Introduction and Background: Today, in 2022, there is a community that receives discrimination, lack of acceptance, and lack of equality. This is the LGBTQ community. They suffer from the indifferences of the way they express themselves resulting in a rise of mental health issues and overall health disparities. Purpose Statement: The purpose of this review is to explore the disparities in mental health for the LGBT community including young adolescents and older adults. The question that drives this review is how does being a member of the LGBT community effect mental health. Literature Review: This literature review utilized search engines such as PubMed, ETSU One Search, and Google Scholar. Articles were chosen from within the past five years and corresponded with disparities in mental health for the LGBT community and the effects of acceptance from others. Key words used during the search of articles included “LGBT”, “mental health”, “suicide”, and “nursing”. A total of four articles and one systematic review were selected. Findings: Adolescents who didn’t have acceptance from others had a higher risk of suicide. Many mental health and substance abuse facilities didn’t have LGBT-specific programs. Healthcare professionals expressed the lack of training with LGBT clients but were willing to learn as it is relevant to their practice. Conclusions: The United States is under pressure as we watch the LGBT community become victims of inequality and health disparities. There is a need for more training and cultural competency, and implications of programs and resources specifically for the LGBT community.

Objectives Main objectives of this doctoral thesis were to review available information on pharmacological properties of benzodiazepines and their age-related changes; to evaluate the prevalence of benzodiazepine use in older patients residing in long term care facilities; to investigate the association between use of benzodiazepines and occurrence of falls in acutely hospitalized older patients; and to describe utilization of benzodiazepines in the Czech Republic. Methods A narrative review of literature focused on pharmacokinetics, pharmacodynamics, adverse effects and association of benzodiazepines with falls in older population was conducted. The evaluation of benzodiazepine use in long term care facilities was analysed in a retrospective cross-sectional study using data from the EC 7th Framework Program SHELTER project (Service and Health in the Elderly in Long Term Care). A prospective cohort study data of acutely hospitalized patients in Australia were used to evaluate association between benzodiazepines and falls. To describe utilization of benzodiazepines in the Czech Republic, data from the State Institute for Drug Control and from databases of General Health Insurance Fund were used. This dissertation thesis is a summary of published articles from above stated works and analyses. Results...

Mit der vorliegenden Arbeit sollte untersucht werden, ob die Selbstausfüller-Version des STEP (Standardised assessment of elderly people in primary care in Europe) praktikabel und verständlich ist, ob sie von Patienten und Ärzten akzeptiert wird und ob sie nützlich ist, bisher unbekannte gesundheitliche Probleme der Patienten zu entdecken. 1007 von 1540 Patienten über 65 Jahren, die in 28 sächsische Hausarzt-praxen kamen, beantworteten die Selbstausfüller-Version des STEP. Ermittelt wurde, dass 95,8% der teilnehmenden Patienten den Fragebogen ohne Hilfe ausfüllen konnten. Die durchschnittliche Zeit zum Beantworten des Fragebogens nahm, abhängig vom Alter der Patienten, von 17 bis 25 Minuten zu. Vierzehn der 75 Fragen der Selbstausfüller-Version wurden von mehr als 9% der Patienten nicht beantwortet. Die Patienten gaben bei acht der 14 häufig nicht beantworteten Fragen Verständnisprobleme an. Bei einer Stichprobe von 257 zufällig ausgewählten Patienten wurden 281 gesundheitliche Probleme (1,1 pro Patient) entdeckt, die den Hausärzten noch nicht bekannt gewesen waren. Die Hausärzte gaben an, dass 16,4% dieser neuen Probleme eine Konsequenz hatten, vordergründig die physischen Probleme. Bemerkenswert war, dass die neu entdeckten psycho-sozialen Probleme keinerlei Konsequenzen hatten. Die Selbstausfüller-Version war praktikabel, nützlich und wurde von den meisten Patienten gut akzeptiert. Einige Fragen sollten hinsichtlich der Verständlichkeit überprüft werden. Weitere Studien müssen zeigen, warum einige neu entdeckte Probleme keine Konsequenzen hatten, ob diese Probleme gebessert werden können und ob es nötig ist, diese Probleme zu ermitteln. / The study was designed to evaluate the acceptance of the self-rated version of the Standardized Assessment of Elderly People in primary care in Europe (STEP) by patients and general practitioners, as well as the feasibility, comprehensibility, and usefulness in gaining new information. In all, 1007 of 1540 patients aged 65 and above, from 28 different Saxon general practices took part. We recognized that 96% of the patients were able to fill in the questionnaire by themselves. It took them an average of approximately 20 minutes to do so. Further analysis of 257 randomly selected patients identified 281 previously unknown problems (1.1 per patient). In the practitioners’ opinion, 16% of these problems, particularly physiological and mental ones, could lead to immediate consequences. Remarkably, newly identified psychosocial problems were not followed by any consequences. Fourteen of the 75 questionnaire items were not answered by more than 9% of the participants. Eight of the 14 frequently unanswered items were marked as difficult to understand by the patients. Altogether the self-rating version of the STEP was found to be feasible and useful. It was well accepted among patients; however, some questions need further review to improve their comprehensibility. Furthermore, it should be investigated why some identified problems do not have consequences and whether there is a need to record these issues at all.

