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Background: People with intellectual disabilities can experience homelessness, and some of the reasons differ from the general homeless population. Specific policy and practice responses are required. Method: A systematic review of studies examining homelessness among people with intellectual disabilities utilizing CINAHL, MEDLINE, PsycINFO and Sociological Abstracts databases from inception to November 2019. Results: The search produced 259 papers, and following screening, a total of 13 papers were included in the review. The themes identified were (i) pathways into homelessness, (ii) experiencing homelessness and (iii) routes out of homelessness. Conclusions: People with ID become homeless due to multifactorial issues. The identification of people within homeless services and their care and support concerns remains challenging, impacting upon the provision of assessments, interventions, care and supports. Psychosocial assessments, interventions and supports are necessary to assist people with ID to leave homelessness.

Education programs can help families of trans young people to accept and support a trans family member. However, little has been written about the design and development of such programs. This article seeks to fill this gap in the literature by detailing the design and development of an education program for families of trans young people. A seven-step learner-centered, outcomes-based approach was used as the basis for program design and development. The process also included participatory elements throughout, including input from professionals, families, and trans young people in a consultation and evaluation process. This culminated in the development of an eight-module online education program. The approach presented in this article may be of value to anyone interested in developing an education resource for families of trans young people, and it would be recommended to consider how such an approach could be applied in a specific context. The program also provided an opportunity for involvement from professionals, families, and trans young people in the community, and it would be important for anyone working in the area to consider how such participation could be both enhanced and enabled.

Objective: The aim of this systematic review was to examine the research evidence concerning the views and experiences of people with intellectual disabilities regarding their participation in and the effectiveness of relationship and sex education programmes. Methods: A systematic search of relevant electronic databases was conducted using defined inclusion criteria. All papers reviewed were from October 1998 to October 2018. PRISMA guidelines were followed in the design and reporting of the systematic review. Results: A total of eight studies published in English were included in the review. Data were analysed and the key themes identified were (1) designing and developing relationship and sex education programmes, (2) participating in relationship and sex education programmes and (3) perceived benefits of relationship and sex education programme participation. Conclusion: This review identified that people with intellectual disabilities are accessing relationship and sex education programmes and appear to find them helpful. Further research is required to investigate the extent to which programmes impact on long-term behaviours that enable the development of sustainable relationships and reduce the unintended consequences of sexual activities. Implications for policy, practice and future research developments are discussed.

There is an increased interest in the experiences of youth who identify as trans* to promote individual human rights and provide socially inclusive health and social care. This scoping review aimed to explore the experiences of youth who identify as trans*. A full search of relevant electronic databases was undertaken from the years 2006 to 2016. The search resulted in 1,656 hits and following the application of rigorous criteria, 20 papers were included in the final review. Date extraction was executed by two of the authors and a quality assessment tool was used to review the papers. The data were analyzed, and the key themes that emerged included the following: stigma, discrimination, and mental health; family relationships and supports; educational concerns; health care experiences; and vulnerability and health risks. The findings from the review are discussed, and the implications for policy, research, education, and practice are highlighted.

In a contested Indo-Pacific region with a rising and assertive China militarily and economically, Australia must look beyond the US as the sole guarantor of its security. Australia realises the importance of maintaining the US–Australia alliance, but it must also seek other like-minded nations to ensure peace and prosperity in the region. The potential development of an enhanced Franco-Australian partnership in the Indo-Pacific presents a promising alliance against the backdrop of heightened US-China rivalry, concerns over maritime security, challenges to sovereignty and economic prosperity. Australia, as a small to medium nation in the South Pacific, must develop and expand its geostrategic partnerships. As Australia seeks to grow, expand or reinforce existing partnerships within a contested and competitive environment, the potential benefits of an enhanced Franco-Australian alliance in the Indo-Pacific are significant and worthy of careful consideration. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate a Health Service Executive (HSE) Foundation Programme in Sexual Health Promotion (FPSHP) with a specific emphasis on capacity building. Design: A mixed-method design using both quantitative and qualitative methods was used to collect the data. Setting: The FPSHP was delivered to staff working in health, education and community settings and was designed and facilitated by sexual health promotion staff who are part of the Irish HSE. Methods: A survey, designed by the researchers, as well as individual telephone interviews with past participants was used to evaluate the programme. Out of a possible 200 participants, 97 completed the questionnaire (response rate 49%), and a total of 22 telephone interviews were completed. Results: There was generally a high level of satisfaction with the FPSHP. Participants reported high levels of individual and intra-organisational capacity-building activities, but apart from networking, interorganisational capacity-building activities were reported less frequently and tended to be ad hoc in nature. Satisfaction with the programme was high and so was the perception of its sustained impact. Motivation, satisfaction with the programme and attending of further training were strong predictors of reported sustained impact. Conclusion: Capacity building in sexual health promotion was affected positively by participation in the programme. Nonetheless, a greater emphasis on capacity building at an inter-organisational level needs to be considered. It is recommended that participants need to be motivated, guided and supported in the use of strategies to achieve this.

