Aging, moderated by demographics.Research Design and MethodsScholars identified Singapore’s Pioneer Generation Policy (PGP) as one of the largest policy implementations in recent years, where the agenda was set by the Prime Minister at an equivalent State of the Union address in 2013, and US$7 billion allocated to fund outpatient health care costs for aged 65 years or older. More than 400,000 older adults received a PGP card and home visits by trained volunteers who co-devised a personalized utilization plan. We leveraged a 10-billion-word data set with more than 30 million newspaper and magazine articles to dynamically track Societal Age Stereotype scores over 8 years from pre- to postpolicy implementation.ResultsSocietal Age Stereotypes followed a quadratic trend: Prior to the Aging Policy Agenda Setting from 2010 to 2014, stereotypes were trending positive; after 2014, it trended downward to become more negative. Medicalization of Aging mediated the relationship between Aging Policy Agenda Setting and Societal Age Stereotypes. Furthermore, Old-age Support Ratio moderated the mediational model, suggesting that the impact of policy on medicalization is stronger when a society is more aged.Discussion and ImplicationsWe provided a framework for policymakers to ameliorate the unintended consequences of aging policies on societal ageism—if unaddressed, it will exert an insidious toll on older adults, even if initial policies are well-intentioned.

Background and Objectives Discussions on age-related issues have begun taking place in earnest, but exactly what dominates public consciousness about these issues is a topic that has yet to kindle scholarly attention. This study analyzes tweets uploaded by age advocacy organizations that have attracted the highest levels of engagement on Twitter. Research Design and Methods We collected 403,426 tweets from 53 accounts. These tweets were posted over 12 years, from 2009 to 2021. After applying our exclusion criteria and collating the top 1% of tweets with the highest levels of engagement, 2,054 tweets were retained for analysis. Both inductive and deductive approaches informed our qualitative content analysis. Results Five themes emerged. “Issues Related to Alzheimer’s Disease or Dementia” (Theme 1) formed the majority of tweets (62%; N = 1,278). Theme 2 “Rising Health Care or Retirement Costs” was the second largest theme (25%; N = 506). Seven percent of the tweets were on “Reframing Aging and Combating Ageism” (Theme 3; N = 138). “Matters Affecting Caregivers” surfaced in Theme 4 (4%; N = 81). Two percent of the tweets were on “Intersectional Concerns” (Theme 5; N = 51). Discussion and Implications As age advocacy organizations step up to engage the public constructively in matters regarding later life, there is a compelling need to quell public anxiety about old age and to sensitize society to the struggles confronted by older adults. In undertaking the range of activities needed to do so, age advocacy organizations should consolidate efforts even as they rethink existing strategies to effectuate change.

Objectives The World Health Organization launched a recent global campaign to combat ageism, citing its ubiquity and insidious threat to health. The historical context that promoted this pernicious threat is understudied, and such studies lay the critical foundation for designing societal-level campaigns to combat it. We analyzed the trend and content of aging narratives over 210 years across multiple genres—newspaper, magazines, fiction, nonfiction books—and modeled the predictors of the observed trend. Method A 600-million-word dataset was created from the Corpus of Historical American English and the Corpus of Contemporary American English to form the largest structured historical corpus with over 150,000 texts from multiple genres. Computational linguistics and statistical techniques were applied to study the trend, content, and predictors of aging narratives. Results Aging narratives have become more negative, in a linear fashion (p = .003), over 210 years. There are distinct shifts: From uplifting narratives of heroism and kinship in the 1800s to darker tones of illness, death, and burden in the 1900s across newspapers, magazines, and nonfiction books. Fiction defied this trend by portraying older adults positively through romantic courtship and war heroism. Significant predictors of ageism over 210 years are the medicalization of aging, loss of status, warmth, competence, and social ostracism. Discussion Though it is unrealistic to reverse the course of ageism, its declining trajectory can be ameliorated. Our unprecedented study lay the groundwork for a societal-level campaign to tackle ageism. The need to act is more pressing given the Covid-19 pandemic where older adults are constantly portrayed as vulnerable.