The aim of this study is to describe situations that nurses experience as strenuous in their work with elders in institutional environment. The study focuses on the content and structure of the situations, meanings the nurses put in the situations and how they manage to handle the situations. The approach was to have a phenomenological perspective and a theoretical frame of reference in the CPT model  (CognitivePhenomenological-Transactional view) from Lazarus and Manet as well as inAntonovsky's discussion about the importance of general resistance resources against stressful events. The study is based on observations and interviews with five nurses working in three different institutions and in five different wards. The thesis states that factors in the work organisation such as lack of a common caring philosophy, ignorance of the nurses' role and function, communication problems with other organisations, imbalance between demands and resources are experienced as strenuous. Situations with pain and pain relieving, constant shouting from patients and  severe confusion were pointed out as particularly stressful in the interaction with patients. The nurses use a number of strategies in order to handle these strains, such as seeking social support, planned problemsolving, positive reappraisal and sometimes distancing. From an immediate perspective these strategi.es were efficient and the nurses were satisfied with their work.

Purpose LGBTQ patients experience marginalization and discrimination when seeking healthcare in the Southern Region of the United States. As a result, they experience negative healthcare outcomes. Collecting sexual orientation/gender identity (SOGI data) is vital in decreasing health disparities and improving hospitalized LGBTQ patients’ quality of care. Providers cannot adequately assess health risk factors or deliver culturally competent care without SOGI data knowledge. Aims The aim is to collect SOGI data during intake to implement a standard of care to promote LGBTQ health outcomes and decrease marginalization. Processes To understand how to provide high-quality care to LGBTQ patients, providers receive instruction on the importance of collecting SOGI data and cultural competency training using the Gay and Lesbian Medical Association (GLMA) guideline. After IRB determined the project as not research involving human subjects, SOGI data questions (your current gender identity is and describe your sexual orientation) were added to the EHR demographic health history section. Provider adoption of collecting SOGI data is measured by extracting data from the EHR. Results Results will determine the providers’ responsiveness to implementing SOGI data questions into the EHR. Limitations Provider having a choice of collecting SOGI data, the small sample size of providers, and the project’s location are limitations. Conclusions LGBTQ individuals have more health inequities and face marginalization when accessing healthcare. SOGI data collection is essential for assessing health risk factors, improving health outcomes, and creating a safe and inclusive healthcare environment for LGBTQ patients.

