Syftet med denna studie var att undersöka mäns ensamhet med perspektiv från yrkesverksamma på kriscentrum för män. Studien avser också undersöka hur och om dessa centrum arbetar med problematiken och om det går att identifiera kopplingar mellan den rådande mansnormen och mäns ensamhet. Sju kvalitativa semistrukturerade forskningsintervjuer genomfördes med yrkesverksamma på fem olika kriscentrum för män belägna i fem olika orter i Sverige. I studien används Connells maskulinitets teori och Hirdmans genusteori som teoretiskt verktyg. Studien identifierar i sitt resultat en koppling mellan mansnormen och ensamhet. Den enskilda orsak som enligt studien leder till ensamhet är separation från en kärlekspartner. Resultatet visar även att de yrkesverksamma på kriscentrum för män uppfattar att många av männen de möter i sin profession har en ensamhetsproblematik. / The aim of this study was to examine the issue of men’s loneliness through the perspectives of employees at crisis centers for men. The purpose of this study also relates to an inquiry into if and how these centers work with this issue and if it is possible to make a connection between the loneliness and the current norms concerning masculinity. Seven qualitative semi-structured research interviews were conducted with employees at five different crisis centers for men, located in five disparate towns in Sweden. Connell’s theory regarding masculinity and Hirdman’s theory on gender are both utilized as the theoretical framework for the study. The result section of the study identifies a connection between the norms associated with masculinity and loneliness. The primary cause which, according to this study, leads to loneliness is the separation from a romantic partner. Furthermore, the results show that the employees at crisis centers for men perceive that a majority of the men they come into contact with through their work struggle with issues surrounding loneliness.

El aislamiento como medida restrictiva durante la pandemia por el virus SARS-COV-2 ha generado efectos negativos en la población, especialmente en la salud de los adultos mayores. Se realizó una revisión de la literatura empleando las bases de datos de SCOPUS, Google Scholar, PubMed y Scielo publicados a partir de diciembre de 2019. Para los resultados, se hizo la asociación de aislamiento social con COVID-19, consecuencias físicas, efectos psicológicos, enfermedades neurodegenerativas, y la evaluación y manejo. Los artículos empleados brindan información de un periodo de tiempo determinado, por lo cual se desconoce cuáles podrían ser los efectos a largo plazo, y si realmente hay una diferencia con el estado de salud previo a la pandemia. Sin embargo, es de suma importancia establecer medidas para mitigar los efectos tanto a nivel físico como mental, que estén adaptadas a la realidad de cada país.

This qualitative multiple-case study was designed to explore how CEOs in philanthropy learn to make strategic decisions. The study builds off the following premises: (1) as part of their role, CEOs need to make critical decisions in a complex and rapidly changing environment; (2) due to the role of a CEO there are power dynamics at play, and these may have an impact on how CEOs are able to engage in conversation; and (3) due to the staff reporting to the CEO and the CEO reporting to the board, they are essentially peerless within their respective organization, possibly contributing to a sense of isolation. The research site of this study was across a number of organizations, one for each participant. There were three primary sources of data: semi-structured interviews, data collection of publicly available documents, and critical incident reports. Key findings included that: (1) all participants engaged with staff and/or the Board of directors before making a strategic decision, either to obtain buy-in or get information needed to make the decision; (2) informal learning was the primary way participants learned what activities they needed to partake in, in order to make a critical decision; and (3) having full authority and responsibility helped CEOs in their decision-making, while power and other interpersonal dynamics hindered a CEOs ability to make a critical decision. Two main categories of CEOs emerged during the data collection process, those who were deemed Reflective and those who were Action-Oriented. Although not part of this research study’s original design, the data collection took place during the COVID-19 pandemic and also after a resurgence of attention to police brutality against Black people in the United States and other violence towards historically marginalized groups. These themes were prevalent throughout the data gathered for this study and findings and analysis. The overarching recommendation emanating from this research is that succession plans should be put in place in order to best develop potential candidates for the role of CEO.