Objectives Ageism has increased over 200 years and costs the U.S. health care system $63 billion a year. While scholars agree on the consequences of ageism, there are disagreements on whether it is related to the demographics of aging, or society’s cultural values. We test both hypotheses across 20 countries. Method To circumvent the sampling limitations of survey studies, we used an 8-billion-word corpus, identified 3 synonyms with the highest prevalence—aged, elderly, old people—and compiled the top 300 words (collocates) that were used most frequently with these synonyms for each of the 20 countries. The resulting 6,000 collocates were rated on an ageism scale by 2 raters to create an ageism score per country. Cultural dimension scores—Power Distance, Individualism, Masculinity, Uncertainty Avoidance, and Long-term Orientation—were taken from Hofstede, and demographics—size and speed of population aging—came from the World Development Indicators. Results Of the 20 countries, UK topped the ageism table, while Sri Lanka had the lowest ageism score. Multiple regression models showed that higher levels of masculinity and long-term orientation are associated with ageism, controlling for other cultural dimensions, demographics (size and speed of aging), and economics (GDP-per-capita). Discussion Our findings blunt the deterministic nature of ageism at the societal level. Demographics is only one side of the ageism coin, and the cultural side is equally, if not more important. This study lays the groundwork to tackle societal ageism—one of our generation’s most pernicious threats.

Lately, there have been news reports on the rise of older content creators on various social media outlets. However, while journalists have picked up on this topic, scholars have been slow to accord it any attention. Our study delves into this topic and looks at how older TikTokers’ self-perceptions of aging are expressed in their videos. Specifically, we analyze the valence of the content of these videos and factors associated with older adults’ self-presentations. TikTok has only gone from strength to strength since its global launch in 2017. Even as stay-at-home orders and safe distancing protocols amid the COVID-19 pandemic have led to a dramatic increase in the consumption of media across various platforms, TikTok stands out among its rivals in terms of growth and user activity. Given its wide reach, content on TikTok has the potential to influence public opinion. We collated 1,382 videos created by TikTokers aged 60 and above with at least 100,000 followers. These videos amassed over 3.5 billion views. Following previous studies, three raters coded each video for valence (negative-neutral-positive). We found that women created twice as many videos as men. The middle-old group (ages 75–84) created more videos than the young-old and oldest-old groups. Positive videos outnumbered negative ones by 10 times. As hypothesized, themes linked to positive self-portrayals were ‘physical functioning’ (p < .001) and ‘social interaction’ (p < .001). Conversely, ‘cognitive functioning’ (p < .001) evidenced a negative association, controlling for age and gender of the user. This is one of the first studies on older adults’ self-portrayals of aging on TikTok. Our findings suggest that older adults tend to portray themselves positively across various domains on the application. If used purposefully, TikTok may serve as a promising platform for improving public perceptions of old age.

The current media studies of COVID-19 devote asymmetrical attention to social media, in contrast, newspapers have received comparatively less attention. Newspapers are an integral source of current information that are syndicated and amplified by social media to a wide global audience. This is one of the first known studies to operationalize news media diversity and examine its association with cultural values during the pandemic. We tracked the global diversity of COVID-19 coverage in a news media database of 12 billion words, collated from 28 million articles over 7000 news websites, across 8 months. Media diversity was measured weekly by the number of unique descriptors of 10 target terms of the pandemic (e.g., COVID-19, coronavirus) and normalized by the corpus size for the respective countries per week. Government Stringency was taken from the Oxford COVID-19 Government Response Tracker and cultural scores were taken from Hofstede’s Cultural Values global database. Results showed that Media Diversity Rate increased 6.7 times over 8 months, from the baseline period (October–December 2019) to during the pandemic (January–May 2020). Mixed effects modelling revealed that higher COVID-19 prevalence rates and governmental stringency predicted this increase. Interestingly, collectivist cultures are linked to more diverse media coverage during COVID-19. It is possible that news outlets in collectivist societies are motivated to present a diverse array of topics given the impact of COVID-19 on every segment of society. Of broader significance, we provided a framework to design targeted public health communications that are culturally nuanced.