Introduction: Internationally mental distress is more prominent in the LGBTI community than the general population. The LGBTIreland study was set up to take stock of this in the Republic of Ireland. This paper reports on the analysis of the transgender group with reference to minority stress theory and cognitive dissonance theory. Method: An online survey was conducted addressing several aspects of mental health and distress that received responses from all groupings (n = 2,264) among which 12.3% (n = 279) identified as transgender. The survey consisted of several validated tools to measure depression, anxiety, stress (DASS-21), coping (CSES), self-esteem (RSES), alcohol and drugs misuse (AUDIT) and a variety of questions addressing demographics, experiential aspects, coping and self-related factors. Data analysis focused on predicting mental distress using DASS-general (composite of depression, anxiety and stress). Results: Transgender participants reported higher levels of mental distress, self-harm, suicidal ideation and attempts, and lower levels of self-esteem in comparison with the LGB groups, as well as the general population. Hierarchical multiple regression showed that 53% of variance in mental distress could be predicted from reduced self-esteem, the experience of harassment and not belonging in school. Furthermore, mental distress was highest among younger participants, those who were 'not out', those who had self-harmed and used avoidant coping. There was no significant difference in distress levels among those who had sought mental health support and those who had not. Conclusions: To understand mental distress in transgender people, the minority stress model is useful when taking into account both adverse external (environmental) and internal (cognitive/emotional) factors. The cognitive dissonance mechanism is essential in outlining the mechanism whereby gender incongruence is associated with psychological discomfort, low self-esteem and high mental distress. [ABSTRACT FROM AUTHOR]

Poor physical and mental ill-health is experienced by many LGBTQ+ people, compounded by a reluctance to access healthcare services. This reluctance is attributed to experiences of heteronormative assumptions and negative attitudes encountered. Despite increasing recognition of the need to include LGBTQ+ health in undergraduate healthcare programmes, inconsistencies and gaps in content, skills development, and assessment are still apparent. The aim of the study was to identify LGBTQ+ health content within nursing and midwifery pre-registration programmes and identify education best practice and innovation. A mixed-methods study involving a quantitative and qualitative design was undertaken. The qualitative findings from a nursing perspective were extracted from the dataset for further detailed analysis and are reported in this paper. Information about the study and an online survey were distributed to 135 Schools of Nursing and Midwifery in the UK and Ireland. Individual semi-structured online interviews took place with academics. Qualitative data from 29 survey responses and 12 follow-up interviews were thematically analysed. Eight of the 12 follow-up interviews were held with nursing academics and following data analysis three themes emerged: (i) LGBTQ+ health across the lifespan; (ii) taking the initiative for LGBTQ+ health inclusion; and (iii) identifying and overcoming challenges. The findings highlight the endeavours by nursing academics to integrate LGBTQ+ health within pre-registration programmes to meet the education needs of students and the opportunity to develop curriculum content to address the needs and concerns of LGBTQ+ people across the lifespan. [ABSTRACT FROM AUTHOR]

