Societal perceptions of caregivers linked to culture across 20 countries: Evidence from a 10-billion-word database

Narratives of pregnancy across 19 Countries: Analysis of a 1.5-billion-word news media database

Pregnancy is a universal experience shaped by sociocultural contexts. News media presents a unique opportunity to analyze public narratives of pregnancy and how it differs across cultures. Our study aims to (1) identify the most prevalent overall themes in news media narratives of pregnancy across 19 English-speaking countries, and (2) compare pregnancy narratives across geographic regions. We used the largest English news media corpus that included over 30 million news articles from more than 7000 news websites across 19 countries, and extracted a one-year data subset (2019; 1.5 billion words). Of the primary search terms 'pregnant' and 'pregnancy', we collated 240,464 descriptors that met criteria of lexical proximity and semantic bonding. Thereafter, we used topic modelling to identify the five most prevalent pregnancy-related themes: (1) complications and risk, (2) crime, (3) celebration, (4) celebrity births, and (5) contraception. Although there were regional differences, themes of complications and risk were most common, comprising 39.6% of all pregnancy narratives in our big-data corpus. The second-most dominant theme was crime (20.8%). Narratives of contraception were more prevalent in Europe, North America, and Oceania (27.2-31.3%) compared to Africa and Asia (11.9-19.6%). Though the vast majority of pregnancies are healthy, themes of complications and risk dominated the news media discourse; unchecked, this may be an avenue for misinformation, stress, and anxiety. In addition, lower prevalence of contraception narratives in Africa and Asia may reflect a gap that requires the attention of policymakers in building culturally-adapted programs to promote family planning and encourage open discussions about sexual health. Results contribute to the academic repository of societal representations of pregnancy through a big-data lens, providing contextual information for future development, implementation and evaluation of localized pregnancy-related campaigns.

Motivators for family carers of persons with dementia in Kenya

OBJECTIVES

The number of people with dementia is on the rise in Kenya and across Africa. Although family carers act as the main providers of dementia care in Kenya, there is still a significant knowledge gap regarding why family members care for someone with dementia. This study explores perceived drivers of care for people with dementia in a rural Kenyan context.

METHODS

Participants were recruited in Makueni County, Kenya. Primary data were derived from a focus group discussion (FGD) and five individual interviews with family carers of people with dementia. To complement interpretation, triangulation occurred through using data from FGDs with healthcare workers and members of the general public. All audio recordings were transcribed verbatim and inductive thematic analysis performed using NVIVO 12.

RESULTS

Using the Positioning Theory, we sought to generate information pertaining to motivation for becoming a family carer. Five themes emerged from the analysis and included: (i) self-fulfillment, (ii) familial obligation, (iii) cultural and religious beliefs, (iv) reciprocity, and (v) societal pressures. These themes described the nature of care given to people with dementia, based on what the participants perceived as compelling and/or motivating factors.

CONCLUSIONS

Our findings describe the unique motivators of family carers for people with dementia in Kenya. The ability to find meaning in the caregiving experience could contribute to development of effective support systems, interventions and policies for dementia carers with the aim of improving the overall quality of dementia care in Kenya.

Care burden and the predictive role of spiritual well-being and religious coping: A cross sectional study among Iranian family caregivers of patients with stroke

Background and Aims

The burden of care after a stroke is gaining recognition as a significant healthcare issue. Factors like religion and spirituality, encompassing religious coping and spiritual health, prove to be influential in anticipating the challenges faced by caregivers. The present study aimed to determine the relationship between care burden, spiritual health, and religious coping among caregivers of stroke patients.

Methods

This cross-sectional research was conducted with the participation of 129 caregivers of stroke patients. The data was collected using the Ellison and Paloutzian spiritual well-being instruments, Pargament Religious Coping (RCOPE) brief version, and the Zarit burden interview (ZBI). Through a census, participants were recruited for the investigation. Data were analyzed using descriptive and inferential statistics (multivariate linear regression analysis).

Results

The study results indicate a strong and statistically significant relationship between the burden of caring and spiritual health (p < 0.001, β = 0.33). Furthermore, specific variables were identified as indicators of an increased burden of care, including positive religious coping (p = 0.04, β = 0.63), the familial relationship between the caregiver and patient, specifically as a child (p = 0.001, β = 29.26), and a sister (p < 0.001, β = 35.93).

Conclusion

It is advisable to consider adopting and implementing appropriate support measures for coping strategies rooted in religion and spirituality. So, it is recommended to enhance the provision of comprehensive support, including psychological and religious interventions. This can be achieved through the collaborative efforts of support groups comprising psychiatric nurses, psychiatrists, psychologists, and religious experts.