Background Healthcare professionals’ empathetic behaviors have been known to lead to higher satisfaction levels and produce better health outcomes for patients. However, empathy could decrease over time especially during training and clinical practice. This study explored factors that contributed to the development of empathy in the healthcare setting. Findings could be used to improve the effectiveness and sustainability of empathy training. Method A qualitative approach, informed by aspects of grounded theory, was utilized to identify factors that enabled the development of empathy from the perspectives of doctors, nurses, allied healthcare workers and students. Twelve sessions of focus group discussions were conducted with 60 participants from two hospitals, a medical school, and a nursing school. Data was analyzed independently by three investigators who later corroborated to refine the codes, subthemes, and themes. Factors which influence the development of empathy were identified and categorized. This formed the basis of the creation of a tentative theory of empathy development for the healthcare setting. Results The authors identified various personal (e.g. inherent characteristics, physiological and mental states, professional identity) and external (e.g. work environment, life experience, situational stressors) factors that affected the development of empathy. These could be further categorized into three groups based on the stability of their impact on the individuals’ empathy state, contributed by high, medium, or low stability factors. Findings suggest empathy is more trait-like and stable in nature but is also susceptible to fluctuation depending on the circumstances faced by healthcare professionals. Interventions targeting medium and low stability factors could potentially promote the development of empathy in the clinical setting. Conclusions Understanding factors that impact the development of empathy allows us to develop measures that could be implemented during training or at the workplace leading to improve the quality of care and higher clinical work satisfaction.

Although there has been an increase in awareness of the struggles experienced by caregivers, discourse on caregiving remains confined mostly to academia, policy circles or the family unit. There have been suggestions that public discourse on informal caregiving dwells overwhelmingly on the outsize toll it takes on the health of caregivers. However, few studies have examined societal narratives on caregivers—a gap our study aims to fill. We leveraged an online media database of 12 billion words collated from over 30 million articles to explore societal narratives on caregivers in six Asian countries. Computational linguistics and statistical analysis were applied to study the content of narratives on caregivers. The prevalence of societal narratives on caregivers was highest in Singapore—five times higher than Sri Lanka, which evidenced the lowest prevalence. Findings reveal that the inadequacies of institutional care as well as the need to train and empower caregivers are pressing issues that need to be prioritized on the policy agenda in Asia. Of broader significance, the diverse capabilities across Asia present opportunities for cross-country learning and capacity-building.

Background Current media studies of COVID-19 devote asymmetrical attention to social media, in contrast, newspapers have received comparatively less attention. Newspapers are an integral source of current information—that are syndicated and amplified by social media to a wide global audience. This is the first-known study to investigate the impact of cultural values and pandemic severity on media attention towards COVID-19. Findings lay the groundwork for targeted public health communications that are culturally nuanced. Objective We investigated the impact of cultural values and pandemic severity on Media Attention towards COVID-19 across 18 countries. Methods We tracked the global volume of COVID-19 coverage (to measure media attention) over 8 months in a news media database of 12 billion words with 30 million articles from over 7,000 news media sites. Predictors of Media Attention towards COVID-19 came from the Oxford COVID-19 Government Response Tracker (incidence and mortality) and Hofstede’s Cultural Values. Results Media attention toward COVID-19 increased 55 times over 8 months. Higher rates of new cases and deaths predicted this exponential increase. Countries with higher power distance, uncertainty avoidance, and long-term orientation, were associated with increased media attention, controlling for covariates. Conclusions Cultural values play a significant role in the news media’s attention toward COVID-19, controlling for pandemic severity. We provided a framework to design targeted public health communications that are culturally nuanced.

Background Contributions of older adults amid the COVID‐19 pandemic have been eclipsed by discourse positioning them as an at‐risk population. We assess whether age‐based framing (e.g., senior citizen) is associated with more negative stereotyping in the media compared to familial role‐based framing (e.g., grandparent) across 8 months, from a baseline period (October 2019–December 2019) to the onset of the pandemic (January 2020–May 2020). Methods Leveraging a 12‐billion‐word news media database—with over 30 million news articles from over 7000 websites—we identified the most common synonyms for age‐based framing (e.g., senior citizen) and familial role‐based framing (e.g., grandparent). For each framing category, we compiled the most frequently used descriptors every month, amassing 488,907 descriptors in total. All descriptors were rated from 1 (very negative) to 5 (very positive) to determine a Cumulative Aging Narrative Score (CANS) for age‐based and familial role‐based framing. Results Age‐based framing of older adults increased negative stereotyping in the media by 7 times compared to familial role‐based framing during COVID‐19. The percentage of positive topics for age‐based framing was significantly lower during COVID‐19 (35%) than before (61%). Conversely, the percentage of positive topics for familial role‐based framing was higher during the pandemic (91%) than before (70%). Conclusion This is one of the first empirical studies on whether framing older adults based on age or role is linked to more negative stereotypes during COVID‐19. We argue for a more role‐centered approach in framing older adults so that their contributions are acknowledged and valued by society. This article is protected by copyright. All rights reserved.

