Ageism and lookism as stereotypes of health disparity in intensive care units in Iran: a critical ethnography.

BACKGROUND: The intensive care unit presents structural complexities, and the prevailing power imbalance between patients and staff can lead to health disparities. Hence, unveiling the underlying factors that give rise to and reinforce these disparities can contribute to their prevention. This study aims to shed light on the stereotypes linked to ageism and lookism, which perpetuate health disparities within the intensive care unit setting in Iran. METHODS: This critical ethnographic study employed Carsepkan's approach and was carried out in intensive care units in the west of Iran from 2022 to 2023. The data collection and analysis were conducted through three interconnected stages. In the initial stage, more than 300 h of observations were made at the research site. In the subsequent stage, a horizon analysis was performed. Conversations with 14 informants were conducted in the final stage to enrich the dataset further. Then the analysis process was carried out as in the previous step to uncover an implicit culture of health disparity. To verify the validity and reliability of the study, credibility, conformability, dependability, and transferability were all taken into account. FINDINGS: The ageism and lookism stereotypes emerged from seven main themes; youth-centric; negative ageism; age-friendliness; age-related priority; centered care for pediatric patients and families; appearance-centeredness; and a contradiction between belief and behavior. CONCLUSION: This critical study showed that ageism and lookism stereotypes permeated the intensive care unit's culture. These stereotypes have the potential to influence equality dynamics, as well as to foster and support health disparity in the intensive care unit.

Edadismo contra las personas mayores en servicios de salud: revisión de alcance* / Ageism directed to older adults in health services: A scoping review / Ageísmo direcionado às pessoas idosas em serviços de saúde: uma revisão de escopo

Objetivo: mapear las expresiones y medidas para combatir el edadismo contra las personas mayores en los servicios de salud. Método: revisión de alcance de estudios primarios en inglés, español y portugués, sin delimitación temporal, recopilados de 14 bases de datos. Dos revisores independientes realizaron de forma ciega la selección de títulos, resúmenes y texto completo, el corpus estuvo compuesto por 41 artículos. La extracción de datos se realizó por pares. Los datos se presentaron en resúmenes narrativos y cuadros. Resultados: las expresiones de edadismo se manifiestan a nivel interpersonal, mediante imágenes y actitudes que deprecian, infravaloran la vida y deslegitiman las necesidades de las personas mayores, y a nivel institucional, por medio de barreras para acceder a los servicios de salud, que provocan falta de atención y descuido. Las medidas para combatirlo consisten en intervenciones educativas y ampliación de los canales de comunicación entre las personas mayores, los profesionales de la salud y gestores. Conclusión: los resultados pueden hacer que los profesionales de la salud estén atentos a la (falta de) atención debido al sesgo etario y sensibilizarlos para que enfrenten el edadismo mediante la adquisición del conocimiento científico. Hay lagunas de conocimiento tanto en el análisis del fenómeno en el contexto del Sistema Único de Salud como sobre las expresiones implícitas de edadismo.

Objective: to map the expressions of ageism directed to older adults in health services and the respective coping measures. Method: a scoping review of primary studies in English, Spanish and Portuguese, without time delimitation and collected from 14 databases. Selection of the titles, abstracts and full text was in charge of two independent and blinded reviewers, totaling a corpus comprised by 41 articles. Data extraction was performed by pairs. The data were presented in narrative summaries and charts. Results: the ageism expressions are understood at the interpersonal level through images and attitudes that depreciate, devalue life and delegitimize older adults' needs, as well as at the institutional level, which confers barriers to accessing health services, generating non-assistance and neglect. The coping measures consist of educational interventions and expansion of communication channels between aged people, health professionals and managers. Conclusion: the results may make health professionals vigilant for care/neglect guided by age bias and sensitive for coping with ageism by obtaining diverse scientific knowledge. The analysis of the phenomenon in the Unified Health System context constitutes a knowledge gap, as well as the implicit ageism expressions.

