Erosion of Meaning in Life: African Asylum Seekers’ Experiences of Seeking Asylum in Ireland

The narratives of 16 African asylum seekers indicated that the asylum system in Ireland eroded the various sources from which they could derive meaning in life (MIL). The endurance of a protracted asylum process, prohibition from entering the labour force and residence in institutionalized accommodation appeared to erode asylum seekers’ sense of self-efficacy, purpose, worth, value and belonging. Experiencing a cumulative erosion of all derivations of MIL appeared to inform asylum seekers’ appraisals that they were living a post-migratory life devoid of meaning and consequently reduced psychological wellbeing. Study findings warrant further investigation into the mediating role MIL may play in asylum seekers’ post-migratory mental health while also indicating that current and future responses to asylum seekers’ mental distress must be adequately cognisant of and actively address the socio-cultural and socio-political context that asylum seekers inhabit

A crucial role for interleukin (IL)-1 in the induction of IL-17–producing T cells that mediate autoimmune encephalomyelitis

It was recently demonstrated that interleukin (IL)-23–driven IL-17–producing (ThIL-17) T cells mediate inflammatory pathology in certain autoimmune diseases. We show that the induction of antigen-specific ThIL-17 cells, but not T helper (Th)1 or Th2 cells, by immunization with antigens and adjuvants is abrogated in IL-1 receptor type I–deficient (IL-1RI−/−) mice. Furthermore, the incidence of experimental autoimmune encephalomyelitis (EAE) was significantly lower in IL-1RI−/− compared with wild-type mice, and this correlated with a failure to induce autoantigen-specific ThIL-17 cells, whereas induction of Th1 and Th2 responses was not substantially different. However, EAE was induced in IL-1RI−/− mice by adoptive transfer of autoantigen-specific cells from wild-type mice with EAE. IL-23 alone did not induce IL-17 production by T cells from IL-1RI−/− mice, and IL-23–induced IL-17 production was substantially enhanced by IL-1α or IL-1β, even in the absence of T cell receptor stimulation. We demonstrate essential roles for phosphatidylinositol 3-kinase, nuclear factor κB, and novel protein kinase C isoforms in IL-1– and IL-23–mediated IL-17 production. Tumor necrosis factor α also synergized with IL-23 to enhance IL-17 production, and this was IL-1 dependent. Our findings demonstrate that IL-1 functions upstream of IL-17 to promote pathogenic ThIL-17 cells in EAE

Systematic review of educational interventions on older LGBT+ adults : recommendations for practice, education and research

Aim of the review: Research demonstrates that inequalities in outcomes on health and social wellbeing for LGBT+ older adults are perpetuated by a lack of inclusive services and cultural competence among the health and social care workforce. The aim of this review is to describe the educational interventions used to educate health and social care practitioners on the needs of older LGBT+ adults and the impact of such interventions on practitioners' knowledge, attitudes and competence. Search and review methodology: A systematic search of peer-reviewed papers published before February 2020 was conducted in the electronic databases MEDLINE, CINAHL, PsycINFO, EMBASE, ERIC, Social Sciences Full Text and Web of Science. The search resulted in a screening of 2509 papers with 9 matching the inclusion criteria which were rated using the MERSQI quality measure. Findings: Positive outcomes were demonstrated across the studies, especially an increase in knowledge. Increases in skills and attitudes was less evident, especially in studies using shorter and less diverse intervention designs. Findings suggest that interventions that incorporate diverse teaching strategies, especially interactive experiential activities such as storytelling and inclusion of LGBT+ older adults, leads to higher engagement, increased awareness and empathy in participants. Conclusions and implications: Professional and vocational education is an important tool to improve cultural competency. Findings suggest that educators need to diversify intervention contents, approach LGBT+ education from an interdisciplinary perspective and involve LGBT people in the design, delivery and evaluation of education. This may have a positive impact on transfer of learning into practice and provide a more sustainable approach in addressing LGBT+ ageing inequalities in practice settings. Findings also suggest that researchers need to develop more robust study designs such as randomized controlled trials and focus on the longitudinal effects of educational interventions, which could improve the quality of study designs. Ethical approval: Ethical approval was not necessary

Exploring the concept of resilience in older LGBT+ people : a mixed study systematic review

[Abstract not available

Defining and researching the concept of resilience in LGBT+ later life : findings from a mixed study systematic review