The COVID-19 crisis has sparked a resurgence of scholarly interest in the issue of ageism. Whether the outbreak thwarts or facilitates efforts to combat ageism hinges upon public sentiments toward the older demographic. This study aims to explore discourse surrounding older adults by analyzing 183,179 related tweets posted during the COVID-19 pandemic from February to December 2020. Overall, sentiments toward older adults became significantly less negative over time, being the least negative in April, August, and October, though the score remained below the neutral value throughout the 11 months. Our topic modelling analysis generated four themes: "The Need to Protect Older Adults" (41%), "Vulnerability and Mortality" (36%), "Failure of Political Leadership" (12%), and "Resilience" (11%). These findings indicate nascent support for older adults, though attempts to show solidarity may well worsen benevolent ageism.

Singapore is one of the first known countries to implement an individual-centric discharge process across all public hospitals to manage frequent admissions—a perennial challenge for public healthcare, especially in an aging population. Specifically, the process provides daily lists of high-risk patients to all public hospitals for customized discharge procedures within 24 h of admission. We analyzed all public hospital admissions (N = 150,322) in a year. Among four models, the gradient boosting machine performed the best (AUC = 0.79) with a positive predictive value set at 70%. Interestingly, the cumulative length of stay (LOS) in the past 12 months was a stronger predictor than the number of previous admissions, as it is a better proxy for acute care utilization. Another important predictor was the “number of days from previous non-elective admission”, which is different from previous studies that included both elective and non-elective admissions. Of note, the model did not include LOS of the index admission—a key predictor in other models—since our predictive model identified frequent admitters for pre-discharge interventions during the index (current) admission. The scientific ingredients that built the model did not guarantee its successful implementation—an “art” that requires the alignment of processes, culture, human capital, and senior management sponsorship. Change management is paramount, otherwise data-driven health policies, no matter how well-intended, may not be accepted or implemented. Overall, our study demonstrated the viability of using artificial intelligence (AI) to build a near real-time nationwide prediction tool for individual-centric discharge, and the critical factors for successful implementation.

Background and Objectives Older adults are exhibiting greater diversity in their aging trajectories. This has led to movements by the World Health Organization and AARP to reframe aging. We compare role-based framing and age-based framing of older adults over 210 years—a time span beyond the reach of traditional methods—and elucidate their respective sentiments and narratives. Research Design and Methods We combined the Corpus of Historical American English with the Corpus of Contemporary American English to create a 600-million-word data set—the largest historical corpus of American English with over 150,000 texts collected from newspapers, magazines, fiction, and nonfiction. We compiled the top descriptors of age-based terms (e.g., senior citizen) and role-based terms (e.g., grandparent) and rated them for stereotypic valence (negative to positive) over 21 decades. Results Age-based framing evidenced a significantly higher increase in negativity (15%) compared to role-based framing (4%). We found a significant interaction effect between framing (age-based vs. role-based) and stereotypic content across 2 centuries (1800s and 1900s). The percentage of positive topics associated with role-based framing increased from 71% in the 1800s to 89% in the 1900s, with narratives of affection and wisdom becoming more prevalent. Conversely, the percentage of positive topics for age-based framing decreased from 82% to 38% over time, with narratives of burden, illness, and death growing more prevalent. Discussion and Implications We argue for a more role-centric approach when framing aging such that age ceases to be the chief determinant in how older adults are viewed in society.