Objetivo: mapear as expressões e medidas de enfrentamento do ageísmo direcionado às pessoas idosas em serviços de saúde. Método: revisão de escopo de estudos primários em inglês, espanhol e português, sem delimitação temporal, coletados em 14 bases de dados. A seleção dos títulos, resumos e texto completo foi realizada por dois revisores independentes e às cegas, totalizando corpus de 41 artigos. A extração dos dados foi realizada por pares. Os dados foram apresentados em resumos narrativos e quadros. Resultados: expressões de ageísmo estão compreendidas no nível interpessoal, por meio de imagens e atitudes que depreciam, desvalorizam a vida e deslegitimam as necessidades das pessoas idosas, e o nível institucional, que confere barreiras ao acesso dos serviços de saúde, gerando desassistência e descuidado. As medidas de enfrentamento consistem em intervenções educativas e ampliação dos canais de comunicação entre pessoas idosas, profissionais da saúde e gestores. Conclusão: os resultados poderão tornar os profissionais da saúde vigilantes para o (des)cuidado guiado pelo viés de idade e sensíveis para o enfrentamento do ageísmo pela obtenção de conhecimentos científicos. A análise do fenômeno no contexto do Sistema Único da Saúde constitui lacuna do conhecimento, bem como as expressões implícitas do ageísmo.

Leaving no one behind: successful ageing at the intersection of ageism and ableism.

BACKGROUND: The concept of 'successful ageing' has been a prominent focus within the field of gerontology for several decades. However, despite the widespread attention paid to this concept, its intersectional implications have not been fully explored yet. This paper aims to address this gap by analyzing the potential ageist and ableist biases in the discourse of successful ageing through an intersectional lens. METHOD: A critical feminist perspective is taken to examine the sensitivity of the discourse of successful ageing to diversity in societies. The paper analyzes how ageist and ableist biases can manifest in the ways we conceptualize ageing, drawing on examples in the context of mental health. RESULTS: We argue that the conventional approach to successful ageing is limited in its ability to account for the experiences of people who have faced intersectional discrimination throughout their lives. Drawing on examples in the context of mental health, we explore among others the link between depression and disabilities. Furthermore, we shed light on the negative impact of ageist and ableist attitudes concerning the diagnosis and treatment of dementia. DISCUSSION: We demonstrate how diversity is often overlooked in discussions of ageing well, and how ageist and ableist biases can manifest in the ways we conceptualize ageing. We argue that focusing solely on the health status as a means of achieving success fails to adequately counter ageism for all people. We further emphasize the role of structural factors, such as ageist attitudes, in shaping the experience of ageing and exacerbating health inequalities. CONCLUSION: Overall, our findings emphasize the need for a more nuanced and inclusive understanding of ageing and therefore an intersectional approach to conceptions of ageing well that recognizes and addresses the biases and limitations of current discourses. Thereby, this paper offers valuable insights into the complex intersections between age and disabilities from a bioethical perspective, highlighting the need for a more inclusive and intersectional approach to ageing.

Ageism as a Source of Global Mental Health Inequity.

Ageism manifests as stereotyping of or discrimination against people-usually older adults-because of their age. Since ageism contributes to global mental health inequity among older people, responding to their needs should be a clinical, ethical, and policy priority. This article suggests how relatively simple, low-cost, high-yield interventions can be implemented globally and domestically to improve the well-being and quality of life of older individuals.

Ageism directed to older adults in health services: A scoping review. / Edadismo contra las personas mayores en servicios de salud: revisión de alcance.

OBJECTIVE: to map the expressions of ageism directed to older adults in health services and the respective coping measures. METHOD: a scoping review of primary studies in English, Spanish and Portuguese, without time delimitation and collected from 14 databases. Selection of the titles, abstracts and full text was in charge of two independent and blinded reviewers, totaling a corpus comprised by 41 articles. Data extraction was performed by pairs. The data were presented in narrative summaries and charts. RESULTS: the ageism expressions are understood at the interpersonal level through images and attitudes that depreciate, devalue life and delegitimize older adults' needs, as well as at the institutional level, which confers barriers to accessing health services, generating non-assistance and neglect. The coping measures consist of educational interventions and expansion of communication channels between aged people, health professionals and managers. CONCLUSION: the results may make health professionals vigilant for care/neglect guided by age bias and sensitive for coping with ageism by obtaining diverse scientific knowledge. The analysis of the phenomenon in the Unified Health System context constitutes a knowledge gap, as well as the implicit ageism expressions. (1) Ageism expressions involve interpersonal and institutional relationships. (2) Ageism directed to older adults permeates from diagnosis to treatment. (3) The coping measures comprise educational actions and also scientific research studies. (4) It is necessary to recognize the presence of ageism in health services. (5) It is necessary to recognize care/neglect practices guided by age bias.

