[Strengthening prevention and health promotion in and for old age]. / Prävention und Gesundheitsförderung im und für das Alter stärken.

BACKGROUND: Disease prevention and health promotion in and for old age have become increasingly more important. Nevertheless, more (national) research and implementation in practice is needed, as the international comparison shows. OBJECTIVE: To develop guiding principles for research and practice on prevention and health promotion in and for old age. MATERIAL AND METHODS: As part of an iterative process, members of the German Society of Gerontology and Geriatrics came together in workshops and symposia to formulate key guiding principles and fields of action for prevention and health promotion. RESULTS: The following were worked out: 1) prevention and health promotion are useful and possible up to oldest age, 2) prevention and health promotion for advanced age should start early, 3) prevention and health promotion must take into account the diversity and heterogeneity of the life situations of old people, 4) prevention and health promotion promote and demand self-determination and participation, 5) prevention of multiple illnesses must be given greater attention, 6) prevention of the need for long-term care and prevention in long-term care must be treated equally, 7) prevention and health promotion must be thought of in terms of life worlds and across sectors, paying particular attention to aspects of social inequality and a focus on resources, 8) prevention and health promotion and the related research must be interdisciplinary and transdisciplinary and be applied at different levels, from molecular to societal. DISCUSSION: The guiding principles outline the focal points of future-oriented ageing, health and healthcare research and open up fields of action but also show the limits of this approach for political decision-makers, researchers and practitioners.

[Distance caregiving: an issue among sociopolitical actors?] / Distance caregiving ­ ein Thema bei soziopolitischen Akteur*innen?

BACKGROUND: Caregiving from a distance is understudied as well as rarely sociopolitically debated in Germany. Accordingly, distance caregiving is a type of informal care work that has been little acknowledged in social law. OBJECTIVE: This article addresses the issue of how aware sociopolitical experts in Germany are of distance caregiving. Moreover, it points out the challenges the experts perceive in the legal framework and which solutions they can identify. MATERIAL AND METHODS: Guided interviews were conducted with six experts from sociopolitical areas in Germany with points of connection to care politics (ministries, associations, organizations). The interviews were analyzed based on the method of summarizing qualitative content analysis (according to Mayring). RESULTS: Even though distance caregiving has played a minor role among the sociopolitical experts, they were aware of individual aspects of this topic, mostly based on having been personally affected. Due to this experience they argued for a broader understanding of care including for example organizational support. They criticized the lack of sociopolitical consideration of distance caregivers and among other things demanded a functioning local support system. CONCLUSION: The interviews indicated a specific and personal awareness of distance caregiving; however, the findings pointed to stronger criticism of the overall situation regarding caregiving relatives. Thus, despite all recent reforms in distance caregiving there is still a need for action on the topic of caregiving relatives.

[Distance caregiving : Empirical findings from the Survey of Health, Ageing and Retirement in Europe]. / Pflege über räumliche Distanz hinweg : Ergebnisse einer Datenanalyse des Survey of Health, Ageing and Retirement in Europe.

BACKGROUND: The support of relatives living far away in terms of distance caregiving between children and their parents has gained in importance in Europe. At the same time, little is known about these care arrangements based on representative European survey data. OBJECTIVE: This article is concerned with the following questions: which statements are possible in Europe about the prevalence of persons caring for at least one parent from a geographical distance? Which forms of support are provided and which other specific socioeconomic and health-related aspects characterize these care situations? In this respect special attention is paid to differences to relatives who provide help close to their parents who are in need of care. MATERIAL AND METHODS: Data from the Survey of Health, Ageing and Retirement in Europe (SHARE) from the sixth wave of the survey in 2015 were used to perform a descriptive analysis and multivariate logistic regression. RESULTS AND CONCLUSION: The analysis showed that distance caregiving is more than a marginal phenomenon in Europe with a prevalence of 11% for a relatively close terminology (over 100 km distance between locations) and 23% for a broader terminology (over 25 km); however, the various countries are very different in terms of prevalence. The findings also point to some significant differences in terms of resources, care tasks and quality of life compared to caregivers in the same household. In light of these dynamically developing distance caregiving arrangements, this article can provide further discussion, critical reflection, and advancement to the operationalization of informal care.