BACKGROUND US president Joe Biden signed an executive action directing federal agencies to combat hate crimes and racism against Asians, which have percolated during the COVID-19 pandemic. This is one of the first known empirical studies to dynamically test whether global societal sentiments toward Asians have become more negative during the COVID-19 pandemic. OBJECTIVE This study aimed to investigate whether global societal sentiments toward Asians across 20 countries have become more negative, month by month, from before the pandemic (October 2019) to May 2020, along with the pandemic (incidence and mortality rates) and cultural (Hofstede’s cultural dimensions) predictors of this trend. METHODS We leveraged a 12-billion-word web-based media database, with over 30 million newspaper and magazine articles taken from over 7000 sites across 20 countries, and identified 6 synonyms of “Asian” that are related to the coronavirus. We compiled their most frequently used descriptors (collocates) from October 2019 to May 2020 across 20 countries, culminating in 85,827 collocates that were rated by 2 independent researchers to provide a Cumulative Asian Sentiment Score (CASS) per month. This allowed us to track significant shifts in societal sentiments toward Asians from a baseline period (October to December 2019) to the onset of the pandemic (January to May 2020). We tested the competing predictors of this trend: pandemic variables of incidence and mortality rates measured monthly for all 20 countries taken from the Oxford COVID-19 Government Response Tracker, and Hofstede’s Cultural Dimensions of Individualism, Power Distance, Uncertainty Avoidance, and Masculinity for the 20 countries. RESULTS Before the pandemic in December 2019, Jamaica and New Zealand evidenced the most negative societal sentiments toward Asians; when news about the coronavirus was released in January 2020, the United States and Nigeria evidenced the most negative sentiments toward Asians among 20 countries. Globally, sentiments of Asians became more negative—a significant linear decline during the COVID-19 pandemic. CASS trended neutral before the pandemic during the baseline period of October to November 2019 and then plummeted in February 2020. CASS were, ironically, not predicted by COVID-19’s incidence and mortality rates, but rather by Hofstede’s cultural dimensions: individualism, power distance, and uncertainty avoidance—as shown by mixed models (N=28,494). Specifically, higher power distance, individualism, and uncertainty avoidance were associated with negative societal sentiments toward Asians. CONCLUSIONS Racism, in the form of Anti-Asian sentiments, are deep-seated, and predicated on structural undercurrents of culture. The COVID-19 pandemic may have indirectly and inadvertently exacerbated societal tendencies for racism. Our study lays the important groundwork to design interventions and policy communications to ameliorate Anti-Asian racism, which are culturally nuanced and contextually appropriate.

Background This study evaluated the impact of the adapted version of the Respecting Choices® The Living Matters Advance Care Planning (ACP) facilitator training programme on trainees’ attitudes on facilitation 6 months post-training. Setting and participants Two hundred and twenty-one healthcare professionals consisting of doctors, nurses, medical social workers from different training venues in Singapore participated in the first phase of the study (pre- and post) of which 107 participated in the second phase 6 months later (follow-up). Methods Participants self-rated their attitudes, beliefs and behavioural intentions through surveys at three time points in an evaluation design that utilised repeated measures one-way ANOVA (pre-, post-, follow-up). Between-group differences were also examined using independent t-test. Results At follow-up, mean scores increased significantly in understanding, confidence, and competence. Changes in effect sizes were large. Although trainees continued to think that ACP is emotionally draining for facilitators, more than before, facilitation experience was considered pleasant for themselves with the positive change significant and moderate in effect size. Those who had experience completing/initiating ACP significantly held more positive views than those who did not. Conclusions The ACP facilitator training programme had lasting effects on enhancing the understanding, competence, and confidence of trainees. Importantly, findings showed that experience in actual facilitation within 6 months after training was important and giving trainees opportunities to facilitate is recommended.

Caregivers play an indispensable role in society. In 2017, 41 million family caregivers in the United States provided approximately 34 billion hours of care to their aging parents, spouses, partners and friends. The estimated economic value of their unpaid contributions amounted to $470 billion. Despite their invaluable contributions, caregivers often operate in a reality of inadequate social support. Little is known about the factors linked to the societal perceptions of caregivers, and our study seeks to contribute by filling this gap. Importantly, whether society honors or stigmatizes caregivers is critical as it could impact caregiving decisions and either exacerbate or ameliorate caregiver burden. We leveraged an online media database of 10 billion words collated from over 28 million articles, across 20 countries, to analyze societal perceptions of caregivers. Of the 20 countries, 18 evidenced neutral to positive perceptions of caregivers. Bangladesh and Ghana had the most positive perceptions, while Sri Lanka and Tanzania had the most negative perceptions. Aging demographics and culture (individualism, masculinity and uncertainty avoidance) were significantly associated with perceptions of caregivers. Findings suggest that positive perceptions of caregivers can be better cultivated when caring is lauded as a virtuous act that aids in reducing the care deficit. This study is among the first to analyze the societal perceptions of caregivers globally, and lays the groundwork to design culturally sensitive interventions that increase society’s appreciation for caregivers.