Innovations for an Aging Society through the Lens of Patent Data

BACKGROUND AND OBJECTIVES

An aging population creates fertile ground for devising innovations for older adults. By using patents as a proxy for inventive activity, this study sets the stage for understanding the latest innovations being designed for the older population. Insights will pave the way for a better understanding of inventions that could render society more age-friendly on the innovation front.

RESEARCH DESIGN AND METHODS

To identify the latest innovations targeted at the older population, we collected all patents (N = 326) issued in 2021, specifically those issued between January 5th and December 28th. Upon removing irrelevant data, 120 patents were retained in the data set. Both inductive and deductive modes of reasoning informed our content analysis of the data.

RESULTS

Three themes surfaced. About half (49.2%) of the patents focused on "Preventive Health, Safety, and Independence" (Theme 1). About 38.3% pertained to "Anti-Aging" (Theme 2) and 12.5% were about the "Pathologization of Old Age" (Theme 3).

DISCUSSION AND IMPLICATIONS

This is the first study that evaluates the state of innovations for an aging population. While there are inventions aimed at optimizing the well-being of older adults, there are also those designed due to beliefs that see old age as a problem to solve. As the world experiences a demographic shift, it is imperative that collective ingenuity be harnessed to build a society conducive to all facets of the aging experience.

Age Advocacy on Twitter Over 12 Years

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.

Support Needs in Carers of People With Parkinson's From Early to Later Stages: A Qualitative Study With 36 Carers in 11 European Countries

BACKGROUND

Parkinson's Disease (PD) is associated with considerable carer burden, but there has been little qualitative research on the support needs of carers of People with Parkinson's (PwP).

METHODS

Semi-structured in-depth interviews with carers of PwP in 11 European countries.

RESULTS

Interviews with 36 carers of PwP were analysed. At the time of diagnosis, carers often felt that they had a role in helping get a diagnosis and then in dealing with the impact of the diagnosis on the family. Information on medication was seen as particularly important for carers, and many of the carers felt that their informational needs differed from that of the PwPs. Many of the carers also felt that they needed to be present at all appointments to request referrals or ask for medication changes. Carers of those in the later stages of the disease often reported feeling isolated and not having any time for themselves.

CONCLUSIONS

The involvement of carers should be addressed more actively in the management of Parkinson's.

Transiting Back Home: Caregivers' Lived Experiences in Caring for Loved Ones on the Nasogastric Tube in the Home-Setting in Singapore

INTRODUCTION

Little is understood about caregivers' lived experiences when first caring for patients on the nasogastric tube at home in an Asian setting. To enhance understanding, our study aimed to chart these caregivers' psycho-emotional evolutions felt during such caregiving experiences in Singapore.

METHOD

Utilizing purposive sampling, a descriptive phenomenological study was performed, with semi-structured interviews of 10 caregivers of persons on nasogastric tube feeding conducted. Thematic analysis was utilized.

RESULTS

Our findings chart four psycho-emotional transitions of a caregiver's journey in nasogastric tube feeding and the cultural dynamics involved-(a) Disruption of Caregivers' Normality: Attempting to Grasp Reality, (b) Encountering Road-Blocks: Despondency Arises and Frustrations Abound, (c) Adjusting to the New Normal: Reclaiming Confidence and Positivity, (d) Thriving and Integrating into the New Normal, and (e) Cultural Dynamics At Play.

DISCUSSION

Our findings illuminate the understanding of caregivers' varying needs, guiding delivery of culturally-congruent caregiver support targeted at each psycho-emotional evolution.

Portrayals of older adults in over 3000 films around the world

BACKGROUND

Presently, most film analyses related to older adults are peculiar to American cinema. However, film industries outside the United States are influential in their own right. As ageism is a pan-cultural phenomenon, it is important to explore filmic representations of older persons globally. This study is the first to offer a portrait of how filmic portrayals of older persons differ across regions.

METHODS

We leveraged a 200-million-word movie corpus comprising over 25,000 scripts from 88 countries in 11 regions. The movies span a period of nearly 90 years, from 1930 to 2018. We identified synonyms of "older adult(s)" and compiled the top descriptors that co-occurred most frequently with them. Seventeen thousand five hundred and eight descriptors were generated from 3384 movies. Using these descriptors, we calculated the valence of filmic portrayals of older adults on a scale of 1 (most negative) to 5 (most positive) in each region.