[Current findings on distance caregiving : What do we know and what do we not (yet) know?] / Aktuelle Befunde zu "distance caregiving" : Was wissen wir und was (noch) nicht?

BACKGROUND: Demographic change, increasing work mobility as well as changed family patterns lead to social relationships over long distances; however, support from relatives from a distance is hardly debated in the German-speaking region. The project "DiCa" (2016-2019) studies various dimensions of long-distance caregiving. OBJECTIVE: This article presents the state of the art in research on specific characteristics of care arrangements from a distance. In addition, it presents the underlying challenges, strategies, and supportive as well as hindering conditions. MATERIAL AND METHODS: Systematic literature review. RESULTS: These studies, conducted largely in the Anglo-American region, draw a clear picture of who distance caregivers are (in general well-educated daughters or daughters-in-law) and that they make a substantial contribution to care in terms of organization, coordination, and emotional support in addition to visits. Distance impedes the flow of information about the health condition of the person in need of care and limits the possibilities to react to the needs at short notice or in crisis situations. Distance caregivers are often faced by financial as well as emotional burdens due to the care situation and lack of control even if there are some support strategies and compatibility between care and occupation, e.g. emergency management, local support networks, flexible working arrangements. CONCLUSION: In the German-speaking region, pertinent studies on long-distance caregiving are missing. Internationally, the numbers of cases are not always clear and there is a lack of sound knowledge on the assessment of the care arrangements on the part of the distance caregiver, the actual role of the distance, specific barriers, conflicts, effective strategies and solution options. This applies to people in family homecare as well primary care facilities and employers.

Das Potenzial neuer Technologien zur Unterstützung von Pflege über eine räumliche Distanz - Literaturstand und qualitative Befunde.

The potential of technological assistance to support distance caregiving - literature review and empirical results Abstract.Background: Due to demographic change, increasing labour mobility and changing family patterns, social relationships often exist over long distances. Supporting relatives over a distance is therefore a highly topical issue but still little discussed, also in Germany and Switzerland. Aim: The project "DiCa" (2016 - 2019) with an interdisciplinary research team from Germany (EH Ludwigsburg) and Switzerland (Careum School of Health, Zurich) aims to investigate different dimensions of "Distance Caregiving". This paper deals with the possible use of new technologies to support these care arrangements. Methods: Based on a literature review, qualitative interviews were conducted with "Distance Carers" and partner companies in Germany to investigate the use of new technologies in the context of "Distance Caregiving". Results: There are initial approaches concerning technical solutions in home care and in companies. So far communication options via telephone and smartphone and flexible working time and workplace regulations have played an important role. However, the potential of new technologies does not seem to be fully explored. Conclusions: In order to make the most of the various possibilities of innovative technologies in the context of "Distance Caregiving" for those affected but also for companies, well-researched information and independent advice and counseling are required for all parties involved in the care process.

[Gerontologically oriented study programs in Germany : Critical review]. / Gerontologisch orientierte Studiengänge in Deutschland : Kritische Bestandsaufnahme.

The objective of this article is a state-of-the-art analysis and critical reflection of the status quo of gerontologically oriented study programs in higher education in Germany. The major impulse for writing this article was provided by the newly established working group "Gerontological Education", which was inaugurated at the joint annual conference of sections III and IV of the German Society of Gerontology and Geriatrics in Mannheim in 2015. A systematic review of gerontological study programs shows that the number of such programs has increased in Germany over the past decade. At the same time there has been a dynamic development across the country whereby well-established programs were closed and new ones were initiated. New study programs were primarily initiated at universities of applied sciences and private universities. A tendency away from explicit gerontology programs towards other academic disciplines (e.g. sociology, social work, psychology, sports, health and rehabilitation sciences) in combination with gerontological contents can be observed. These degree programs are rooted in their respective disciplines and focus primarily on health and social issues. Given the heterogeneity of study programs the working group "Gerontological Education" could become a new forum for leaders of such programs, students, alumni and employers of gerontologists for critical reflection and further development of gerontological quality benchmarks.