Development of the item pool for the 'WHO-ageism scale': conceptualisation, item generation and content validity assessment.

OBJECTIVES: ageism harms individuals' health and wellbeing and can be costly to societies. Reliable and valid measures that can quantify ageism are critical for achieving accurate data on its global prevalence, determinants and impacts, and to evaluate the effectiveness of interventions to reduce it. Ageism scales exist; however, none have been demonstrated to validly measure ageism in a manner consistent with consensus definitions of the concept (i.e. as manifested in all of stereotypes, prejudices and discrimination), whilst also quantifying ageism against all groups, from a target and perpetrator perspective, and across diverse country settings. Our objective was to develop an item pool to meet this need. METHODS: we completed the conceptualisation, item generation and content validity assessment phases of a new World Health Organisation (WHO) WHO-ageism item pool that aims to measure the multi-dimensional nature of ageism. These phases drew on a review of available evidence, an experts' workshop and structured content validity reviews conducted by experts in scale development and ageism drawn from every world region defined by WHO. RESULTS: our resulting item pool is designed to provide a multi-dimensional measure of ageism against all ages measured from both a perpetration and experienced perspective and that can produce valid and reliable scores within diverse country contexts and comparable scores across these contexts. CONCLUSIONS: our item pool is the first major step in providing a global and comprehensive measure of ageism. Future phases of research will refine the item pool and establish the statistical psychometric properties of the final tool.

Explaining the process of formation of ageism among the iranian older adults.

BACKGROUND: Ageism is considered as one of the consequences of the industrialization of societies, which appears in various forms in different cultures. This study aimed to explain the process of formation of ageism among the older adults people. METHODS: The research was conducted using grounded theory method. Data were collected from 28 participants using in-depth semi-structured interviews and field notes. Data were analyzed using open, axial, and selective coding. RESULTS: Fear of loneliness and rejection striving to tackle ageism "was identified as the core category of the study. Concepts such as "family context" and "cultural context" were relevant. After identifying the strategies used by the older adults in response to the context ("maintaining integrity", "socio-cultural care" and "proper health care", "striving to tackle ageism") was the most important process in ageism by the Iranian older adults. CONCLUSION: Findings of this study indicated that individual, family and social factors play an important role in the process of ageism among the older adults. These factors sometimes exacerbate or moderate the process of ageism. By recognizing these factors, various social institutions and organizations (including the health care system and the national media (radio and television)) can help the older adults achieve successful aging by emphasizing the issues related to the social aspect.

"With your age, what do you expect?": Ageism and healthcare of older adults in Spain.

INTRODUCTION: Ageism could influence the relationship between older patients' meeting needs and healthcare professionals' answers. AIMS: To highlight the experience of older adults with healthcare systems, how they perceive ageism from their healthcare providers, and to explore the relationship between perceived ageism and self-perception of aging (SPA). METHODS: We conducted an exploratory qualitative study. The participants were 14 women over 65 who lived alone in their homes. RESULTS: Professional responses ignored the expression of preferences of the older patients and excluded them from decision-making processes. These answers influenced older patients' use of health services. Moreover, the negative aspects predominated in a SPA influenced by the internalization of stereotypes and a relationship weighed down by ageist behaviors on the part of health professionals. CONCLUSION: Explicit situations of ageism influence an imbalance in power relations between older patients and healthcare professionals, a misuse of health services, and a negative SPA.

A Phenomenological Understanding of the Intersection-ality of Ageism and Racism Among Older Adults: Individual-Level Experiences.

