Mark Luborsky

• PhD
• Managing Director at Wayne State University

This article suggests a shift in focus from stories as verbal accounts to narrative interpretation of the every day as a resource for achieving person‐centred health and social care. The aim is to explore Ricoeur's notion of narrative and action, as expressed in his arguments on a threefold mimesis process, using this as a grounding for the use of...

From the laughing clubs of India and robotic granny minders of Japan to the “Flexsecurity” system of Denmark and the elderscapes of Florida, experts in this collection bring readers cutting-edge and future-focused approaches to our aging population worldwide. In this fourth edition of an award-winning text on the consequences of global aging, a tea...

Background Older persons with cognitive impairment (CI) risk social isolation. Strong evidence shows that perceived loneliness, or inadequate social networks, triggers and increases health problems. How homecare systems address social participation remains unknown; anecdotal data suggests there are significant gaps. This study’s objective was to id...

Objective: The aim of this study was to describe the implementation of a data-driven, unit-based walkthrough intervention shown to be effective in reducing the risk of workplace violence in hospitals. Methods: A structured worksite walkthrough was conducted on 21 hospital units. Unit-level workplace violence data were reviewed and a checklist of...

This paper reports findings from a study that compared older (n = 21, ≥ age 50) and younger (n = 96, ≤ age 49) African Americans’ stories (N = 117) of living with HIV/AIDS to determine how they make sense of the experience. The purpose was to: (1) identify and describe the cultural models African Americans use to inform their stories of living with...

Objective: To evaluate the effects of a randomized controlled intervention on the incidence of patient-to-worker (Type II) violence and related injury in hospitals. Methods: Forty-one units across seven hospitals were randomized into intervention (n = 21) and control (n = 20) groups. Intervention units received unit-level violence data to facili...

Although many studies link teamwork in health care settings to patient safety, evidence linking teamwork to hospital worker safety is lacking. This study addresses this gap by providing evidence linking teamwork perceptions in hospital workers to worker injuries, and further, finds a linkage between manager commitment to safety and teamwork. Organi...

We are grateful for the thoughtful comments on our recent article, “Underreporting of Workplace Violence: Comparison of Self-Report and Actual Documentation of Hospital Incidents” (Arnetz, Hamblin, Ager, et al., 2015). The writer raises issues that are well worthy of discussion. However, on a number of points, there has been some misunderstanding t...

Objective: A systematic literature review was conducted to characterise the current state of knowledge concerning the definition, categorisation, and operationalisation of leisure activity in studies examining its possible role in preventing later-life cognitive decline. Following PRISMA guidelines for a systematic review, the study examined peer-r...

Worker-to-worker (Type III) violence is prevalent in health care settings and has potential adverse consequences for employees and organizations. Little research has examined perpetrator characteristics of this type of violence. The current study is a descriptive examination of the common demographic and work related characteristics of perpetrators...

This study examined differences between self-report and actual documentation of workplace violence (WPV) incidents in a cohort of health care workers. The study was conducted in an American hospital system with a central electronic database for reporting WPV events. In 2013, employees (n = 2010) were surveyed by mail about their experience of WPV i...

This study examined differences between self-report and actual documentation of workplace violence (WPV) incidents in a cohort of health care workers. The study was conducted in an American hospital system with a central electronic database for reporting WPV events. In 2013, employees (n = 2010) were surveyed by mail about their experience of WPV i...

To identify common catalysts of worker-to-worker violence and incivility in hospital settings. Worker-to-worker violence and incivility are prevalent forms of mistreatment in healthcare workplaces. These are forms of counterproductive work behaviour that can lead to negative outcomes for employees, patients and the organisation overall. Identifying...

Background and Objectives: Worker-to-worker (Type III) violence in hospitals is primarily non-physical but threatens worker psychological health. Despite theories about why this violence is perpetrated, less is known about the perpetrators themselves. This study aimed to identify individual and job-related characteristics of Type III perpetrators a...