Who uses technical aids in old age? Exploring the implementation of technology-based home modifications in Europe.

Introduction: Home modifications and features, e.g., handrails or ramps for people using wheelchairs, should allow residents with functional limitations to maintain social participation, health, and wellbeing for aging in place. However, there is little evidence in relation to the individual characteristics shaping this implementation of technology-based home modifications. Current studies often focus on describing the distribution of certain implementations in households but do not provide information on factors predicting the implementation or detailed and multifaceted data on associations with characteristics of the older user. This article, therefore, examines the use of well-established technological aids and home modifications (e.g., ramps, handrails, automatic doors, bathroom or kitchen modifications, chair lifts, and alerting devices) in the households of older adults in Europe. We refer to Lawton's and Nahemow's concept of personal-environment fit and describe the use of technical aids across 18 countries, analyze associations with individual characteristics and social resources, and compare those associations and variance explanation between older adults in their third age ("young-old", 65-79 years) and older adults in their fourth age ("old-old", 80+). Methods: Drawing on representative data from the Survey of Health, Ageing, and Retirement in Europe (SHARE), wave 6, a total of N = 38,553 older adults aged 65-105 years (M = 74.4 years, SD = 7.1; 55% women) were analyzed by performing hierarchical logistic regression analyses. Results: Indicators of functioning explained the highest proportion of variance, followed by social resources, and variance explanation was higher for the fourth age than for the third age. In particular, older adults with physical limitations, a larger social network, and those who received care from a child outside the household were more likely to have home modifications installed. Discussion: The study provides an overview of associations of diverse variables with assistive devices and modifications in the home and can serve as a starting point for public health activities concerning the heterogeneity of people aged 65 years and older.

AI revolution in healthcare and medicine and the (re-)emergence of inequalities and disadvantages for ageing population.

AI systems in medicine and healthcare are being extensively explored in prevention, diagnosis, novel drug designs and after-care. The application of AI technology in healthcare systems promises impressive outcomes such as equalising healthcare, reducing mortality rate and human error, reducing medical costs, as well as reducing reliance on social services. In the light of the WHO "Decade of Healthy Ageing", AI applications are designed as digital innovations to support the quality of life for older persons. However, the emergence of evidence of different types of algorithmic bias in AI applications, ageism in the use of digital devices and platforms, as well as age bias in digital data suggests that the use of AI might have discriminatory effects on older population or even cause harm. This paper addresses the issue of age biases and age discrimination in AI applications in medicine and healthcare systems and try to identify main challenges in this area. It will reflect on the potential of AI applications to amplify the already existing health inequalities by discussing two levels where potential negative impact of AI on age inequalities might be observed. Firstly, we will address the technical level of age bias in algorithms and digital datasets (especially health data). Secondly, we will discuss the potential disparate outcomes of automatic decision-making systems (ADMs) used in healthcare on the older population. These examples will demonstrate, although only partially, how AI systems may create new structures of age inequalities and novel dimensions of exclusion in healthcare and medicine.

Gender differences in the determinants of mature entrepreneurship? The case of Germany.

Mature female entrepreneurs represent a non-traditional model of self-employed workers in both ways: in terms of gender and age. The transition into self-employment for women aged 45 years and older represents a topic of aging research that still tends to be overlooked. Previous studies found ambivalent results for the issue regarding motives and entrepreneurial pathways between former employmen or unemployment-and starting one's own business and the ways in which these entrepreneurial activities are shaped by social differences (such as gender) and biographically accumulated resources and restrictions. This article studies biographical-related factors and motivations that determine what is variously referred to as mature entrepreneurship for men and women aged 45 and above. Using data from the German Socio-Economic Panel (SOEP), the descriptive analysis explains the main gender differences among people within the target age group who have taken the step into self-employment. The multivariate analysis interrogates the main determinants that govern any increase in the probability of becoming self-employed after the age of 45 and seeks to identify the main differences between women and men in relation to such determinants. The results show substantial gender-based occupational segregation in entrepreneurship patterns in this age group, with men working longer hours on average than women and enjoying higher average earnings. However, the multivariate analysis shows that the main drivers for mature entrepreneurship are similar for both men and women and that necessity represents an important factor for everyone for starting a business.