OBJECTIVES: Ageism is a prevalent, insidious social justice issue that has harmful effects on the health of older adults. Preliminary literature explores the intersectionality of ageism with sexism, ableism, and ageism experienced among LGBTQ+ older adults. Yet, the intersectionality of ageism with racism remains largely absent from the literature. Therefore, this study explores the lived experience of the intersectionality of ageism and racism among older adults. METHODS: This qualitative study applied a phenomenological approach. Twenty participants 60+ years of age (M = 69, standard deviation = 8.84) in the U.S. Mountain West identifying as Black, Latino(a), Asian-American/Pacific Islander, Indigenous, or White engaged in a 1-hr interview between February and July 2021. A 3-cycle coding process applied constant comparison methods. Five coders independently coded interviews, engaging in critical discussion to resolve disagreements. An audit trail, member checking, and peer debriefing enhanced credibility. RESULTS: This study focuses on individual-level experiences exemplified by 3 umbrella themes and 7 subthemes. The subthemes are (a) compounding oppression, (b) intersection of disparities, (c) White privilege, (d) racism and ageism: being tokenized or ignored, (e) ageism and racism: unspoken bias, (f) racism versus ageism: overt or covert? and (g) racism versus ageism: differentiated or ubiquitous? DISCUSSION: The findings indicate how ageism may be racialized through stereotypes related to mental (in)capability. Practitioners can apply the findings to enhance support for older adults by designing interventions aimed at reducing racialized ageist stereotypes and increasing collaboration through education across anti-ageism/anti-racism initiatives. Future research should focus on the impacts of the intersectionality of ageism and racism on specific health outcomes in addition to structural-level interventions.

[Discrimination perceived by elderly adults in the use of health services: an integrative review]. / Discriminação percebida por adultos mais velhos no uso de serviços de saúde: uma revisão integrativa.

This paper analyzes the current evidence on discrimination perceived by elderly adults (> 50 years) in the use of health services and identifies factors associated with this discriminatory experience. It involved an integrative literature review, carried out on the Biblioteca Virtual de Saúde, CINAHL, Medline, Scopus, and Web of Science search websites, in June/2021. The key words used were social discrimination or ageism; middle-aged, or aged 80 and over or elderly; health services or health services for the elderly, including synonyms, in Portuguese, English, and Spanish. The search strategy identified 1,165 articles; 19 met the eligibility and inclusion criteria and were included in this integrative review. They comprise quantitative and qualitative studies published between 2002 and 2021; about 60% carried out in the United States and Australia. The prevalence of discrimination in the use of health services ranged from 2% to 42%. The report of discriminatory practices was associated with ethnic-racial characteristics, sex, age, sexual orientation, physical appearance, and social class. By giving visibility to the theme, this work aims to stimulate the definition of concrete ways to tackle discrimination, in an attempt to interrupt the perpetration of inequities in the health care area.

Este trabalho analisa as evidências atuais sobre a discriminação percebida por adultos mais velhos (> 50 anos) no uso de serviços de saúde e identifica os fatores associados a essa experiência. Trata-se de uma revisão integrativa da literatura, realizada a partir de pesquisa nos sítios eletrônicos Biblioteca Virtual de Saúde, CINAHL, Medline, Scopus e Web of Science, em junho de 2021. Foram utilizados os descritores: discriminação social ou ageismo; pessoa de meia-idade ou idoso de 80 anos ou mais ou idoso; e serviço de saúde ou serviço de saúde para idosos, incluindo sinônimos, nos idiomas português, inglês e espanhol. A estratégia de busca identificou 1.165 artigos; 19 cumpriram os critérios de elegibilidade e inclusão. O acervo inclui estudos quantitativos e qualitativos publicados entre 2002 e 2021; cerca de 60% realizados nos Estados Unidos e Austrália. A prevalência de discriminação no uso de serviços de saúde variou de 2% a 42%. O relato de práticas discriminatórias se mostrou associado a características étnico-raciais, sexo, idade, orientação sexual, aparência física e classe social. Ao dar visibilidade ao tema, este trabalho visa estimular a definição de formas concretas de enfrentamento à discriminação e interromper a perpetração de iniquidades no âmbito da atenção à saúde.

Covid-19 and age discrimination: benefit maximization, fairness, and justified age-based rationing.