Aims: To identify and synthesize the available evidence of youths with asthma and their experience of self‐management education. Design: Systematic literature review of qualitative studies with meta‐synthesis of findings. Data sources We searched five databases, CINAHL Complete, Embase, MEDLINE (EBSCO) PsycINFO, ASSIA and the Global Index Medicus (formerly the WHOLIS). Initial search in September 2019 and updated in July 2020 and July 2022. Review Methods: The systematic review was conducted in accordance with the JBI methodology for systematic reviews of qualitative evidence. Qualitative data were extracted, meta‐summarized and then meta‐synthesized. Results: Eighteen studies were identified for inclusion in this review and three themes were identified: The theory and practice gap, contemporary health‐seeking preferences and the psychosocial impacts of living with asthma. Conclusion: The needs of youths with asthma are specific and must be measurable against the change in asthma outcomes for this group. They have unmet self‐management educational needs that stakeholders, involved in their care and support, should address. Education and practice policy should focus on youth‐centric approaches. Through meaningful engagement with youths, stakeholders can identify their support needs, requirements and preferences to successfully underpin the theory and practice of self‐management education. Impact This review synthesized evidence of youths with asthma and their experiences of self‐management education, highlighting their specific self‐management information needs. The findings highlight several implications for healthcare professionals in education, practice and research. This age profile is under‐explored and further research into this population would work towards filling the theory and practice gap and highlighting the identified psychosocial issues faced by this group. [ABSTRACT FROM AUTHOR]

BACKGROUND: There are several tests recommended by the American Thoracic Society (ATS) to evaluate for airway hyper-responsiveness (AHR), one of which is methacholine challenge testing (MCT). Few studies have examined the correlation of baseline spirometry to predict AHR in MCT, especially in the younger, relatively healthy military population under clinical evaluation for symptoms of exertional dyspnea. The study aim was to retrospectively correlate baseline spirometry values with MCT responsiveness. METHODS: This study is a retrospective review of all MCT performed at Brooke Army Medical Center/Wilford Hall Medical Center over a 12-y period; all completed studies were obtained from electronic databases. The following parameters were analyzed from the studies: baseline FEV1, FVC, FEV1/FVC, mid-expiratory flow (FEV25-75%), FEV25-75%/FVC. Studies were categorized based on baseline obstruction, restriction, FEF25-75% lower limit of normal, and response to bronchodilator testing (if completed); these values were compared based on methacholine reactivity and severity. RESULTS: Methacholine challenge studies (n = 1,933) were reviewed and categorized into reactive (n = 577) and nonreactive (n = 1,356) as determined by ATS guidelines. The mean baseline FEV1 (% predicted) with MCT reactivity was 88.0 6 13.0% versus no MCT reactivity was 92.7 6 13.0% (P < .001). The mean baseline FVC (% predicted) was 93.1 ± 13.7% versus 95.3 ± 13.5% (P < .001). The mean baseline FEV25-75% (% predicted) was 80.0 ± 22.1% versus 89.0 ± 23.4% (P < .001). Based on partition analysis, methacholine reactivity was most prevalent with baseline obstruction, n = 115 (43%), and in the absence of obstruction, when the FEF25-75% (% predicted) was below 0.70, n = 111 (40%). The negative predictive value with normal spirometry was 73%. CONCLUSIONS: The analysis of baseline spirometry prior to MCT proved useful in the evaluation of exertional dyspnea in a military population. The presence of airways obstruction (FEV1/FVC < lower limit of the normal range) followed by a reduction in FEV25-75% < 70% predicted showed a positive correlation with underlying AHR. In patients with exertional dyspnea and normal baseline spirometry, the use of the FEF25-75% may be a useful surrogate measurement to predict reactivity during MCT and consideration for additional testing or treatment [ABSTRACT FROM AUTHOR]

The aim of this research was to assess the psychological effects of the novel coronavirus disease (COVID-19) on mental health nurses. An internet-based questionnaire that included the Impact of Event Scale-Revised (IES-R) and the Zung Self Rating Anxiety Score (SAS) was used to assess the impact of the pandemic on the wellbeing of mental health nurses in an Irish mental health service. Among the nurses surveyed (n = 161), 12% of the participants had an overall IES-R score from 24 to 32 indicating that posttraumatic stress disorder (PTSD) was a clinical concern, while 38% had an overall IES-R score >32 indicating that PTSD was a probable diagnosis. The mean SAS score that had been converted to anxiety index scores was 40.78 (SD = 9.25). The results showed that 30% of mental health nurses experienced anxiety levels from moderate to extreme. Overall findings confirm that mental health nurses are experiencing psychological distress as a result of working during the COVID-19 pandemic. Nurses who were <30 years of age or who were in their current roles for less than a year or were ward-based and worked full-time, were most likely to be affected. Working during COVID-19 has not been routine work practice and for a cohort of workers who are already under pressure, the sacrifice in terms of general well-being has been immense. The offer of individualized psychological support for mental health nurses working during the pandemic should be both practical in nature and flexible enough to meet individual needs. [ABSTRACT FROM AUTHOR]

