Enriching or Discouraging? Competing Pictures of Aging and Paid Work in Later Life

The picture and experience of work and retirement are continuously changing in Canada and will likely continue to change into the future with the aging of the population. There are two pictures of work in older age presented in the literature: a positive and enriching picture and a picture that highlights the challenges facing some older workers. The positive and enriching picture focuses on the experiences of older individuals who are able to continue working if they want to work and are able to work; those who continue working because they are motivated by work rather than pay or new opportunities for growth; and, older workers who are appreciated for their skill and education. However, these positive experiences are not shared by all older workers. For some, working at older ages is motivated by financial survival rather than personal pleasure. This financial insecurity may have occurred due to a work displacement in mid-life or the inability to secure stable and non-precarious employment throughout the life course. Some older workers may find it challenging to find new work if they are unskilled or lack up-to-date skills. Many older workers may want to continue working but are unable to do so as a result of personal health circumstances or disability, lack of accommodations in the workplace, or caregiving responsibilities. Others who want to work may face discrimination in the labour market due to ageism. As the population ages and new generations reach old age with varying work trajectories, alongside changes in policies surrounding public pension plans, the need for a better understanding of new experiences of work and retirement is more important now than ever. The key areas of focus in this report are experiences of employment for older workers and work-retirement transitions. This report addresses the need to redefine the terms “older worker” and “retirement”, due to their shifting meanings over time. The implications of the 2008 recession on older workers are also discussed. The report concludes by discussing the impact of policy reforms on older workers

Towards A Critical Approach To Benefits Realisation Of Information Systems In The NHS

This paper discusses a conceptual approach to the study of benefits realisation of information systems (IS) within the context of the UK National Health Service (NHS). Benefits realisation has become an important topic of study for both academics and practitioners. The focus and concerns of such studies cover a spectrum of concepts ranging from positivist to more interpretive discussion with many prescribing practical methods for effective delivery of benefits from investment in IS. However, much of this work has failed to translate espoused ideals into successful action and insufficient attention has been given to the social and political aspects of the topic. Furthermore, closer inspection of the literature reveals that use of concepts is varied. The purpose of this paper is to review the existing knowledge on benefits realisation of IS, propose a framework that synthesises and extends existing research and suggest what is missing is a critical approach

Poster Introductions III--Aging with Long-Term Physical Impairment: The Significance of Social Support

As the population ages more people are reaching old age having lived with a long-term physical impairment. This vulnerable group of people has specific needs that are often different from those of someone who reaches old age without a pre-existing physical impairment. This paper focuses on the significance of social support in ameliorating the aging experience when living with long-term physical impairment. It is based on a qualitative study of the aging experiences of eight men and women living in Ontario, Canada who were between the ages of 50 and 68 and had lived with their physical impairment for more than 10 years. Two participants had impairments on account of multiple sclerosis, two on account of rheumatoid arthritis, one had loss of limb, one had muscular dystrophy, one had hip deterioration from age 12, and one had polycystic kidney disease. Data were gathered through in-depth, semi-structured interviews. The findings suggest that coping with long-term physical impairment may be a lonely experience when the person lacks a strong network of family and/or friends to offer emotional support as they deal with the constant changes that can occur. Participants felt their experiences of aging with long-term physical impairment were improved when they shared their thoughts, feelings and problems with others. The paper also discusses the significance of gender and marital status with regard to access to social support. Rebecca Casey is a PhD candidate in Sociology at McMaster University. Her research interests include aging, disability, health and policies. Her MA thesis, at Lakehead University, focused on the experience of aging with long-term physical impairment. The poster presentation is based on this research. Rebecca’s PhD dissertation will use data collected through the Research Action Alliance on the Consequences of Work Injury (RAACWI), to focus on poverty and to relate it to aging concerns, such as loss of pensions through employment changes, reduced income following an injury and lack of employment opportunities due to reduced physical abilities. Sharon Dale Stone is Professor of Sociology at Lakehead University, where she is also affiliated with the Women’s Studies, Gerontology, and Masters of Public Health programs. Her research focuses on experiences of living with chronic impairments and issues that arise as a result. She recently published A Change of Plans: Women’s Stories of Hemorrhagic Stroke (2007) and is writing an analysis of the experiences of women who survived a hemorrhagic stroke at a young age. She is currently working with a team of academic researchers and community activists to investigate the experiences of injured workers with the worker’s compensation system

Kentucky Law Survey: Professional Responsibility

In the face of persistent criticism of the legal profession, from within as well as without, the Kentucky Supreme Court exhibits a certain degree of ambivalence toward issues of professional responsibility. This ambivalence manifests itself in two ways. First, the Court\u27s treatment of different categories of professional misconduct seems at times unjustifiably inconsistent. The Court reacts to certain misconduct in an almost uniformly harsh manner, evincing the attitude of a strict disciplinarian for the practicing bar. Occasionally, however, the Court responds to various other kinds of equally gross misconduct with apparently undue leniency. In such cases the Court seems to perceive itself as a forgiving guardian of erring practitioners. Second, even within certain categories of misconduct toward which the Court generally reacts harshly, the Court will sometimes respond with unexplained moderation. The regular failure of the Court to explain the discrepancies in punishment assessed for similar instances of misconduct engenders uncertainty regarding the Court\u27s attitude toward that misconduct. Certainly unprofessional conduct arises in many contexts, forms, and degrees, and not every breach of professional ethics should result in the same sanction-harsh or lenient. The Court must mold its punishment to fit its view of the seriousness of the offense and the mitigating factors involved, a process which naturally leads to some variations in the treatment of different offenders. Still, the reader of the Court\u27s professional responsibility opinions issued during this survey period might well conclude that the Court is not as determined to eradicate some forms of egregious misconduct as it is others and might further conclude that punishment for similar offenses is not uniformly imposed

EHRs Connect Research and Practice: Where Predictive Modeling, Artificial Intelligence, and Clinical Decision Support Intersect

Objectives: Electronic health records (EHRs) are only a first step in capturing and utilizing health-related data - the challenge is turning that data into useful information. Furthermore, EHRs are increasingly likely to include data relating to patient outcomes, functionality such as clinical decision support, and genetic information as well, and, as such, can be seen as repositories of increasingly valuable information about patients' health conditions and responses to treatment over time. Methods: We describe a case study of 423 patients treated by Centerstone within Tennessee and Indiana in which we utilized electronic health record data to generate predictive algorithms of individual patient treatment response. Multiple models were constructed using predictor variables derived from clinical, financial and geographic data. Results: For the 423 patients, 101 deteriorated, 223 improved and in 99 there was no change in clinical condition. Based on modeling of various clinical indicators at baseline, the highest accuracy in predicting individual patient response ranged from 70-72% within the models tested. In terms of individual predictors, the Centerstone Assessment of Recovery Level - Adult (CARLA) baseline score was most significant in predicting outcome over time (odds ratio 4.1 + 2.27). Other variables with consistently significant impact on outcome included payer, diagnostic category, location and provision of case management services. Conclusions: This approach represents a promising avenue toward reducing the current gap between research and practice across healthcare, developing data-driven clinical decision support based on real-world populations, and serving as a component of embedded clinical artificial intelligences that "learn" over time.Comment: Keywords: Data Mining; Decision Support Systems, Clinical; Electronic Health Records; Implementation; Evidence-Based Medicine; Data Warehouse; (2012). EHRs Connect Research and Practice: Where Predictive Modeling, Artificial Intelligence, and Clinical Decision Support Intersect. Health Policy and Technology. arXiv admin note: substantial text overlap with arXiv:1112.166