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1.
Gerontologist ; 2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34636402

RESUMO

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 healthcare cost, 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 healthcare costs for aged 65 years/older. Over 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 dataset with over 30 million newspaper and magazine articles to dynamically track Societal-Age-Stereotype scores over 8 years from pre-to-post policy implementation. RESULTS: Societal-Age-Stereotypes followed a quadratic trend: Prior to the Aging-Policy-Agenda-Setting from 2010-2014, stereotypes were trending positive; after 2014, it trended downwards to become more negative. Medicalization-of-Aging mediated the relationship between Aging-Policy-Agenda-Setting and Societal-Age-Stereotypes. Further, 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 policy makers 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.

2.
J Med Internet Res ; 2021 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-34678754

RESUMO

BACKGROUND: President Joe Biden signed an executive action on Jan 26, 2021, directing federal agencies to combat hate crimes and racism against Asians that 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 Covid-19. OBJECTIVE: To test whether global societal sentiments toward Asians, across 20 countries, have become more negative, month-by-month, from pre-pandemic (October 2019) to May 2020, and the pandemic (incidence and mortality rates) and cultural (Hofstede's cultural dimensions) predictors of this trend. METHODS: We leveraged a 12-billion-word online-media database, with over 30 million newspaper and magazine articles taken from over 7,000 sites across 20 countries, and identified six 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 two independent researchers to provide a Cumulative Asian Sentiment Score (CASS) per month. This allowed us to track statistically significant shifts in societal sentiments toward Asians from a baseline period (Oct'19-Dec'19) to the onset of the pandemic (Jan'20-May'20). We tested 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'19, Jamaica and New Zealand evidenced the most negative societal sentiments toward Asians; when news of the coronavirus broke in January'20, the U.S. and Nigeria evidenced the most negative sentiments toward Asians, among 20 countries. Globally, sentiments of Asians became more negative-a statistically significant linear decline during the Covid-19 pandemic. CASS trended neutral before the pandemic during the baseline period of October'19 to November'19, then dived in February'20. CASS were, ironically, not predicted by Covid-19's incidence and mortality rates, but 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 towards 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 that are culturally nuanced and contextually appropriate.

3.
PLoS One ; 16(9): e0256358, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34469446

RESUMO

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.


Assuntos
COVID-19/epidemiologia , Meios de Comunicação de Massa , Narração , Pandemias , SARS-CoV-2 , Mídias Sociais , Humanos
4.
BMJ Open ; 11(9): e045224, 2021 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-34521657

RESUMO

OBJECTIVE: To define clinical empathy from the perspective of healthcare workers and patients from a multicultural setting. DESIGN: Grounded theory approach using focus group discussions. SETTING: A health cluster in Singapore consisting of an acute hospital, a community hospital, ambulatory care teams, a medical school and a nursing school. PARTICIPANTS: 69 participants including doctors, nurses, medical students, nursing students, patients and allied health workers. MAIN OUTCOME MEASURES: A robust definition of clinical empathy. RESULTS: The construct of clinical empathy is consistent across doctors, nurses, students, allied health and students. Medical empathy consists of an inner sense of empathy (imaginative, affective and cognitive), empathy behaviour (genuine concern and empathic communication) and a sense of connection (trust and rapport). This construct of clinical empathy is similar to definitions by neuroscientists but challenges a common definition of clinical empathy as a cognitive process with emotional detachment. CONCLUSIONS: This paper has defined clinical empathy as 'a sense of connection between the healthcare worker and the patient as a result of perspective taking arising from imaginative, affective and cognitive processes, which are expressed through behaviours and good communication skills that convey genuine concern'. A clear and multidimensional definition of clinical empathy will improve future education and research efforts in the application and impact of clinical empathy.

6.
Artigo em Inglês | MEDLINE | ID: mdl-34444578

RESUMO

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.


Assuntos
Ageismo , Estereotipagem , Opinião Pública , Televisão , Estados Unidos
7.
Artigo em Inglês | MEDLINE | ID: mdl-34444448

RESUMO

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.


Assuntos
Inteligência Artificial , Hospitalização , Idoso , Hospitais Públicos , Humanos , Tempo de Internação , Alta do Paciente , Singapura
8.
PLoS One ; 16(7): e0251161, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34197470

RESUMO

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

9.
Gerontologist ; 2021 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-34323967

RESUMO

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.

10.
Artigo em Inglês | MEDLINE | ID: mdl-33786581

RESUMO

OBJECTIVES: Older adults experience higher risks of getting severely ill from COVID-19, resulting in widespread narratives of frailty and vulnerability. We test: (1) Whether global aging narratives have become more negative from before to during the pandemic (Oct'19 to May'20) across 20 countries; (2) Model pandemic (incidence and mortality), and cultural factors associated with the trajectory of aging narratives. METHODS: We leveraged a 10-billion-word online-media corpus, consisting of 28 million newspaper and magazine articles across 20 countries, to identify nine common synonyms of 'older adults' and compiled their most frequently-used descriptors (collocates) from Oct'19 to May'20-culminating in 11,504 collocates that were rated to create a Cumulative-Aging-Narrative-Score-(CANS) per month. Widely used cultural dimension scores were taken from Hofstede, and pandemic variables, from the Oxford COVID-19 Government Response Tracker. RESULTS: Aging narratives became more negative as the pandemic worsened across 20 countries. Globally, scores were trending neutral from Oct'19 to Feb'20, and plummeted in Mar'20, reflecting COVID-19's severity. Pre-pandemic (Oct'19), UK evidenced the most negative aging narratives; peak-pandemic (May'20), South Africa took on the dubious honor. Across the 8-month period, Philippines experienced the steepest trend towards negativity in aging narratives. Ageism, during the pandemic, was ironically, not predicted by COVID-19's incidence and mortality rates, but by cultural variables: Individualism, Masculinity, Uncertainty Avoidance, and Long-term Orientation. DISCUSSION: The strategy to reverse this trajectory lay in the same phenomenon that promoted it: A sustained global campaign-though, it should be culturally nuanced and customized to a country's context.