In Colorado in 2014, suicidal ideation or suicide attempts occurred up to 10 times more frequently among transgender persons than the general population. This reality occurred within a milieu of stigma that included transgender persons' negative perceptions of healthcare, a higher incidence of psychological distress, and an uncertain role for social isolation in their well-being. The purpose of this quantitative study was to explore the interactions between social isolation, supportive medical care, and psychological distress within the framework of Meyer's minority stress theory. Data were acquired from the 2014 Colorado Transgender Health Survey conducted by the One Colorado Education Fund (n = 417). These survey data were analyzed using multivariate techniques and structural equation modeling. Key findings were that psychological health and social integration were positively related (p < .001), supportive medical care and psychological health were positively related (p = .016) and influenced by race and gender identity (p = .05), and, social integration and supportive medical care were not significantly associated. Access to medical care and disease history influenced these relationships (p < .001), and 5 distinct gender identity/race groups emerged. The positive social change implications stemming from this study include recommendations for healthcare and policy-making bodies to improve understanding regarding gender and racial disparities in medical and psychological healthcare, to expand collection of gender identity and victimization data, to improve availability of adequate insurance coverage, and, to foster employment and housing equity. Implementation of these recommendations may improve the lives of transgender Coloradans.

This is a literature study, and it was done with the purpose of analyzing the consequences of loneliness among the elderly people. This study’s focus is on the consequences of loneliness among the elderly on an individual level and examining elderly’s position in society. Key terms in this study have been elderly and lioness. Loneliness is a hard defined term due to its complexity being a feeling, and therefore experienced differently from individual to individual. In our study we have used various articles and reports to answer our question of issue. There were studies that indicated that loneliness had a negative effect on the elderly. It was mainly mental illness in the form of depression but also physical health problems. However, there are studies that indicate that it is not possible to conclude that loneliness can cause health problems. In our study, various risk factors have been identified that may explain why older people tend to experience the feeling of loneliness. Example of risk factors that have been identified in our studies are the status of a partnership, economic factors, gender, family etcetera. Besides these factors another factor that is mentioned as a reason why the elderly tends to live in loneliness is discrimination that takes place in society. Based on the theory of ageism, we concluded that the elderly has a lower status in society and discrimination is a contributing factor.

Physical activity is a well-known protective factor against poorer mental health outcomes. Feelings of depression, social isolation, and stress have increased since the onset of the COVID-19 pandemic. Public health measures implemented to mitigate the spread of the virus have had some unintended consequences on older adults’ physical and mental health. Researchers and government officials recommend physical activity to minimize the negative psychological and physiological impacts of COVID-19. However, older adults have generally shown less moderate-to-vigorous physical activity and positive behavioural adaptations during the COVID-19 pandemic, highlighting a need for physical activity programs and strategies targeted for older adults. Filling this gap, the current study developed and implemented a remote exercise training program for older adults. Employing a measurement burst design with repeated ecological momentary assessments, the current longitudinal randomized control study examined the dynamic relationships of physical activity, depressive symptoms, social isolation, and COVID-19 related stress in older adults. The results from multilevel model analyses showed: (1) the exercise training program was effective in increasing physical activity; (2) sex, age, and group assignment were significant predictors of physical activity; (3) physical activity did not reduce depressive symptoms over time; (4) social isolation is directly associated with depressive symptoms; and (5) COVID-19 stress is inversely associated with depressive symptoms. At-home physical activity programming could be an effective way to increase physical activity among older adults; thus, more research into at-home physical activity programs is needed. / Graduate

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第21633号 / 医博第4439号 / 新制||医||1034(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 横出 正之, 教授 木原 正博, 教授 今中 雄一 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DGAM

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Syftet med litteraturöversikten var att sammanställa och beskriva äldre personers erfarenheter av social delaktighet vid ensamhet och social isolering. Litteraturöversikten genomfördes med resultat från 13 st kvalitativa artiklar inhämtade från databaserna PubMed, CINAHL, PsycINFO och AMED. Författarna identifierade likheter och skillnader och dataanalysen resulterade i två teman; När det sociala livet förändras samt Att upprätthålla social delaktighet. Resultatet visar på att förluster i det sociala nätverket och sviktande hälsa påverkar äldre personers sociala delaktighet. Det framkommer även att aktiviteter som utförs i enskildhet eller tillsammans med andra var ett sätt att hantera förluster i det sociala nätverket. Vidare framkommer det att nära relationer samt att engagera sig i andra och göra aktiviteter tillsammans är viktiga för välmående och kan även fungera som stöd vid förändringar i livet. Slutsatsen i litteraturöversikten är att klientcentrering är av vikt för att främja till social delaktighet då äldre personer har olika behov och hanterar förändring på olika sätt. Vidare är det av vikt att utveckla interventioner med fokus på aktiviteter i sällskap med andra för att stödja social delaktighet för äldre personer. / The purpose of this literature review was to compile and describe older people's experiences of social participation in loneliness and social isolation. The literature review was performed with results from 13 qualitative articles obtained from the databases PubMed, CINAHL, PsycINFO and AMED. The authors identified similarities and differences and the data analysis resulted in two themes; When social life changes and To maintain social participation. The results show that losses in the social network and failing health influences older people’s social participation. It also appears that activities performed alone or together with others were a way of dealing with losses in the social network. Furthermore, it emerges that close relationships and doing activities for and with others are important for well-being and can also serve as support for changes in life. The conclusion of this literature review is that client centeredness is important for promoting social participation as older people have different needs and handle a changed life situation in different ways. Further, it is important to develop interventions with focus on activities in the company of others to support possibilities for social participation among older people.