Age-based rationing remains highly controversial. This question has been paramount during the Covid-19 pandemic. Analyzing the practices, proposals, and guidelines applied or put forward during the current pandemic, three kinds of age-based rationing are identified: an age-based cut-off, age as a tiebreaker, and indirect age rationing, where age matters to the extent that it affects prognosis. Where age is allowed to play a role in terms of who gets treated, it is justified either because this is believed to maximize benefits from scarce resources or because it is believed to be in accordance with the value of fairness understood as (a) fair innings, where less priority is given to those who have lived a full life or (b) an egalitarian concern for the worse off. By critically assessing prominent frameworks and practices for pandemic rationing, this article considers the balance the three kinds of age-based rationing strike between maximizing benefits and fairness. It evaluates whether elements in the proposals are, in fact, contrary to the justifications of these measures. Such shortcomings are highlighted, and it is proposed to adjust prominent proposals to care for the worse off more appropriately and better consider whether the acquired benefits befalls the young or the old.

The Association between Ageist Attitudes, Subjective Age, and Financial Exploitation Vulnerability Among Older Adults.

Ageism, or age-based negative stereotypes, prejudice, and/or discriminatory behaviors toward older adults, has been linked with various detrimental physical and psychological consequences. The current study examined the relevance of ageist attitudes to financial exploitation vulnerability (FEV) among older adults and investigated whether feeling older than one's chronological age (i.e., older subjective age) moderated the ageist attitudes-FEV association. 230 participants (M age = 72.08, SD = 5.74) filled out scales assessing ageist attitudes, subjective age, and provided relevant sociodemographic information. High levels of ageist attitudes and an older subjective age were associated with increased FEV. Moreover, the ageist attitudes-FEV association was significantly stronger among participants reporting an older subjective age. The results highlight the importance of taking into account ageism and subjective age in order to gain a deeper understanding of the underlying mechanisms which render older adults vulnerable to financial exploitation. Practical and empirical implications are discussed.

The Role of Ageism in Climate Change Worries and Willingness to Act.

This study examined the association of negative ageist prescriptive expectations regarding older people with worries about climate change and willingness to act. An online survey was completed by 250 Australians over the age 18. Higher levels of ageism (e.g., negative prescriptive views towards older people) were associated with fears about the impact of climate change on one's life, worries about the impact of climate change on older members of the family, and willingness to pay higher taxes to fight climate change. Holding more negative prescriptive views towards older people can serve as an incentive to act and at the same time carries an emotional negative valence associated with concerns and worries about the impact of climate change. Although willingness to act and concerns about climate change may inspire adaptation and mitigation efforts, it is important to ensure that they are not tied to ageism.

O cuidado em saúde promovido pelas religiões afro-brasileiras / Health care promoted by afro-brazilian religions / El cuidado en salud promovido por las religiones afrobrasileñas

No decorrer da história, sempre foram infindáveis os casos em que os sujeitos recorriam a centros espíritas ou terreiros de religiões de matrizes africanas em decorrência de problemas como doenças, desempregos ou amores mal resolvidos, com o objetivo de saná-los. Por conta disso, este artigo visa apresentar os resultados da pesquisa relacionados ao objetivo de mapear os processos de cuidado em saúde ofertados em três terreiros de umbanda de uma cidade do litoral piauiense. Para isso, utilizamos o referencial da Análise Institucional "no papel". Os participantes foram três líderes de terreiros e os respectivos praticantes/consulentes dos seus estabelecimentos religiosos. Identificamos perspectivas de cuidado que se contrapunham às racionalidades biomédicas, positivistas e cartesianas, e faziam referência ao uso de plantas medicinais, ao recebimento de rezas e passes e à consulta oracular. A partir desses resultados, podemos perceber ser cada vez mais necessário, portanto, que os povos de terreiros protagonizem a construção, implementação e avaliação das políticas públicas que lhe sejam específicas.(AU)

In history, there have always been endless cases of people turning to spiritual centers or terreiros of religions of African matrices due to problems such as illnesses, unemployment, or unresolved love affairs. Therefore, this article aims to present the research results related to the objective of mapping the health care processes offered in three Umbanda terreiros of a city on the Piauí Coast. For this, we use the Institutional Analysis reference "on Paper." The participants were three leaders of terreiros and the respective practitioners/consultants of their religious establishments. We identified perspectives of care that contrasted with biomedical, positivist, and Cartesian rationalities and referred to the use of medicinal plants, the prescript of prayers and passes, and oracular consultation. From these results, we can see that it is increasingly necessary, therefore, that the peoples of the terreiros lead the construction, implementation, and evaluation of public policies that are specific to them.(AU)