11.
Artigo em Inglês | MEDLINE | ID: mdl-33300996

RESUMO

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

12.
Artigo em Inglês | MEDLINE | ID: mdl-33099600

RESUMO

OBJECTIVES: Ageism has increased over 200 years and costs the US healthcare system $63 billion a year. While scholars agree on the consequences of ageism, there are disagreements on whether it is related to the demographics of aging, or society's cultural values. We test both hypotheses across 20 countries. METHODS: To circumvent the sampling limitations of survey studies, we used an 8-billion-word corpus, identified three synonyms with the highest prevalence-aged, elderly, old people-and compiled the top 300 words (collocates) that were used most frequently with these synonyms for each of the 20 countries. The resulting 6000 collocates were rated on an ageism scale by two raters to create an ageism score per country. Cultural dimension scores- Power Distance, Individualism, Masculinity, Uncertainty Avoidance Long-term Orientation-were taken from Hofstede, and demographics-size and speed of population aging-came from the World Development Indicators. RESULTS: Of the 20 countries, UK topped the ageism table while Sri Lanka had the lowest ageism score. Multiple regression models showed that higher levels of masculinity and long-term orientation are associated with ageism, controlling for other cultural dimensions, demographics (size and speed of aging), and economics (GDP-per-capita). DISCUSSION: Our findings blunt the deterministic nature of ageism at the societal level. Demographics is only one side of the ageism coin, and the cultural side is equally, if not more important. This study lays the groundwork to tackle societal ageism-one of our generation's most pernicious threats.

13.
Artigo em Inglês | MEDLINE | ID: mdl-32824658

RESUMO

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


Assuntos
Envelhecimento , Longevidade , Feminino , Humanos , Masculino , Personalidade , Estudos Prospectivos
14.
Artigo em Inglês | MEDLINE | ID: mdl-32659983

RESUMO

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


Assuntos
Pessoas com Deficiência , Planejamento em Saúde , Política de Saúde , Isolamento Social , Idoso , Idoso de 80 Anos ou mais , Feminino , Previsões , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Singapura
15.
PLoS One ; 13(1): e0191252, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29385157

RESUMO

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


Assuntos
Negativismo , Neuroticismo , Adulto , Ansiedade/epidemiologia , Comparação Transcultural , Depressão/epidemiologia , Análise Fatorial , Feminino , Indicadores Básicos de Saúde , Humanos , Masculino , Modelos Psicológicos , Inventário de Personalidade/estatística & dados numéricos , Psicometria/estatística & dados numéricos , Singapura/epidemiologia , Estresse Psicológico , Estados Unidos/epidemiologia , Adulto Jovem
16.
J Craniomaxillofac Surg ; 46(3): 485-491, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29311019

RESUMO

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


Assuntos
Beleza , Orelha/anatomia & histologia , Adulto , Idoso , Demografia , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato , Fatores Sociológicos , Adulto Jovem
18.
J Transcult Nurs ; 29(5): 402-409, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29308714

RESUMO

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


Assuntos
Serviços de Assistência Domiciliar/normas , Enfermeiras e Enfermeiros/psicologia , Adulto , Cuidadores/psicologia , Diversidade Cultural , Tomada de Decisões , Feminino , Teoria Fundamentada , Serviços de Assistência Domiciliar/organização & administração , Serviços de Assistência Domiciliar/tendências , Humanos , Entrevistas como Assunto/métodos , Relações Enfermeiro-Paciente , Enfermeiras e Enfermeiros/tendências , Pesquisa Qualitativa , Singapura
19.
Plast Reconstr Surg ; 140(1): 20e-32e, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28654590

RESUMO

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


Assuntos
Nádegas/anatomia & histologia , Relação Cintura-Quadril , Adulto , Idoso , Beleza , Demografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Autorrelato , Fatores Sociológicos , Adulto Jovem
20.
J Craniomaxillofac Surg ; 45(5): 655-660, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28318919

RESUMO

BACKGROUND: Perception of beauty is influenced by the individual's demographic background and characteristics. However, objective measurements and ratios remain the foundation for aesthetic evaluations. This study aimed to elucidate if there exists a universally applicable ideal upper to lower lip ratio. METHODS: An interactive online survey was designed. Modifiable ranges of lip ratios were achieved via digital alteration, enabling participants to change the ratio of a single female model's lips. The questionnaire was translated into multiple languages and sent to more than 9000 plastic surgeons and the general public worldwide. Demographic data were collected and analysis of variance was used to investigate respective lip ratio preferences. RESULTS: A total of 1011 responses from 35 different countries (response rate of 14%) was gathered. The majority of survey takers (60%) chose the 1.0:1.0 lip ratio as most attractive. No differences were found in respect to lip ratio preference and the self-reported ethnicity. However, interesting preferences prevailed when analyzing the subgroups regarding lower lip size. CONCLUSION: Age, gender, country of residence, and profession significantly impact individual upper to lower lip ratio preferences. However, a 1.0:1.0 lip ratio can apparently be considered most pleasing in females.


Assuntos
Lábio/anatomia & histologia , Adulto , Fatores Etários , Idoso , Beleza , Feminino , Humanos , Lábio/cirurgia , Masculino , Pessoa de Meia-Idade , Padrões de Prática Médica/estatística & dados numéricos , Fatores Sexuais , Cirurgia Plástica/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
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