Bakgrund Ensamhet och social isolering är en växande utmaning i takt med att befolkningen blir äldre. I vissa länder är det upp till en tredjedel av de äldre personerna som upplever ensamhet. Ensamheten och den sociala isoleringen kan ha negativa hälsoeffekter samt leda till ökade behov av sjukvård. Trots att äldre personer som upplever ensamhet och social isolering uppsöker hälso- och sjukvården i högre grad blir den här gruppen ofta förbisedd. Detta till följd av en brist på tid samt kunskap och medvetenhet om problemområdet hos vårdpersonal. Syfte Syftet var att belysa äldre personers upplevelse av ensamhet och social isolering. Metod En icke-systematisk litteraturöversikt genomfördes baserat på 19 vetenskapliga originalartiklar med kvalitativ och kvantitativ design. De inkluderade artiklarna inhämtades i databaserna PubMed och CINAHL. Samtliga artiklar har genomgått en kvalitetsgranskning utifrån Sophiahemmet Högskolas bedömningsmall. Artiklarna analyserades med integrerad dataanalys. Resultat Tre huvudkategorier identifierades; Ensamhetens upplevda ursprung, Upplevda känslor relaterade till ensamhet och Upplevda hanteringsstrategier mot ensamhet. Resultatet visade att ensamhet upplevdes orsakas av den åldrande kroppen, förlusten och frånvaron av viktiga personer, av en avsaknad av meningsfulla aktiviteter samt personlighetsdrag. Ensamhet och social isolering kunde leda till känslor av tomhet, övergivenhet och hopplöshet men även till positiva upplevelser. Hanteringsstrategier mot ensamheten handlade om acceptans och anpassning samt attityder och inställning. Vidare framkom tro och spiritualitet, aktiviteter och relationer som viktiga hanteringsstrategier. Slutsats Litteraturstudien visade att upplevelsen av ensamhet och social isolering innefattade såväl fysiska, sociala som emotionella aspekter. Främst kunde upplevelsen kopplas till ett lidande hos den äldre personen. En ökad förståelse och kunskap om hur äldre personer upplever ensamhet och social isolering kan medvetandegöra problematiken samt berika sjuksköterskans kompetens. / Background  Loneliness and social isolation are growing challenges as the population ages. In some countries up to a third of older persons experience loneliness. Loneliness and social isolation can have negative health effects and lead to an increased need for healthcare. Despite the fact that older persons who experience loneliness and social isolation seek health care to a greater extent, this group is often overlooked. This is due to a lack of time as well as knowledge and awareness of the problem on the part of healthcare staff. Aim  The aim was to describe elderly persons’ experience of loneliness and social isolation. Method  A non-systematic literature review was conducted based on 19 original articles with a qualitative and quantitative design. The included articles were retrieved from the databases PubMed and CINAHL. All articles have undergone a quality review based on Sophiahemmet University's assessment template. The articles were analyzed using integrated data analysis. Results  Three main categories were identified; Perceived origins of loneliness, feelings related to loneliness and coping strategies against loneliness. The results showed that loneliness was perceived to be caused by the aging body, the absence and loss of important persons, by a lack of meaningful activities and by a person's personality traits. Loneliness and social isolation could lead to feelings of emptiness, abandonment and hopelessness but also to positive experiences. Coping strategies included acceptance and adaptation as well as attitudes. Furthermore, faith and spirituality, activities and relationships emerged as important coping strategies. Conclusions  This literature review showed that the experience of loneliness and social isolation included physical, social and emotional aspects. Mainly, the experience could be linked to suffering for the elderly person. An increased understanding and knowledge of how older persons experience loneliness and social isolation can raise awareness of the problem and enrich the nurse's competence.