Objective: To determine the feasibility of an online cognitive behavioral therapy for insomnia (CBT-I) in bereaved older adults. Participants: The study participants include adults aged 55 and older (N = 30) that lost a loved one within the past five years and are currently experiencing symptoms of insomnia. Methods: This study used an experimental design and was guided by the Transitions Theory developed by Meleis. Descriptive statistics and t-tests were used to measure changes within and between groups. Experimental arm had the CBT-I online treatment and the control arm had attention controlled online tasks. Intervention fidelity was measured. Results: The online CBT-I intervention is a feasible intervention for bereaved older adults with insomnia. High retention rates were shown in both groups, and both groups’ insomnia and mood symptoms improved at post- study measurement. There were no statistically significant differences seen in any measure between groups. Conclusions: Transitions in older adult life includes loss of friends and family as well as development of sleep issues. The Transitions Theory is useful for informing the design of behavioral interventions in this older population. Further research is needed to understand how sleep can be improved by cost effective online interventions that might not include solely CBT-I.

No description available.

Current research in the field of geriatric audiology focuses on the audiological assessment and management. However there is a lack of published work describing the perspectives of the geriatric individuals with a hearing loss regarding the audiological service delivery received. This study aimed to determine the perspectives of the geriatric individuals with a hearing loss in this regard. Convenience sampling was utilised to recruit 50 geriatric individuals who wore hearing aids, in Gauteng. A two phase methodology was employed in this study. Phase one included a questionnaire aimed to determine the geriatric individuals’ perspectives of the audiological assessment and management processes conducted by the audiologist. Phase two, a focus group discussion regarding audiological service delivery, included 7 geriatric individuals who were randomly selected from the 50 geriatric individuals in phase one of the study. Results revealed that geriatric individuals with a hearing loss; perceived the audiological services received as adequate. However the results obtained from the questionnaire indicate that the majority of these geriatric individuals were not provided with a full test battery of assessment and management procedures as required. Therefore South African audiologists need to evaluate the assessment and management procedures used when working with the geriatric population. AFRIKAANS : Resente navorsing in die veld van geriatriese oudiologie fokus hoofsaaklik op oudiologiese evaluering en behandeling. Daar bestaan egter beperkte literatuur wat geriatriese individue met ‘n gehoorverlies se persepsies beskryf oor die proses van evaluering en dienslewering. Gevolglik was die doel van hierdie studie om geriatriese individue met ‘n gehoorverlies se persepsies aangaande oudiologiese dienste te bepaal. ‘n Twee-fase metodiek is in hierdie studie aangewend. ‘n Vraelys is in fase een gebruik om 50 geriatriese individue met ‘n gehoorverlies en wat gepas is met gehoorapparate, se persepsies aangaande oudiologiese dienslewering te bepaal. Sewe geriatriese individue het deelgeneem aan die tweede fase, naamlik ‘n fokusgroepbespreking aangaande oudiologiese dienslewering. Resultate dui daarop dat geriatriese individue met ‘n gehoorverlies die oudiologiese dienste wat hulle ontvang het as voldoende ervaar, Die meerderheid van die geriatriese individue het egter aangedui dat ’n.volledige oudiologiese toetsbattery nie tydens die evaluasieproses uitgevoer is nie en toepaslike gehoorapparaatevaluering- en passingsprosedures nie gevolg is nie. Die implikasies hiervan is dat oudioloë werksaam in Suid-Afrika die evaluering- en behandelingsprosedures wat toegepas word vir die geriatriese populasie, voortdurend moet evalueer en aanpas. Copyright / Dissertation (M. Communication Pathology)--University of Pretoria, 2009. / Speech-Language Pathology and Audiology / unrestricted