(In)visible and (Un)heard? Older Adults as Guests on COVID-Related Political Talk Shows in Germany.

Background and Objectives: The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected older adults. Despite calls to include older people in societal decision making, the extent to which older adults have participated in the pandemic-related public debate is unknown. This study investigated older adults' (65+ years) voice and visibility as guests on political talk shows as an important arena of public debate. Specifically, we examined how often older adults appeared as guests, their characteristics, and how older versus younger guests discussed the pandemic. Research Design and Methods: Judges assessed all guests' age, gender, migration experience, functional aids, and professional background on all episodes of the 4 most-watched political talk shows in Germany between January 1 to December 31, 2020 (N = 136 episodes, K = 754 guests). We used an exploratory sequential mixed-methods approach and frame analysis on all episodes featuring older guests (n = 37), to first identify how guests discussed the pandemic, and then assess differences in positions between older and younger guests (<65 years). Results: Older guests rarely appeared (12.2% of all guests, 9.6% of guests on COVID-related episodes) and if they did, they were majorly male, young-old, German-born professionals with no functional aids. Rather than appearing as "peer advocates" of older adults, older guests framed the pandemic similarly to younger guests, with a tendency to more strongly address disproportionate restrictions of civil liberties in society. Discussion and Implications: Results suggest that one prominent part of German media failed to represent the diverse voice of a population most affected by the COVID-19 pandemic in 2020. Differences between how older and younger guests discussed the pandemic may reflect their privileged background in addition to generational differences in attitudes toward government. Future research in other social fora and of other social groups of older adults might facilitate understanding how older adults shaped the public debate on the COVID-19 pandemic.

Resonant Retiring? Experiences of Resonance in the Transition to Retirement.

In the process of life course transitions, relations between the self and the world transform, which can according to Hartmut Rosa be framed as resonance. This article focuses on the retirement transition and thus on the exit from gainful employment as one of the central spheres of our world relationship in late modernity. It raises the following questions: How do experiences of resonance change in the course of the retirement transition? Does the loss of gainful employment lead to disruptions or even the absence of resonance in terms of alienation? And which role do dimensions of social inequality, such as gender, income, education or mental health status play for resonance transformations in the transition to retirement? In terms of a reflexive mixed-methods design, this article combines quantitative panel data from the German Ageing Survey (2008-17) with a qualitative longitudinal study from the project "Doing Retiring" (2017-21). Our results show that the transition from work to retirement entails a specific "resonance choreography" that comprises a phase of disaffection (lack of resonance) at the end of one's working life followed by a liminal phase in which people search for intensified experiences of resonance. We outline practices in which transitioning subjects seek out resonance, and the experiences they make within this process according to their social positions. We thereby find that the desire for resonance tends to be beyond intentional resonance management which manifests in products and services like coaching or wellness. In our conclusions, we discuss how resonance theory and retirement research/life course research can be fruitfully combined, but also highlight the methodological challenges the operationalization of resonance entails.

Implementation of Assistive Technologies and Robotics in Long-Term Care Facilities: A Three-Stage Assessment Based on Acceptance, Ethics, and Emotions.

