The needs of lesbian, gay, bisexual and transsexual (LGBT) who are affected by dementia: a comprehensive scoping review

Purpose: Our aim was to undertake a comprehensive scoping review of the literature to explore the needs of people who identify as lesbian, gay, bisexual or transgender (LGBT) and are affected by dementia. Background: In the UK it is estimated that 850,000 people are currently living with dementia and this is expected to rise to over 1 million by the year 2025 with reports suggesting 5-7% of the population identify as LGBT. Evidence suggests that the LGBT population both delay in accessing healthcare and experience heteronormative services creating inequalities in experiencing good appropriate dementia care and support. There is a need to determine existing knowledge about the needs of the LGBT population who are affected by dementia in order to inform future practice, research and policy. Methods: Four databases were systematically searched along with article bibliographies. Only studies exploring LGBT populations and dementia were included, no further predetermined criteria was applied. Results: Of the 3737 papers identified 16 papers were included. The focus of studies ranged from an emphasis on LGBT partners and/or carers of people with dementia, staff and residents attitudes to LGBT people, and service provision and education around LGBT issues. Conclusion: Early findings indicate a need for a more open discussion about individual needs regarding sexuality and dementia, across all health and care settings regarding dementia care. There is some awareness of the LGBT population in long term care provision and their specific needs are beginning to be addressed, however education of policy providers, managers, staff and other residents is still required

Sexual orientation identity in relation to unhealthy body mass index:Individual participant data meta-analysis of 93 429 individuals from 12 UK health surveys

Background: Lesbian, gay and bisexual adults are more likely than heterosexual adults to experience worse health outcomes. Despite increasing public health interest in the importance of maintaining a healthy body weight, no study has considered sexual orientation identity (SOI) and unhealthy BMI categories among adults in the UK population. Methods: Individual participant data meta-analysis using pooled data from population health surveys reporting on 93 429 adults with data on SOI, BMI and study covariates. Results: Adjusting for covariates and allowing for between-study variation, women identifying as lesbian (OR = 1.41, 95% CI: 1.16, 1.72) or bisexual (OR = 1.24, 95% CI: 1.03, 1.48) were at increased risk of overweight/obesity compared to heterosexual women, but men identifying as gay were at decreased risk (OR = 0.72, 95% CI: 0.61, 0.85) compared to heterosexual men. Increased risk of being underweight was seen for women identifying as ‘other’ (OR = 1.95, 95% CI: 1.07, 3.56), and men identifying as gay (OR = 3.12, 95% CI: 1.83, 5.38), bisexual (OR = 2.30, 95% CI: 1.17, 4.52), ‘other’ (OR = 3.95, 95% CI: 1.85, 8.42). Conclusions: The emerging picture of health disparities in this population, along with well documented discrimination, indicate that sexual orientation should be considered as a social determinant of health

Dominant Modes Identification of Linear Systems via Geometrical Search

This paper presents a novel approach, based on the theory of hyperplanes, for mode identification of linear systems. The proposed approach can operate on either a set of ordinary differential equations (converted to diagonal form, if needed) or a set of partial fractions derived from a synthesized transfer function of the system under analysis. For either format, the linear system is structured to have as unknown variable a vector containing the residues. Singular value decomposition is initially used to identify an initial sparsity of the residue vector where the number of nonzero values corresponds to the pre-defined order of the dominant poles (eigenvalues) under search. An algorithm based on geometrical search of hyperplanes is used to optimize the selection of the nonzero residue locations, minimizing the residual of the zero residue hyperplanes. Finally, a recalculation of the residues is carried out by using the obtained optimal sparsity.acceptedVersio

The effects of social distancing and self-isolation during the COVID-19 pandemic on adults diagnosed with asthma: A qualitative study

This study aimed to explore how social distancing and self-isolation measures, aimed at protecting vulnerable groups from COVID-19, affected the wellbeing and physical activity levels among adults diagnosed with asthma. Twenty-seven participants took part across four online focus groups. Transcripts were analysed using thematic analysis. Participants reported becoming more health conscious due to being labelled as vulnerable. Their relationship with the severity of their asthma was altered and they reported making positive changes to increase their physical activity levels. Findings suggest there is a window of opportunity to engage with people diagnosed with asthma to promote beneficial lifestyle changes and self-management

Exploring the impact of dementia friendly ward environments on the provision of care : a qualitative thematic analysis

Dementia-friendly wards are recent developments to improve care for patients with dementia in acute hospitals. This qualitative study used focus groups to understand the impact of dementia friendly ward environments on nurses experiences of caring for acutely unwell patients with dementia. Qualified nurses and health care assistants working in an acute NHS Trust in England discussed their perceptions and experiences of working in a dementia-friendly ward environment. Four themes developed from the thematic analysis: (1) ‘It doesn’t look like a hospital’: A changed environment, (2) ‘More options to provide person-centred care’: No one size fits all, (3) ‘Before you could not see the patients’: A constant nurse presence and (4) ‘The ward remains the same’: Resistance to change. Recommendations and implementations for practice are discussed

The mental health of lesbian, gay, and bisexual adults compared with heterosexual adults: results of two nationally representative English household probability samples

BACKGROUND: Evidence on inequalities in mental health in lesbian, gay, and bisexual people arises primarily from non-random samples. AIMS: To use a probability sample to study change in mental health inequalities between two survey points, 7 years apart; the contribution of minority stress; and whether associations vary by age, gender, childhood sexual abuse, and religious identification. METHODS: We analysed data from 10 443 people, in two English population-based surveys (2007 and 2014), on common mental disorder (CMD), hazardous alcohol use, and illicit drug use. Multivariable models were adjusted for age, gender, and economic factors, adding interaction terms for survey year, age, gender, childhood sexual abuse, and religious identification. We explored bullying and discrimination as mediators. RESULTS: Inequalities in risks of CMD or substance misuse were unchanged between 2007 and 2014. Compared to heterosexuals, bisexual, and lesbian/gay people were more likely to have CMD, particularly bisexual people [adjusted odds ratio (AOR) = 2.86; 95% CI 1.83-4.46], and to report alcohol misuse and illicit drug use. When adjusted for bullying, odds of CMD remained elevated only for bisexual people (AOR = 3.21; 95% CI 1.64-6.30), whilst odds of alcohol and drug misuse were unchanged. When adjusted for discrimination, odds of CMD and alcohol misuse remained elevated only for bisexual people (AOR = 2.91; 95% CI 1.80-4.72; and AOR = 1.63; 95% CI 1.03-2.57 respectively), whilst odds of illicit drug use remained unchanged. There were no interactions with age, gender, childhood sexual abuse, or religious identification. CONCLUSIONS: Mental health inequalities in non-heterosexuals have not narrowed, despite increasing societal acceptance. Bullying and discrimination may help explain the elevated rate of CMD in lesbian women and gay men but not in bisexual people

A systematic review of the characteristics of interventions that promote physical activity in adults with asthma

Physical activity is promoted in the asthma population through pulmonary rehabilitation, but limited funding and facilities are available. This review aimed to examine the effectiveness of interventions that promote physical activity and identify the behaviour change techniques (BCTs) and other intervention components used. Five databases were searched, and 25 studies met the inclusion criteria. Interventions had a significant positive effect on physical activity, sedentary behaviour, quality of life and asthma symptoms. BCTs used across intervention and control groups were similar in studies that showed effects and those that did not. Future interventions should employ techniques that help to maintain behaviour change