Objectives Older adults experience higher risks of getting severely ill from coronavirus disease 2019 (COVID-19), resulting in widespread narratives of frailty and vulnerability. We test: (a) whether global aging narratives have become more negative from before to during the pandemic (October 2019 to May 2020) across 20 countries; (b) model pandemic (incidence and mortality), and cultural factors associated with the trajectory of aging narratives. Methods We leveraged a 10-billion-word online-media corpus, consisting of 28 million newspaper and magazine articles across 20 countries, to identify nine common synonyms of “older adults” and compiled their most frequently used descriptors (collocates) from October 2019 to May 2020—culminating in 11,504 collocates that were rated to create a Cumulative Aging Narrative Score per month. Widely used cultural dimension scores were taken from Hofstede, and pandemic variables, from the Oxford COVID-19 Government Response Tracker. Results Aging narratives became more negative as the pandemic worsened across 20 countries. Globally, scores were trending neutral from October 2019 to February 2020, and plummeted in March 2020, reflecting COVID-19’s severity. Prepandemic (October 2019), the United Kingdom evidenced the most negative aging narratives; peak pandemic (May 2020), South Africa took on the dubious honor. Across the 8-month period, the Philippines experienced the steepest trend toward negativity in aging narratives. Ageism, during the pandemic, was, ironically, not predicted by COVID-19’s incidence and mortality rates, but by cultural variables: Individualism, Masculinity, Uncertainty Avoidance, and Long-term Orientation. Discussion The strategy to reverse this trajectory lay in the same phenomenon that promoted it: a sustained global campaign—though, it should be culturally nuanced and customized to a country’s context.

We explored psychosocial pathways to longevity, specifically, the association between psychological well-being and mortality in a 20-year prospective cohort study of 7626 participants. As hypothesized, high self-acceptance and interdependence were associated with decreased mortality risk, controlling for other psychological components (purpose, positive relations, growth, mastery) and potential confounders: personality, depression, self-rated health, smoking status, body mass index (BMI), illness, and demographics. Self-acceptance decreased mortality risk by 19% and added three years of life. Longevity expectation fully mediated the relationship between self-acceptance and mortality. Interdependence decreased mortality risk by 17% and added two years of life. Serenity towards death fully mediated the relationship between interdependence and mortality. This is the first known study to investigate self-acceptance, interdependence, and serenity toward death as promoters of longevity, and distilled the relative contributions of these factors, controlling for covariates&mdash, all of which were measured over multiple time points. Theoretically, this study suggests that components of well-being may make meaningful contributions to longevity, and practically recommend that self-acceptance and interdependence could be added to interventions to promote aging health.

Against a rapidly aging population, projections are done to size up the demand for long-term care (LTC) services for long-range policy planning. These projections are typically focused on functional factors such as disability. Recent studies indicate the importance of social factors, for example, socially isolated seniors living alone are more likely to be institutionalized, resulting in higher demand for LTC services. This is one the first known studies to complete a 40-year projection of LTC demand based on disability and social isolation. The primary micro dataset was the Retirement and Health Survey, Singapore&rsquo, s first nationally representative longitudinal study of noninstitutionalized older adults aged 45 to 85 with over 15,000 respondents. Disability prevalence across the mild to severe spectrum is projected to increase five-fold over the next 40 years, and the number of socially isolated elders living alone is projected to grow four-fold. Regression models of living arrangements revealed interesting ethnic differences: Malay elders are 2.6 times less likely to live alone than their Chinese counterparts, controlling for marital status, age, and housing type. These projections provide a glimpse of the growing demand for LTC services for a rapidly aging Singapore and underscore the need to shore up community-based resources to enable seniors to age-in-place.