Assistive technologies including assistive robots (AT/AR) appear to be a promising response to the increasing prevalence of older adults in need of care. An increasing number of long-term care facilities (LTCFs) try to implement AT/AR in order to create a stimulating environment for aging well and to reduce workload for professional care staff. The implementation of new technologies in an organization may lead to noticeable cultural changes in terms of social interactions and care practices associated with positive or negative emotions for the employees. This applies especially for LTCFs with high rates of vulnerable residents affected by increasing care needs and specific ethics in nursing and cultural rules within the setting. Thus, systematic consideration in leadership management of emotions and ethical aspects is essential for stakeholders involved in the implementation process. In this article, we explicitly focus on the emotions of the employees and leaders within LTCFs. We relate to direct consequences for the organizational well-being and culture, which is of course (indirectly) affecting patients and residents. While aspects of technology acceptance such as safety and usefulness are frequently discussed in academic literature, the topic of emotion-management and ethical questions during the organizational implementation process in LTCFs received little attention. Emotional culture entails affective values, ethical norms and perceptions of employees and further investigation is needed to address the importance of transformational leadership during implementation process. For this purpose, we developed a three-staged assessment tool for implementation of AT/AR in long-term care institutions. Acceptance (A), ethical acceptability (A) and emotional consequences (E) are considered as comprehensive assessment, in which emotional consequences comprise management aspects of transformational leadership (T), emotion-management (E) and organizational culture (O). Based on AAE and TEO, this paper presents an integrated framework illustrated with a illustrative example and aims to combine established approaches with ethical insights in order to unfold potentials of AT/AR in LTCSs.

Senior Entrepreneurship: The Unrevealed Driver for Social Innovation.

From a political and economic perspective, senior entrepreneurship seems to be the response to the demographic consequences of the aging workforce in Europe. Several policies and strategies by the European Union (EU) and the Organization for Economic Co-operation and Development (OECD) promote senior entrepreneurship by creating a favorable environment and frameworks. This article examines the role of senior entrepreneurship as a social innovation understood as a response to unmet needs of population aging in the area of economic activity. In this paper draws on qualitative interviews with 6 experts and 4 senior entrepreneurs (as part of a larger research project) in Poland in addition to the analysis of reports and evaluations of incubator projects. Findings highlight the importance of other factors than financial sustainability of senior entrepreneurship: (1) social connectedness as a means against social isolation, (2) personal self-confidence leading to social and psychological empowerment of the entrepreneurs, and (3) skills, knowledge, and experience that are also strengthening their human capital in the job market. Economic sustainability of the businesses established is not the primary goal in these undertakings. The article suggests that due to the three factors before mentioned that the notion of social innovation in senior entrepreneurship might best be understood as improving the well-being and quality of life of the entrepreneurs themselves. Senior entrepreneurship can be an adequate response to the challenges of the aging population. However, due to the low rates of unemployment, the idea of becoming a senior entrepreneur appears a little tempting.

Comparison of two express immunotechniques with polyelectrolyte carriers, ELISA and FIIAA, for the analysis of atrazine.

Conventional immunoassays on microtiterplates are very useful analytical tools in environmental analysis, but the long assay times, usually in the range of hours, are a drawback. To overcome this disadvantage, the development of fast (express) assay formats is described, which use polyelectrolytes as carriers. Two semi-homogeneous immunochemical methods, namely the polyelectrolyte-ELISA (enzyme-linked immunosorbent assay) and the express-FIIAA (flow injection immunoaffinity analysis) for the analysis of the herbicide atrazine were set-up. Using polyclonal antisera for atrazine, the following results were obtained. Standard curves for atrazine showed a linear range from 3 to 100mugl(-1) in polyelectrolyte-ELISA and 0.3-100mugl(-1) in express-FIIAA. The test midpoints in polyelectrolyte-ELISA and express-FIIAA were 12 and 5mugl(-1), respectively. The duration time of the immunochemical reaction was in both assays 15min, but the total assay time differed (30min (polyelectrolyte-ELISA) and 18min (express-FIIAA)). A significant difference between the formats could be observed in the number of samples that can be determined per day. The polyelectrolyte-ELISA can handle samples in parallel on a microtiterplate (usually 20/plate), whereas in the express-FIIAA the samples are automatically analysed one after another. This first demonstration of these techniques shows the potential of these methods, but also their limitations.