Within the literature, resilience is described as either a trait, an outcome or a process and no universal definition exists. A growing body of research shows that older LGBT+ adults show signs of resilience despite facing multiple inequalities that negatively impact their health and social wellbeing. The aim of this review was to examine how resilience is defined in LGBT+ ageing research and how it is studied. A mixed-study systematic search of peer-reviewed research papers published before June 2022 was conducted using the electronic databases CINAHL, Embase, Medline, PsycInfo, Social Science Database and Web of Science. This resulted in the screening of 7101 papers 27 of which matched the inclusion criteria. A quality appraisal was conducted using the Mixed Methods Appraisal Tool. Findings show that papers often lack a clear definition of resilience and application of resilience theory within the studies, although many of the papers conceptualised resilience as either a trait, process or an outcome. However, resilience was rarely the primary focus of the studies and was researched using a variety of measurement instruments and conceptual frameworks. Given the socioeconomic disparities, diverse social relations, histories of discrimination and stigma, and acts of resistance that have shaped the lives of older LGBT+ populations, resilience is a topic of growing interest for researchers and practitioners. Clear definitions of resilience and application of resilience theory could help improve methods used to study the concept and lead to more robust findings and the development of effective interventions. Greater clarity on the concept of resilience could also broaden the focus of research that informs policies and practice, and support practitioner training in resilience and the particular experiences of older LGBT+ adults

Self-Esteem Challenges of Nursing Students: An Integrative Review

Introduction: Self-esteem among nursing students is important in providing high-quality serviceto clients, yet each study in this field has described only a portion of existing relevant knowledge.Integrative review studies are the best practice for identification of existing nursing knowledge.The purpose of this study was to determine self-esteem challenges among nursing students. Methods: An integrative review was conducted in this study. The databases ProQuest, Medlineon PubMed, Science Direct, Google Scholar and Iran Medix were used for the review. The articleswere retrieved in three steps, including searching by search terms, reviewing the proceedingsbased on inclusion criteria and final retrieval and assessment of the available full texts. We used alist of keywords, including nursing, self-esteem and challenges and mixed them with "AND" and"OR" as a search strategy. Papers were included and eligible if they were associated with problemsrelated to nursing students’ self-esteem. Those studies that focused only on the self-esteem ofregistered nurses or patients were excluded. Search results were limited to the years 1960-2014. Results: Our findings showed three major challenges, including challenges associated withinconsistency in determining the level of students’ self-esteem, self-esteem associated challengesin professionalism of students, and the psychosocial challenges pertaining to the consequences oflow self-esteem. Conclusion: The findings suggest there is a need for more qualitative research to explore thefactors that contribute to self-esteem in nursing students with a particular focus on the factorsthat increase or decrease self-esteem. In addition, strategies to maintain and increase self-esteemneed to be designed, implemented and evaluated

Working with families affected by mental distress: stakeholders' perceptions of mental health nurses educational needs

Family and informal caregivers provide a substantial amount of care and support to people who experience mental health problems. The aim of this study was to explore mental health nurses’, students’ and service users’ perceptions of the knowledge, skills and attitudes that are required by mental health nurses to work with families and carers using a qualitative methodology. Three themes emerged from the data: Knowledge of the family and how mental distress affects the family; Working with the family – support and education and Valuing the role of the family. The three themes demonstrate the complexity of preparing mental health nurses to work with families and carers and the paper offers recommendations about how this might be achieved

Educating health and social care practitioners on the experiences and needs of older LGBT+ adults: Findings from a systematic review

Aim(s): To report review findings into interventions used to educate the health and social care workforce on the experiences and needs of LGBT+ older adults. Background: Research demonstrates that inequalities in outcomes on health and social well-being for LGBT+ older adults are perpetuated by the cumulative disadvantages from discrimination and social exclusion throughout the life course and a lack of culturally competent workforce. Methods: A systematic search of peer-reviewed papers published before February 2020 was conducted in electronic databases. The search resulted in a screening of 2,509 papers with nine matching the inclusion criteria, which were rated using the MERSQI quality measure. Results: Studies demonstrated some positive outcomes of interventions, especially an increase in knowledge, but less so in skills and attitudes. Discussion: More robust designs such as randomized controlled trials, the use of standardized measures and a focus more on the longitudinal impact of educational interventions could improve the quality of study designs. Conclusion(s): Diversification of intervention content and patient and public involvement in the design, delivery and evaluation of educational interventions could improve efforts and have a more sustained impact on LGBT+ ageing inequalities. Implications for Nursing Management: Nurse managers have important roles in supporting staff education and ensuring LGBT+ inclusive practice