Background Seldom in history does one get a ‘front row seat’—with large-scale dynamic data—on how online news media narratives shift with a global pandemic. News media narratives matter because they shape societal perceptions and influence the core tent poles of our society, from the economy to elections. Given its importance—and with the benefit of hindsight—we provide a systematic framework to analyze news narratives of Covid-19, laying the groundwork to evaluate policy and risk communications. Objectives We leverage a 10-billion-word-database of online news, taken from over 7,000 English newspapers and magazines across 20 countries, culminating in 28 million articles. First, we track the volume of Covid-19 conversations across 20 countries from before to during the pandemic (Oct’19 to May’20). Second, we distill the phases of global pandemic narratives, and elucidate regional differences. Methods To track the volume of Covid-19 narratives, we identified 10 target terms—Coronavirus, Covid-19, Covid, nCoV, SARS-CoV-2, Wuhan Virus, Virus, Disease, Epidemic, Pandemic—and tracked their combined monthly prevalence across eight months from October 2019 through May 2020. Globally, across 20 countries, we identified 18,042,855 descriptors of the target terms. Further, these descriptors were analysed with natural language processing models to generate the top five topics of Covid-19 that were labelled by two independent researchers. This process was repeated across six continents to distil regional topics. Results Our model found four phases of online news media narratives: Pre-pandemic, Early, Peak and Recovery. Pre-pandemic narratives (Oct’19–Dec’19) were divergent across regions with Africa focused on monkeypox, Asia on dengue fever, and North America on Lyme disease and AIDS. Early (Jan–Feb’20) and Peak Pandemic (Mar–May’20) evidenced a global convergence, reflecting the omnipresence of Covid-19. The brief transition from early to peak pandemic narratives underscored the pandemic’s rapid spread. Emerging from the embers of the pandemic’s peak were nascent recovery words that are regionally divergent—Oceania focused on hope and an uncertain future while North America centered on re-opening the economy and tackling discrimination. Conclusions Practically, we presented a media barometer of Covid-19, and provided a framework to analyse the pandemic’s impact on societal perceptions—laying the important groundwork for policy makers to evaluate policy communications, and design risk communication strategies.

Recently, 194 World Health Organization member states called on the international organization to develop a global campaign to combat ageism, citing its alarming ubiquity, insidious threat to health, and prevalence in the media. Existing media studies of age stereotypes have mostly been single-sourced. This study harnesses a 1.1-billion-word media database comprising the British National Corpus and Corpus of Contemporary American English—with genres including spoken/television, fiction, magazines, newspapers—to provide a comprehensive view of ageism in the United Kingdom and United States. The US and UK were chosen as they are home to the largest media conglomerates with tremendous power to shape public opinion. The most commonly used synonym of older adults was identified, and its most frequently used descriptors were analyzed for valence. Such computational linguistics techniques represent a new advance in studying aging narratives. The key finding is consistent, though no less alarming: Negative descriptions of older adults outnumber positive ones by six times. Negative descriptions tend to be physical, while positive ones tend to be behavioral. Magazines contain the highest levels of ageism, followed by the spoken genre, newspapers, and fiction. Findings underscore the need to increase public awareness of ageism and lay the groundwork to design targeted societal campaigns to tackle ageism—one of our generation’s most pernicious threats.

Liver transplant candidates must cope with significant physiological and psychological challenges. The Brief COPE is a frequently used measure of coping behavior; however, knowledge of the scale’s factor structure and construct validity is limited with regard to liver transplant candidates. This study assessed the validity of the Brief COPE in 120 liver transplant candidates using exploratory factor analysis. Results revealed a 6-factor solution, only 2 of which were consistent with the original scale assignments. Construct validity of the 6 Brief COPE scales yielded in this study was demonstrated. The results indicate that the Brief COPE is valid, reliable, and can be meaningfully interpreted in liver transplant patients. Future research should confirm this factor structure and examine its predictive validity prior to widespread use among liver transplant patients. Suggestions are presented for enhancing the care of transplant candidates by promoting the use of adaptive coping mechanisms to manage distress.