Al identificar una necesidad creciente de atención al adulto mayor, corroborada por estadísticas nacionales donde se estudian sus condiciones laborales, de salud, sociales, entre otras, se halló de suma importancia la creación de un espacio nuevo dedicado exclusivamente a la población adulta mayor en Lima, y que se diseñe específicamente para ellos, ya que los centros actuales son en su mayoría remodelaciones de edificios antiguos que originalmente tenían otros usos, y que por lo tanto la arquitectura no responde directamente a las funciones requeridas. Asimismo, este nuevo edificio deberá brindar los siguientes 4 servicios esenciales: alojamiento y servicios básicos de vivienda, atención médica geriátrica, zonas para el desarrollo de funciones cognitivas y psicológicas, y por último el diseño de zonas sociales y recreacionales. El proyecto busca por lo tanto reunir en un edificio los espacios necesarios para que las personas adultas mayores reciban, además de alojamiento, una atención integral y multidisciplinaria de triple aspecto: físico, mental y social; con la finalidad de promover en ellos hábitos saludables que aumenten su calidad de vida, sentido de pertenencia, salud mental y física y su reintegración con la sociedad. / By identifying a growing need for care for the elderly, corroborated by national statistics where their working, health, social, and other conditions are studied, the creation of a new space dedicated exclusively to the elderly population in Lima can be easily seen as of utmost importance. The building must be designed specifically for them, since the actual elderly centers spotted in Lima are mainly adaptations of old houses that originally had other uses, and therefore the architecture does not respond directly to the required functions. Likewise, this new building must provide the following 4 essential services: housing and basic housing services, geriatric medical care, areas for the development of cognitive and psychological functions, and finally the design of social and recreational areas. The project therefore seeks to gather in a building the necessary spaces for the elderly to receive, in addition to accommodation, a comprehensive and multidisciplinary care of triple aspect: physical, mental and social; with the purpose of promoting in them healthy habits that increase their quality of life, sense of belonging, mental and physical health and especially their re-integration with society. / Tesis

Bakgrund: Den äldre befolkningen ökar och fler drabbas av sjukdomen diabetestyp 2, detta påverkar deras hälsa och välbefinnande. Tidigare forskning visar attdiabetes påverkar äldres liv psykiskt och fysiskt. Personcentrerad vård ärbetydelsefullt för att uppnå bättre behandlingsresultat. Forskning om äldresupplevelser av livet med diabetes kan ge en ökad förståelse hos vårdgivaren vilketkan skapa bättre möjligheter till personcentrerad vård.Syfte: Att belysa äldres upplevelser av att leva med diabetes mellitus typ 2.Metod: Litteraturstudie som baseras på 11 kvalitativa studier. Datainsamling hargenomförts via databaserna PubMed och CINAHL. Inspiration har tagits frånGraneheim och Lundmans metod för innehållsanalysen.Resultat: Dataanalysen resulterade i tre teman och varje tema delades in i tvåsubteman; Känslomässig upplevelse (rädsla och frustration), upplevelse avständigt kämpande (mål och hälsa, motivation till behandling) och upplevelse avstöd från omgivning (mötet med sjukvårdspersonal, mötet med familj och vänner).Konklusion: Litteraturstudien har visat att äldres upplevelser av att leva medsjukdomen är negativa men positiva upplevelser framkommer också. Dessaupplevelser är individuella men likheter finns också och detta beror på olikafaktorer. Det finns få studier om äldres upplevelser av att leva med diabetesmellitus typ 2, därför anses personcentrerad vård viktig i behandlingen samt merforskning för ökad kunskap. / Background: The elderly population is increasing and more people suffer from thedisease type 2 diabetes, this affects their health and wellbeing. Previous researchshows that diabetes affects older people's life mentally and physically. Personcenteredcare is important for achieving better treatment results. Research onelderly people's experiences of life with diabetes could provide a betterunderstanding of the healthcare providers, which can create better opportunitiesfor person-centered care.Objective: To highlight elderly people's experiences of living with diabetesmellitus type 2.Method: A literature review based on 11 qualitative studies. Data collection wasconducted via PubMed and CINAHL. Inspiration has been taken from Granheimand Lundman's method for content analysis.Results: Data analysis resulted in three themes and each theme was divided intotwo subthemes; emotional experience (fear and frustration), experience ofconstantly struggling (goals and health, motivation for treatment) and theexperience of support from the surroundings (the meeting with the medical staff,meeting with family and friends).Conclusion: The literature has shown that older people's experiences of livingwith the disease are negative but positive experiences also emerged. Theseexperiences are individual but there are also similarities and this is due to variousfactors. There are few studies on elderly people's experiences of living with type 2diabetes mellitus, therefore person-centered care is vital in treatment and moreresearch for greater knowledge