A lo largo de la historia, siempre hubo casos en los cuales las personas buscan en los centros espíritas o terreros de religiones africanas la cura para sus problemas, como enfermedades, desempleo o amoríos mal resueltos. Por este motivo, este artículo pretende presentar los resultados de la investigación con el objetivo de mapear los procesos de cuidado en salud ofrecidos en tres terreros de umbanda de una ciudad del litoral de Piauí (Brasil). Para ello, se utiliza el referencial del Análisis Institucional "en el Papel". Los participantes fueron tres líderes de terreros y los respectivos practicantes / consultivos de los establecimientos religiosos que los mismos conducían. Se identificaron perspectivas de cuidado que se contraponían a las racionalidades biomédicas, positivistas y cartesianas, y hacían referencia al uso de plantas medicinales, al recibimiento de rezos y pases y a la consulta oracular. Los resultados permiten concluir que es cada vez más necesario que los pueblos de terreros sean agentes protagónicos de la construcción, implementación y evaluación de las políticas públicas destinadas específicamente para ellos.(AU)

Expressions of ageism during the pandemic as perceived by older persons / Expressões de idadismo durante a pandemia segundo a percepção de pessoas idosas

OBJECTIVE: To describe expressions of ageism as perceived by older persons during the COVID-19 pandemic. METHODS: Cross-sectional, exploratory, and descriptive study, including 134 older adults who answered a digital questionnaire, between January and July 2022. A word cloud was used to identify stereotypes. Prejudice was assessed using the Anxiety about Aging scale and discrimination was measured using the Ageism Survey. In addition, a semi-structured questionnaire was used to identify the types of discrimination experienced in the pandemic. RESULTS: Older persons tend to reproduce stereotypes associated with experience and wisdom, with the presence of biopsychosocial changes and dependence, and enjoyment of life. Most older persons reported discrimination (93.50%), especially perceived through "telling jokes about older persons" (72.39%). In the pandemic setting, the most perceived discriminatory manifestations referred to policies, practices, or norms related to the pandemic (38.06%) and when reading and watching news in the newspaper, the Internet, and television (35.07%). CONCLUSION: The findings suggest that older persons experienced ageism during the pandemic and show the need for programs and policies aimed at education on ageing, so as to reduce the stigmas of old age and discrimination, aiming to foster healthy ageing.

OBJETIVO: Descrever expressões de idadismo percebidas por pessoas idosas durante a pandemia de COVID-19. METODOLOGIA: Estudo transversal, exploratório e descritivo, realizado com 134 idosos que responderam a um questionário digital, entre janeiro e julho de 2022. Para identificar os estereótipos, elaborou-se uma nuvem de palavras. O preconceito foi avaliado por meio da Escala de Ansiedade sobre Envelhecer e a discriminação foi mensurada por intermédio do Ageism Survey. Além disso, utilizou-se um questionário semiestruturado para identificar os tipos de discriminação sofridos na pandemia. RESULTADOS: Pessoas idosas tendem a reproduzir estereótipos associados à experiência e sabedoria, com presença de alterações biopsicossociais e dependência, e de fruição da vida. A maioria das pessoas idosas relatou discriminação (93,50%), especialmente percebida por meio de "contar piadas sobre idosos" (72,39%). No contexto da pandemia, as manifestações discriminatórias mais percebidas referiram-se às políticas, práticas ou normas relacionadas à pandemia (38,06%) e ao ler e assistir notícias no jornal, internet e televisão (35,07%). CONCLUSÃO: Os dados sugerem o idadismo vivenciado por pessoas idosas na pandemia e evidenciam a necessidade de criação de programas e políticas voltados para a educação em envelhecer, a fim de reduzir os estigmas da velhice e a discriminação, com vistas à promoção do envelhecimento saudável.