RESULTS

Positive representations of older adults in movies were lacking in all 11 regions. Four regions fell into the neutral zone and the remaining seven in the negative zone. Representations of older persons were the least negative in East Asia and South Asia, and most negative in Southeast Asia as well as the Middle East and North Africa (MENA). Our topic modeling revealed that older adults were portrayed as venerable in both South and East Asia. Meanwhile, older people were associated with death in MENA. The idea that society is ill-equipped to handle an aging population was hinted at in Southeast Asia.

CONCLUSIONS

As societies worldwide navigate a major demographic turning point, it is vital that filmmakers rethink portrayals of old age. In articulating the filmic narratives surrounding old age in different regions, our study lays the foundation to combat ageism on the big screen.

Videos about older adults on TikTok

Besides being one of the fastest growing platforms since entering the social media fray in 2016, TikTok is notably monopolized by teenagers, which makes it a veritable source of information not to be overlooked by gerontologists. Currently, most studies regarding age stereotypes on social media have examined content on Twitter and Facebook. Our study explores how older adults are portrayed on TikTok and the factors associated with these portrayals. We analyzed 673 videos with the hashtags #Boomer and/or #OkBoomer that received over 5.4 billion views and categorized them into nine topics. Five of these topics (e.g., 'Warmth/Coldness') were extracted from previous studies on age stereotypes. The remaining four topics were unique to our dataset (e.g., 'Wealth Gap'). The outcome variable was 'Negative Age Stereotypes' which was rated on a binary scale. One in two videos about older adults featured negative content. As hypothesized, videos containing negative age stereotypes were more likely to be about the 'Values and Beliefs of Older Adults' (7 times), 'Negative Encounters with Older Adults' (8 times) or 'Older Adults Antagonizing the Young' (13 times). Conversely, videos which portrayed older adults as 'Warm' were 43% less likely to contain negative stereotypes. As the phenomenon of an aging population fast unfolds, it is imperative that society relinquishes its tendency to stereotype individuals on the grounds of age. By examining the possible mechanisms driving negative stereotypes of older adults on TikTok, our study provides the basis upon which such stereotypes can be counteracted. In doing so, it paves the way both to improve the well-being of older persons and to foster intergenerational solidarity.

Assessing caregiving experience in COPD: content validity of the Zarit Burden Interview in Canadian and Portuguese caregivers

PURPOSE

Informal caregivers play an important role in chronic disease management but their experience is often neglected. The objective of this study was to explore the content validity of the Zarit Burden Interview (ZBI) in caregivers of individuals with COPD in Canada and Portugal.

MATERIALS AND METHODS

Cognitive debriefing interviews were conducted with informal caregivers of individuals with moderate to very severe COPD. Participants completed the ZBI and verbalised their thinking process to assess the adequacy of the questionnaire's content and instructions. Content validity was assessed using deductive content analysis of interviews and descriptive statistics of questionnaire responses.

RESULTS

Nine caregivers from Canada (age = 67 ± 8 years) and 13 from Portugal (age = 69 ± 7 years) participated. For Canadian caregivers, 3/22 items were not understood, and 8/22 items were not relevant to at least 1/3 of them. For Portuguese caregivers, 1/22 items were not understood, and 20/22 items were not relevant to at least 1/3 of them. The distribution of response choices was approximately symmetrical for 17/22 items in the Canadian sample. The response option "no/never" was selected by at least 75% of Portuguese participants for 18/22 items.

CONCLUSIONS

The instrument was well understood by caregivers of people with COPD, but its relevance is uncertain.IMPLICATIONS FOR REHABILITATIONInformal caregivers provide essential care for people living with disability and chronic disease, but their experience is often neglected.The Zarit Burden Interview assesses caregiver burden but has not been validated in caregivers of people with chronic obstructive pulmonary disease.In its current form, the Zarit Burden Interview does not adequately represent the experience of COPD caregivers.We recommend selecting tools that assess caregiver burden that have been validated in the caregiver population of interest.