Aim and objectives: The aim of this systematic review was to identify the views and experiences of fathers regarding their child's Autism Spectrum Disorder diagnosis. Background: The diagnosis of a child's Autism Spectrum Disorder may be a stressful experience, creating uncertainty for parents. There has been a limited research focus on the views and experiences of fathers in relation to the diagnosis of Autism Spectrum Disorder of their child. Design: A systematic literature review of quantitative, qualitative and mixed‐methods research studies. Data Sources: Academic Search Complete, CINAHL, MEDLINE and PsycINFO. Methods: From August to October 2020, two authors independently performed a systematic data extraction and appraised the studies using a recognised instrument. The PRISMA checklist was used in the review. Results: Nine papers met the inclusion criteria. Four themes emerged: (a) gradual recognition of developmental delay, (b) an emotional time, (c) coping and adaptation and (d) ongoing adjustments to the fathering role. Conclusions: Nurses and other professionals need to work collaboratively with fathers to improve their experiences and provide supports at the time of Autism Spectrum Disorder diagnosis. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Psychosocial interventions (PSI) are recognized and recommended internationally as they primarily focus on improving a client's mental health and preventing relapse.Limited qualitative studies focus on the similarities and differences on offering PSI in practice across many countries. What this paper adds to existing knowledge?: This manuscript provides readers with qualitative findings of mental health nurses' (MHNs) experiences of using PSI in practice and the need for regular clinical supervision to increase MHNs confidence and enhance the offering of PSI.MHNs want PSI guidelines for the offering of these skills to their client groups across practice settings.MHNs require work release from practice to attend supplementary training on PSI so that they can do their job adequately. What are the implications for practice?: This study sheds light on the similarities and differences on PSI in Irish mental health services. It also highlights what MHNs recognize as important for PSI to be implemented. Clinical supervision and the development of PSI guidelines are necessary so that MHNs feel confident delivering these skills. They also need ongoing work release from practice to attend supplementary PSI training to provide best evidence to enhancing client experiences and positive PSI recovery outcomes. Description: The paper will report on the interview data of trained MHNs' experiences of using PSI within the Irish context. This observational data will be reported elsewhere (Smyth et al. 2020—under review). Introduction: This research is conducted when the current reform of Irish mental health governance demands clarification of key psychosocial skills (PSI) required for mental health nurses (MHNs) to embrace recovery‐orientated ways of working. There is limited evidence about this important topic in Ireland and across countries. Aim: To explore PSI‐trained MHNs' experiences of using PSI within Ireland. Method: A multiple case study methodology was used and situated within an interpretive paradigm. Data were gathered using semi‐structured interviews with 40 PSI‐trained MHNs. Findings: Three overarching themes developed from the analysis. These included (a) PSI‐trained MHNs' understanding and use of PSI; (b) facilitating factors supporting the use of PSI by PSI‐trained MHNs; and (c) obstacles limiting the use of PSI by PSI‐trained MHNs. Discussion: MHNs recognize that regular clinical supervision is required to increase their confidence, along with PSI guidelines for the offering of these skills across practice settings. MHNs also need work release to attend supplementary training on PSI so that they can do their job adequately. Implications for practice: This study suggests that MHNs are often stuck between a rock and a hard place when delivering PSI in practice. MHNs need to be aware that this can affect client outcomes. Relevance statement: This research identified a gap in knowledge within the Irish context but also across the world on this important topic. MHNs need access to regular clinical supervision, PSI guidelines and ongoing PSI training to feel confident in order to keep abreast of the changes happening in mental health practice and research. [ABSTRACT FROM AUTHOR]