Encarceramento feminino: um debate entre criminologia e perspectivas feministas / Female incarceration: a debate between criminology and feminist perspectives / Encarcelamiento femenino: un debate entre la criminología y las perspectivas feministas

Este ensaio teórico-reflexivo tem como objetivo discutir sobre as contribuições dos estudos da criminologia e sua crítica para as diversas formas de aprisionamento feminino, e mais atualmente para o encarceramento em massa no sistema prisional, além de abrir espaço para o debate sobre as diferentes perspectivas feministas e as relações com os estudos criminológicos, sobretudo com os posicionamentos da chamada criminologia crítica. Reconhecem-se importantes avanços e conquistas feministas no debate sobre a estruturação masculinizada do direito penal e do seu fazer jurídico, mas também a manutenção de diversas formas de violência de gênero que configuram um sistema penal antropocêntrico, seletivo, racista e discriminatório. Indica-se a urgência de estudos interseccionais que considerem as particularidades e reinvindicações das mulheres no cárcere e suas formas de militância, sobretudo diante de população carcerária feminina composta majoritariamente por mulheres negras, pobres e periféricas. Faz-se visível a necessidade de uma análise dos fatores que atravessam o encarceramento feminino por uma ótica feminista plural, adequada às realidades que se estudam e atenta às múltiplas perspectivas que podem existir dentro do feminismo.(AU)

This theoretical-reflexive essay aims to discuss the contributions of criminological studies and their critique of the various forms of imprisonment of women, and more recently of mass incarceration in the prison system, in addition to opening space for the debate on the different feminist perspectives and their relations with criminological studies, especially with the positions of the so-called critical criminology. Important feminist advances and conquests are recognized in the debate about the masculinized structure of penal law and its legal practice, but also the maintenance of diverse forms of gender violence that configure an anthropocentric, selective, racist, and discriminatory penal system. It indicates the urgency of intersectional studies that consider the particularities and claims of women in prison and their forms of militancy, especially in the face of the female prison population composed mostly of black, poor, and peripheral women. The need for an analysis of the factors that cross women's imprisonment from a plural feminist perspective, adequate to the realities under study and attentive to the multiple perspectives that may exist within feminism, becomes visible.(AU)

Este ensayo teórico-reflexivo pretende discutir las aportaciones de los estudios criminológicos y su crítica a las distintas formas de encarcelamiento femenino, y más recientemente de encarcelamiento masivo en el sistema penitenciario, además de generar debate sobre las distintas perspectivas feministas y sus relaciones con los estudios criminológicos, especialmente con las posiciones de la Criminología Crítica. Se reconocen importantes avances y logros feministas en el debate sobre la estructuración masculinizada del derecho penal y su práctica jurídica, además del mantenimiento de diversas formas de violencia de género que configuran un sistema penal antropocéntrico, selectivo, racista y discriminatorio. Se necesitan estudios interseccionales que consideren las particularidades y reivindicaciones de las mujeres en prisión y sus formas de militancia, principalmente ante la población penitenciaria femenina compuesta mayoritariamente por mujeres negras, pobres y periféricas. Se hace evidente la necesidad de analizar los factores que inciden en el encarcelamiento femenino desde una perspectiva feminista plural, adecuada a las realidades que se estudian y atenta a las múltiples perspectivas que pueden existir dentro del feminismo.(AU)

An assessment of left-digit bias in the treatment of older patients with potentially curable rectal cancer.

BACKGROUND: Patient age is associated with poorer rectal cancer treatment compliance. However, it is unknown whether left-digit bias (disproportionate influence of leftmost age digit) influences this association. METHODS: The patients diagnosed with stage I-III rectal cancer between 2006 to 2017 in the National Cancer Database were identified. The association between age and receipt of guideline-adherent care was assessed using mixed-effects multivariable analyses. RESULTS: Among 97,960 patients, 46.2% received guideline-adherent overall treatment and 73.3% underwent guideline-adherent surgical resection. Of those who underwent guideline-adherent surgery, 86.4% received guideline-adherent radiotherapy and 56.6% received guideline-adherent chemotherapy. After risk-adjustment, each decade increase in age was associated with 36% decreased odds of guideline-adherent therapy (odds ratio = 0.64, 95% confidence interval = 0.63-0.65). Patients aged 58 to 59 (odds ratio = 1.15, 95% confidence interval = 1.02-1.27) and 78 to 79 (odds ratio = 1.28, 95% confidence interval = 1.08-1.51) had higher odds of guideline-adherent overall treatment compared with patients aged 60 and 80, respectively. However, there were no significant differences in the receipt of guideline-adherent treatment between patients aged 60 vs 61-62 and 80 vs 81-82. CONCLUSION: Older patients with rectal cancer are less likely to receive guideline-adherent care, and a left-digit bias is present. Geriatric assessment-guided treatment decisions could help mitigate this bias.