Background and Objectives: The healthcare industry employs over 5 million workers in U.S. hospitals. Hospital employees are at increased risk for workplace violence and violence-related injury requiring time away from work. A key barrier to violence injury prevention in hospitals is the lack of methodology for prioritizing allocation of limited res...

Background and Objectives: Workplace violence (WPV) is a serious occupational hazard for hospital workers. Injury from WPV can be severe, but little is known about risk factors for violence-related injuries in hospital employees. The aim of this study was to determine risk factors that may identify employees who are at increased risk of injury from...

BackgroundA key barrier to preventing workplace violence injury is the lack of methodology for prioritizing the allocation of limited prevention resources. The hazard risk matrix was used to categorize the probability and severity of violence in hospitals to enable prioritization of units for safety intervention.Methods Probability of violence was...

Purpose: Despite growing knowledge about medical and functional recovery in clinical settings, the long-term issue of community reintegration with a spinal cord injury (SCI) in the military context remains virtually unexamined. Thus, the U.S. Department of Defense created the SCI Qualitative Research Program to advance knowledge about service memb...

AimTo explore catalysts to, and circumstances surrounding, patient-to-worker violent incidents recorded by employees in a hospital system database.Background Violence by patients towards healthcare workers (Type II workplace violence) is a significant occupational hazard in hospitals worldwide. Studies to date have failed to investigate its root ca...

Background: Documented incidents of violence provide the foundation for any workplace violence prevention program. However, no published research to date has examined stakeholders' preferences for workplace violence data reports in healthcare settings. If relevant data are not readily available and effectively summarized and presented, the likelih...

Background and Objectives: Workplace violence between employees (Type III) represents a type of counterproductive work behavior that is prevalent in healthcare settings, ranging from verbal aggression to physical assault. Type III violence undermines a culture of safety, reduces productivity, harms employee well-being, and promotes further violence...

Background and Objectives: Approximately 60% of all nonfatal workplace assaults and violent acts in the United States occur in the health care and social assistance industry, with 22% of incidents occurring in hospitals. The majority of these violent acts are perpetrated by patients (Type II workplace violence). However, most hospitals lack reliabl...

Background and Objectives: Workplace violence is a leading occupational hazard for hospital workers worldwide. However, no studies to date have examined the direct costs incurred by workplace violence in general hospital settings. The aim of this study was to develop methodology for calculating costs resulting from violence directed towards hospita...

This study investigated the relationship between self-assessed overall health (SRH) and walking ability among older adults (n = 239) gauged using three well-established measures of walking ability ("normal" and "fast" walking speeds, and perceived walking difficulty). Logistic regression models adjusted for health, behavioral, and sociodemographic...

'Aging in place' has become a key conceptual framework for understanding and addressing place within the aging process. However, aging in place has been critiqued for not sufficiently providing tools to understand relations or transactions between aging and place, and for not matching the diversity of contemporary society in which people are moving...

Background and Objectives: Nursing home employees are at increased risk for violence and aggression, especially from nursing home residents. However, no studies have considered the implications of violence for the nursing home safety culture. This study examined the association between workplace violence and employee perceptions of nursing home res...

Techniques of possession research among older people tend to accentuate their prizing of things and their use of special dispositions to achieve the protection or 'safe passage' of things as they transfer to a new owner. Such efforts on behalf of possessions may also be undertaken to perpetuate the self. To study the care of things and self in a wi...

The fastest growing segment of the United States HIV population is people aged 50 and older. This heterogeneous group includes people with diverse pathways into HIV positive status in later life, including aging with the disease as well as later life-acquired infections. As people with HIV live into older ages, solving problems of successful second...

To date, only modest gains have been achieved in explaining adherence to medical regimens, limiting effective interventions. This is a particularly important issue for African Americans who are disproportionately affected by the HIV epidemic. Few studies have focused on intragroup variation among African Americans in adherence to ART. The aim of th...

Older adults face a daunting task: while continuing engagements in multiple relationships, investment in their own and others' futures, and developing life interests and capacities, they also reexamine and sometimes reconfigure the place where their social lives and objects are housed. Some relocate, downsize, to a new smaller place and reducing po...