Introduction: Studies are needed to inform the preparation of community nurses to address patient behavioral and social factors contributing to unnecessary readmissions to hospital. This study uses nurses’ input to understand challenges faced during home care, to derive a framework to address the challenges. Methods: Semistructured interviews were conducted to saturation with 16 community nurses in Singapore. Interviews were transcribed verbatim and transcripts independently coded for emergent themes. Themes were interpreted using grounded theory. Results: Seven major themes emerged from 16 interviews: Strained social relationships, complex care decision-making processes within families, communication barriers, patient’s or caregiver neglect of health issues, building and maintaining trust, trial-and-error nature of work, and dealing with uncertainty. Discussion: Community nurses identified uncertainty arising from complexities in social-relational, personal, and organizational factors as a central challenge. Nursing education should focus on navigating and managing uncertainty at the personal, patient, and family levels.

Although pettiness, defined as the tendency to get agitated over trivial matters, is a facet of neuroticism which has negative health implications, no measure exists. The goal of the current study was to develop, and validate a short pettiness scale. In Study 1 (N = 2136), Exploratory Factor Analysis distilled a one-factor model with five items. Convergent validity was established using the Big Five Inventory, DASS, Satisfaction with Life Scale, and Conner-Davidson Resilience Scale. As predicted, pettiness was positively associated with neuroticism, depression, anxiety and stress but negatively related to extraversion, agreeableness, conscientiousness, openness, life satisfaction and resilience. Also, as predicted, pettiness was not significantly related to physical functioning, or blind and constructive patriotism, indicating discriminant validity. Confirmatory Factor Analysis in Study 2 (N = 734) revealed a stable one-factor model of pettiness. In Study 3 (N = 532), the scale, which showed a similar factor structure in the USA and Singapore, also reflected predicted cross-cultural patterns: Pettiness was found to be significantly lower in the United States, a culture categorized as “looser” than in Singapore, a culture classified as “tighter” in terms of Gelfand and colleagues’ framework of national tendencies to oppose social deviance. Results suggest that this brief 5-item tool is a reliable and valid measure of pettiness, and its use in health research is encouraged.

Purpose Ear position contributes significantly to facial appearance. However, while objective measurements remain the foundation for esthetic evaluations, little is known about how an ear should ideally be positioned regarding its rotational axis. This study aimed to further evaluate whether there exists a universally applicable ideal ear axis, and how sociodemographic factors impact such preferences. Materials and methods An interactive online survey was designed, enabling participants to change the axis of a female model's ear in terms of its forward and backward rotation. The questionnaire was sent out internationally to plastic surgeons and the general public. Demographic data were collected and analysis of variance was used to investigate respective preferences. Results A total of 1016 responses from 35 different countries (response rate: 18.5%) were gathered. Overall, 60% of survey takers chose the minus 10 or 5° angles to be most attractive. Significant differences were found regarding sex, ethnicity, country of residence, profession and respective ear axis preferences. Conclusion Across multiple countries and ethnicities, an ear position in slight reclination of minus 5–10° is considered most pleasing in Caucasian females. However, sociodemographic factors significantly impact individual ear axis preferences and should be taken into consideration when performing reconstructive ear surgery.

Background Perception of beauty is influenced by geographic, ethnic, cultural, and demographic factors. However, objective measurements remain the foundation for aesthetic evaluations. In the quest to better define the "ideal" female buttock, this study assumes interdependence among variables such as country of residence, sex, age, occupation, and aesthetic perception, yielding a waist-to-hip ratio that appears most pleasing across most cultures and geographic locations. Methods An online survey was designed. Modifiable ranges of buttock sizes were achieved by means of digital alteration, enabling participants to interactively change the size and waist-to-hip ratio of a single model's buttocks. The questionnaire was translated into multiple languages and sent to more than 9000 plastic surgeons and to the general public worldwide. Demographic data were collected, and analysis of variance was used to elucidate buttock shape preferences. Results A total of 1032 responses were gathered from over 40 different countries. Significant differences regarding preferences for buttock size were identified across the respondents. Overall, 404 of 1032 of survey takers (39 percent) chose the 0.7 waist-to-hip ratio to be their ideal. Significant relationships were distilled between sex, age, self-reported ethnicity, plastic surgeons' country of residence, and ethnic background. For example, surgeons in Latin America preferred the largest buttocks, followed by surgeons in Asia, North America, and Europe, with non-Caucasians preferring larger buttocks than Caucasians. Conclusion There seems to exist a global consensus regarding the ideal waist-to-hip ratio; however, multiple other factors impact the aesthetic perception of the buttocks significantly.