The Challenges of Caring for an Adult Child with Schizophrenia in the Family: An Analysis of the Lived Experiences of Older Parents

The present study aimed to investigate the lived experiences of older parents regarding the challenges in caring for adult children with schizophrenia. The current study was conducted on 16 parental (mother or father) caregivers of adult children with schizophrenia using a descriptive phenomenological qualitative approach and Colaizzi's seven-step method. This study follows the Qualitative Research Checklist (COREQ). The findings showed that the parent caregivers' experiences could be classified into two main themes: "burden of care" and "Negative attitude and inefficient performance." The former consisted of three sub-themes including "disrupted social and family interactions," "helplessness and inefficient support," and "challenges of the healthcare system," while the latter had two sub-themes including "Negative attitude and inefficient performance of the caregivers" and "Negative attitude and inefficient performance of families and society." Older parents have to tolerate a significant burden of care due to their age and physical conditions. Improving the knowledge of specialists, the government's redoubled efforts in multifaceted support for patients and caregivers, creating an integrated team of specialists, and accepting and improving public attitudes against stigma and obvious discrimination in society as important priorities in improving the condition of caregivers and patients with schizophrenia were considered.

Granfluencers on TikTok: Factors linked to positive self-portrayals of older adults on social media

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.

Involvement and burden of informal caregivers of patients with mental illness: the mediating role of affiliated stigma

BACKGROUND

The fear and lack of understanding of mental illness can lead to stigma. The stigma of mental illness affects not only individuals who suffer from it, but also the caregivers. Stigma among caregivers can lead to delay in seeking care, poor adherence to treatment and a high risk of relapse. Caregivers of patients with mental illness are at an increased risk of distress due to the burden to stigma and caregiving burden. An increase in caregivers' burden can lead to a reduction in caregivers' involvement. There is a relationship between caregivers' involvement, burden, and affiliated stigma. The present study examined the mediating role of affiliated stigma in the relationship between caregivers' burden and involvement among informal caregivers of hospital-admitted patients with mental illness in Uganda.

METHODS

A cross-sectional study was conducted among 428 informal caregivers (mean age: 39.6 years [SD±14.6]; females = 62.1%). Information was collected regarding sociodemographic characteristics, affiliated stigma, and the involvement and burden of informal caregivers.

RESULTS

The findings indicate that affiliated stigma serves as a full mediator between the caregiver's roles and involvement (β=15.97, p<0.001). Being female increased the caregivers' burden of caregiving (β= -0.23, p<0.001).

CONCLUSION

The findings in the present study suggest that intervention to address affiliated stigma among caregivers of patients with mental illness should be incorporated into mainstream mental health care to reduce the caregiving burden.

Media attention toward COVID-19 across 18 countries: The influence of cultural values and pandemic severity

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.

The Effect of Psychoeducation on Care Burden Applied to Mothers of Children Who Underwent Allogeneic Bone Marrow Transplantation in Turkey: A Quasi-Experimental Study

OBJECTIVES

The purpose of this study was to examine at the effect of psychoeducation on the care burden for mothers whose children underwent allogeneic bone marrow transplantation (Allo-BMT).

DATA SOURCES

The single group, quasi-experimental study was conducted in a children's BMT unit in the Aegean Region of Turkey. No sampling method was used, and the study sample consisted of 21 mothers who fulfilled the inclusion criteria of turning 18 years old, volunteering for study participation, speaking and understanding Turkish, and having a child who had undergone Allo-BMT. The psychoeducation covered the following topics: (i) Allo-BMT and Child Care After Transplantation, (ii) Feelings Concerning the Disease and the Role of Caregiver, (iii) Stress and Anger Management, and (iv) Family-Spousal and Social Relations. The care burden was measured using the Clinically Adapted Zarit Burden Interview (CA-ZBI). Data analysis was performed on SPSS 20.0 software using repeated measures of analysis of variance (ANOVA) and Bonferroni adjusted post hoc test. After the psychoeducation, a significant difference was found between pretest (26.85 ± 12.9) and posttest (20.42 ± 12.66) care burden of mean scores (P < .05). In addition, a significant difference was found between pretest and follow-up test (20.52 ± 11.49) mean scores of care burden (P < .05).

CONCLUSION

The psychoeducation reduced the care burden experienced by the mothers of the children who underwent Allo-BMT and this positive impact lasted for a month.

IMPLICATIONS FOR NURSING PRACTICE

Nurses, especially consultation liaison psychiatric nurses, can provide similar psychoeducation to caregivers in BMT units, assisting them in protecting their physical and mental health by reducing their care burden.