In recent years, there has been an increasing focus on the role of safety culture in preventing costly adverse events, such as medication errors and falls, among nursing home residents. However, little is known regarding critical organizational determinants of a positive safety culture in nursing homes. The aim of this study was to identify organiz...

Objective. To identify, in community dwelling elders, the determinants of sustained pain improvement or worsening. Design. A longitudinal study with two baseline and 11 monthly follow-up interviews was conducted. Pain was assessed monthly using the Parmelee adaptation of the McGill Pain Inventory. Subjects. Subjects included 109 Caucasian and 132 A...

The construct 'missed dose' is central to many assessments of medication adherence. However, few studies have investigated how patients or clinicians conceptualize missed doses or the extent of the concordance or discordance between clinicians and patients. To address this gap we conducted semi-structured interviews with 45 sero-positive African Am...

Alcohol consumption has been associated with HIV disease progression; yet, the nature of this association is poorly understood. This study sought to determine the influence of patient beliefs about alcohol on ART adherence, and elucidate clinician beliefs about drinking and taking ART. Most patients (85%) believed alcohol and ART do not mix. The th...

Strict adherence to medication regimens is generally required to obtain optimal response to combination antiretroviral therapy (ART). Yet, we have made limited progress in developing strategies to decrease the prevalence of nonadherence. As we work to understand adherence in developed countries, the introduction of ART in resource-poor settings rai...

Oral health is an essential aspect of the overall medical care for patients with HIV. However, fear of status disclosure is a significant barrier to access to care. Preparing future oral health care providers to maintain all aspects of confidentiality and to understand the role stigma plays in the lives of HIV-positive individuals are critical issu...

We explored self-rated health by using a meaning-centered theoretical foundation. Self-appraisals, such as self-rated health, reflect a cultural process of identity formation, whereby identities are multiple, simultaneously individual and collective, and produced by specific historical formations. Anthropological research in Philadelphia determined...

Objective. The aim of this study was to discover and characterize components of engagement in creative activity as occupational therapy for elderly people dealing with life-threatening illness, from the perspective of both clients and therapists. Despite a long tradition of use in clinical interventions, key questions remain little addressed concer...

As the only effective treatment strategy against HIV/AIDS, highly active antiretroviral therapy (HAART) is an extremely promising development in the treatment of HIV/AIDS. The success of HAART highly depends on patient's adherence to this complex treatment. Recent studies found that poor adherence was a major cause of treatment failure and emerging...

Objective. The aim of this study was to discover and characterize components of engagement in creative activity as occupational therapy for elderly people dealing with life-threatening illness, from the perspective of both clients and therapists. Despite a long tradition of use in clinical interventions, key questions remain little addressed concer...

A cross-cultural valid analytic definition of retirement remains elusive in gerontology despite a long tradition of research on the topic. Inadequate attention has been paid to consistently defining the key concepts used to examine retirement and to specifying its occurrence in non-Western, non-industrial societies. This paper critically reviews ba...

With the advent of antiretroviral therapy, HIV has become a chronic illness for those who have access to the medication. But unlike our understanding of acute disease experience which can be grasped within parameters defined by categories of medical diagnosis and treatment, understanding the experience of chronic illness requires that we expand our...

Low adherence is the single most important challenge to controlling HIV through the use of high acting anti-retrovirals (HAART). Non-adherence poses an immediate threat to individuals who develop resistant forms of the virus as well as a public health threat if those individuals pass on treatment-resistant forms of the virus. To understand the conc...

This chapter discusses culture and aging. It discusses the cultural dimensions of aging, shows how culture links communities and individual lives, and provides an overview of aging in a cross-cultural and historical perspective. Illustrative cases and examples are used throughout.

This title presents an overview of gerontology appropriate for beginning, graduate and advanced undergraduate students. The text includes seminal chapters on theory, methodology, physiological processes, health, culture, dying and bereavement, cognitive processes and intellectual abilities, personality, assessment, clinical issues and competency, c...