Age Diversity Management in Organizations Scale: development and evidence of validity / Escala Gestão da Diversidade Etária nas Organizações: desenvolvimento e evidências de validade / Escala Gestión de la Diversidad de Edades en las Organizaciones: desarrollo y evidencias de validez

This study aimed to develop the Age Diversity Management in Organizations scale for the Brazilian context and verify its evidence of validity. The process included five steps: proposal of its definition and development of the items according to the literature; content and semantic validity by judges; semantic validity by the target population; exploratory factorial analysis (EFA); and confirmatory factorial analysis (CFA). The EFA sample consisted of 674 workers from different organizations and the CFA of 722 workers. The final version of the scale was composed of 20 items (α =.91), divided into four factors: retirement preparation practices (5 items, α =.93); equal treatment for workers of different ages (6 items, a=.85), training to promote age diversity (5 items, α =.81), and management practices for older workers (4 items, α =.72). The theoretical and practical implications as well as the limitations of this measure are discussed. (AU)

Este estudo objetivou desenvolver e identificar os indícios de validade da escala Gestão da Diversidade Etária nas Organizações (GeDEO) para o contexto brasileiro. Esse processo incluiu cinco etapas: proposição do conceito e redação dos itens à luz da literatura; validade de conteúdo e semântica por juízes; validação semântica pelo público-alvo; análise fatorial exploratória (AFE) e análise fatorial confirmatória (AFC). A amostra da AFE foi composta por 674 trabalhadores de diversas organizações e, a da AFC, por 722. A versão final possui 20 itens (α = 0,91), com quatro fatores: práticas de preparação para aposentadoria (5 itens, α = 0,93); tratamento equânime a trabalhadores de diferentes idades (6 itens, α = 0,85); treinamento para promoção da diversidade etária (5 itens, α = 0,81) e práticas de gestão de pessoas a trabalhadores mais velhos (4 itens, α = 0,72). As implicações teórico-práticas e as limitações desta medida são discutidas. (AU)

El objetivo fue desarrollar e identificar las evidencias de validez de la escala de Gestión de la Diversidad de Edades en las Organizaciones para el contexto brasileño. Este proceso incluyó cinco pasos: propuesta del concepto y desarrollo de los ítems; validez de contenido y semántica por los jueces; validez semántica por parte de la población objetivo; análisis factorial exploratorio (AFE) y análisis factorial confirmatorio (AFC). La muestra de AFE consistió en 674 trabajadores de diferentes organizaciones, y la de AFC, en 722. La versión final contiene 20 ítems (α = 0,91), divididos en cuatro factores: prácticas de preparación para la jubilación (5 ítems, α = 0,93); igualdad de trato pata los trabajadores de diferentes edades (6 ítems, α = 0,85), capacitación para promover la diversidad de edades (5 ítems, α = 0,81) y prácticas de gestión para trabajadores mayores (4 ítems, α = 0,72). Se discuten las implicaciones teóricas y prácticas, así como las limitaciones de esta medida. (AU)

Digital Ageism: Challenges and Opportunities in Artificial Intelligence for Older Adults.

Artificial intelligence (AI) and machine learning are changing our world through their impact on sectors including health care, education, employment, finance, and law. AI systems are developed using data that reflect the implicit and explicit biases of society, and there are significant concerns about how the predictive models in AI systems amplify inequity, privilege, and power in society. The widespread applications of AI have led to mainstream discourse about how AI systems are perpetuating racism, sexism, and classism; yet, concerns about ageism have been largely absent in the AI bias literature. Given the globally aging population and proliferation of AI, there is a need to critically examine the presence of age-related bias in AI systems. This forum article discusses ageism in AI systems and introduces a conceptual model that outlines intersecting pathways of technology development that can produce and reinforce digital ageism in AI systems. We also describe the broader ethical and legal implications and considerations for future directions in digital ageism research to advance knowledge in the field and deepen our understanding of how ageism in AI is fostered by broader cycles of injustice.