Comparing the Mental Wellbeing and Quality of Working Life among Nurses and Social Care Workers in the UK and Japan in Older Adults’ Care Services during the COVID-19 Pandemic

This study explored and compared the psychological wellbeing, burnout, coping strategies and work-related quality of life amongst health and social care workers in older adults’ care homes and community settings during the COVID-19 pandemic in the United Kingdom (UK) and Japan. A cross-sectional online survey was conducted in the UK (May–July 2021) and a postal survey conducted in Japan (September–October 2021). Participants recruited were health and social care professionals within nursing, social care and social work occupations working in care home or community settings in the UK and Japan during the pandemic. Data were analysed using SPSS. 1327 respondents across the UK and Japan completed the survey. Respondents’ psychological wellbeing was significantly lower in Japan compared to the UK (p ≤ 0.001). UK respondents had significantly higher personal burnout (p < 0.05) and work-related burnout (p < 0.05) while those in Japan had significantly higher client-related burnout (p < 0.001). The novelty of this study relates to exploring mental wellbeing and quality of working life in two culturally contrasting countries. The overall psychological wellbeing and work-related quality of life of staff who work with older adults in the UK and Japan during the COVID-19 pandemic were lower than the population norm. Greater support and flexible working conditions for this workforce are needed to reduce burnout by improving wellbeing and work-related quality of life.

Not Too Old for TikTok: How Older Adults Are Reframing Aging

BACKGROUND AND OBJECTIVES

Although 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 METHODS

We 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.

RESULTS

Three 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 IMPLICATIONS

This 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.

Hostility Toward Baby Boomers on TikTok

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.

How Culture Shapes Informal Caregiver Motivations: A Meta-Ethnographic Review

The provision of informal care presents a significant global challenge. To better understand how cultural factors underpin and shape motivations and willingness to provide informal care for adults, an in-depth qualitative synthesis was conducted. Six electronic databases and a wide range of additional sources were searched. Following meta-ethnographic guidelines, 37 qualitative studies were synthesised. Six main concepts were identified: cultural self-identity, which appeared as an overarching explanatory concept; cultural duty and obligations; cultural values; love and emotional attachments; repayment and reciprocity; and competing demands and roles. These concepts informed a model of cultural caregiving motivations, offering an inductive-based exploration of key cultural motivators and highlighting implications for theory development, future research, policy and practice. The model holds implications for the actual exchange of care. Caregiver motivations should not be taken for granted by healthcare or social care professionals involved in assessment and support planning, educational endeavours at a population level may support caregiving, and support should be sensitive to cultural caregiving motivations.

Ageism on Twitter during the COVID-19 pandemic

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.

A playbook for effective age advocacy on Twitter

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

Cohort profile: Singapore's nationally representative Retirement and Health Study with 5 waves over 10 years

The Retirement and Health Study (RHS) is Singapore's largest nationally representative cohort with over 15,000 participants (aged 45-85 years) followed across five timepoints in 10 years (2014-2024). Accounting for sample weights, the sample represents 1.2 million Singaporeans and permanent residents of a total population of 5.5 million. The RHS sought consent to link survey responses to relevant administrative data, enabling the cross-validation of self-reports with national databases. There are 10 sections in the RHS with over 400 questions, 50% of which are on respondents' physical and mental health, healthcare utilization and insurance; the remaining 50% are about employment history, retirement adequacy, wealth, and household expenditure. The RHS was set up to provide microdata to compliment administrative data for whole-of-government policy making given that Singapore will reach super-aged status by 2026. Sample findings include a need for older adults to balance between immediate financial needs and investments regarding their pension funds. Also, 86% of older adults preferred to transit into partial retirement by reducing workloads. On the health front, existing studies utilising the RHS have revealed latent classes of disabilities, and that intentions to seek employment can mitigate disability developments. Another study reported that physical disability and social isolation was projected to increase, with ethnic disparities in social functioning. Overall, the RHS will be used for evidenced-informed policy agenda setting and evaluation across domains of health, finance, retirement adequacy, social and family development.

Reframing aging during COVID-19: Familial role-based framing of older adults linked to decreased ageism

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 seven 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.

Societal Narratives on Caregivers in Asia

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.

The Impact of Aging Policy on Societal Age Stereotypes and Ageism

Background and Objectives

While 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 Methods

Scholars 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.

Results

Societal 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 Implications

We 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.

Anti-Asian Sentiments during COVID-19 across 20 Countries: Analysis of a 12-billion-word News Media Database

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.

News media narratives of Covid-19 across 20 countries: Early global convergence and later regional divergence

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.

Societal Age Stereotypes in the U.S. and U.K. from a Media Database of 1.1 Billion Words

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.

Implementing an Individual-Centric Discharge Process across Singapore Public Hospitals

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.

Role-Based Framing of Older Adults Linked to Decreased Ageism Over 210 Years: Evidence From a 600-Million-Word Historical Corpus

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-dataset-the largest historical corpus of American English with over 150,000 texts collected from newspapers, magazines, fiction and non-fiction. 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 two 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.