The effects of HIV/AIDS on different societies spanning the globe are only beginning to be described. This article describes HIV/AIDS's emerging impact and consequences for families and societies around the globe, with a primary focus on middle-aged and older members. It first provides the current data on the evolving international profile of the H...

Assistive devices minimize limitations from physical impairment and are integral to rehabilitation. Little is known about older patients' concerns, perceptions, and beliefs about assistive devices. This study used a structured, qualitative approach to describe device perceptions of 103 stroke patients in rehabilitation. Six dimensions of patient co...

This paper examines how labels for impairment are negotiated by people with disabilities during clinical assessment. It builds on Robert Murphy's (1987) explanations of the disability experience as rooted in the individual's sense of having multiple past, present and intended future body-selves. Using transcripts of five consecutive daily clinical...

In gerontology the most recognized and elaborate discourse about sampling is generally thought to be in quantitative research associated with survey research and medical research. But sampling has long been a central concern in the social and humanistic inquiry, albeit in a different guise suited to the different goals. There is a need for more exp...

In research on life-course transitions, the dynamics of reorganizing meanings and lives were examined in interviews with 32 retiring workers in the United States. New retirees engaged in reorganization of self and social identity by work in special projects involving physical labor to demolish and rebuild backyards and household interiors. Findings...

Open-ended responses of caregiving daughters and daughters-in-law were generated by a modified random probe technique to investigate the construct validity of the two subscales of the Affect Balance Scale (ABS), i.e., the 5-item Positive Affect Scale (PAS) and the 5-item Negative Affect Scale (NAS). A set of criteria were developed to distinguish b...

Adversities facing people with disabilities include barriers to meeting daily needs and to social life. Yet, too, fundamental social devaluation erodes an individual's capacity to retain title to the cultural category of a full person. These cultural adversities are important components in the disablement process. The cultural meanings for physical...

the study of themes is traditionally seen as a simple chore of reading through notes and transcripts to identify recurrent statements or behaviors that are then labeled, described, and summarized to portray the person's most frequent . . . experiences or actions consider the benefits of thematic analysis [in the study of aging] / outline the issu...

This introduction outlines how the emerging framework of critical gerontology (CG) may be enhanced by greater emphasis on understanding the cultural influences on research and practice in gerontology. CG pursues empirical insights into the historical and cultural forces shaping the sense of the problem for study, that is, the formulation of topics...

Life narratives have wide appeal because they promote the modern ideal of freeing people to reflect on their life and to share personal meanings and experience in public. Constructing a life story may aid adult development and well-being. This article explores how to enhance these benefits, but criticizes the idealization of stories and their benef...

This paper explores regrets about childlessness in 90 older women interviewed using qualitative methods. Regrets were discussed in the context of the changing meaning of childlessness over the life course. We found that issues of regret are situated in a cultural system that renders childless women marginal. We argue that regrets should be understo...

This article describes differences between elderly Jewish and non-Jewish women in dealing with the death of an adult child. Dimensions of difference include the meaning of the death to the mother, her expression of grief, and her conceptualization of the future in the face of the loss. Results are based on data from 12 Jewish and 17 non-Jewish wome...

Cultural contexts influence the ways individuals interpret and experience functional losses associated with post-polio sequelae. Using in-depth multiple interview case studies from two National Institute on Aging projects, the concept of "biographies" is presented to place the individuals' polio-related experiences within the context of their lives...

Theoretical approaches to conceptualising the notion of generativity have been psychologically or psychosocially based and assume generativity to be a universal phenomenon. Because psychological issues are subsumed within a cultural context, we suggest that generativity is not a universal psychological principle but rather a cultural construct. In...

The key relationships of never married, childless older women, that is, those relationships described as central, compelling, enduring, or significant throughout their lifetimes, were explored in this study. Analysis of qualitative, ethnographically based interviews with 31 women indicated that the key relationships they describe fall into three cl...

Comparative study within a group of systematically elicited life narratives revealed key variations in narrative sequencing and conceptual templates. These dimensions are associated with significant differences in subjective meaning, frames for interpreting experience, and personal adjustment. This paper describes the study methods and results, and...