Induced disorder in graphene enables changes in electrical and thermal transport. It has been shown previously that disorder is very important for electron cooling in graphene through disorder-assisted electron-phonon scattering, particularly via the supercollisions process. Here we study electron-momentum relaxation due to electron-phonon scattering while increasing the degree of disorder. With in-situ scanning thermal microscopy we monitor the temperature rise in the constriction region of a bowtie-shaped graphene device while increasing the disorder by means of feedback-controlled voltage ramps at high-current densities. Analysis of the combined thermal and electrical measurements in the low bias regime shows that the relative change of the momentum scattering rate vs temperature, as measured at room temperature, increases with strong local disorder. By excluding other candidate mechanisms for this phenomenon, including a change of the charge carriers density and activation of optical phonons, we conclude that the increase we observe in the temperature-dependent component of the scattering rate is likely due to new acoustic phonon scattering channels that open up as disorder increases. [Display omitted] [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Bisexual people experience significantly poorer mental health and higher rates of self‐harm and suicidality than their gay, lesbian or heterosexual counterparts.Although little is understood about why these disparities exist, bisexual people have been found to have unique life experiences that separate them from other sexual minority groups.Despite these health disparities and unique experiences, in research and in clinical settings, bisexual people are often incorporated under the LGBTQI+ umbrella and their needs are not seen as being different to those of other sub‐groups. What the paper adds to existing knowledge?: This paper brings together the findings of the small but growing body of literature reporting on the psychosocial support needs of bisexual people.The findings reported on herein provide novel insights, collated and synthesized that will prove valuable to policy makers, service providers and researchers. What are the implications for practice?: This paper clearly illustrates that bisexual people experience significant barriers to accessing the support services they need and that current competent service provision for this population is severely limited.The findings presented in this paper shed light on the unique psychosocial needs of bisexual people and highlight the need for practice change to reduce barriers to service access and ensure inclusive and culturally competent care for this community. Introduction: Despite consistent evidence of poor mental health among what is a relatively large population group, research examining bisexual mental health remains sparse. Aim: To identify the psychosocial needs of people who are bisexual and establish factors that may support or inhibit access to appropriate psychosocial interventions and supports. Method: A qualitative evidence syntheses of the empirical evidence. Results: A total of 15 papers were included in the review. The PRISMA process was used. Following data analysis, four main themes emerged that were (a) experiences of being bisexual, (b) mental health experiences and concerns, (c) service access and responses and (iv) communities and supports. Discussion: Bisexual people have unique and specific psychosocial support needs that relate to, but are also different from, the needs of the broader LGBTIQ+ community. This study provides valuable insights into how future policy, practice, education and training and research can better address the needs of this highly vulnerable group. Implications for Practice: This study highlights the psychosocial complexities associated with bisexuality and provides evidence for the need for improvement in current support services to ensure inclusivity and culturally competent care. [ABSTRACT FROM AUTHOR]

Aim: To examine the experiences and support needs of homeless transgender people by synthesizing the existing evidence. Background: Transgender people face many challenges in society in terms of people's knowledge, understanding and acceptance of a person's gender identity. Evidence regarding the homelessness experiences and available supports to transgender people remains sparse. Methods: A systematic review was undertaken and included qualitative and quantitative studies. A total of twelve papers were included in the review, utilizing the PRISMA method. Methodological quality was evaluated using the Mixed Methods Assessment Tool (MMAT). Results: Following analysis, the themes that emerged were (a) pathways into homelessness, (b) experiences whilst homeless and (c) routes out of homelessness. Conclusion: It has become increasingly clear that the distinct needs of this group are complex and multifaceted. In order to adequately address the issues and concerns comprehensively, coordinated and effective collaborations need to be in place. Implications for nursing management: Clinical nurses need to recognize and respond to the distinct needs of trans homeless people. Nurse managers need to provide leadership to promote the needs of homeless trans people and ensure that policies and procedures are in place that are responsive to issues and concerns. [ABSTRACT FROM AUTHOR]

Aim: This study sought to explore the personal experiences of transgender people with Irish mental health services. Background: The transgender community have been identified as an underserved, under‐researched community in Ireland and abroad. While there has been a surge in research carried out with the community in recent years, there is little known about the personal experiences of Irish transgender people with mental health services. Method: Interpretative phenomenological analysis was used to inform data collection and analysis of semi‐structured interviews carried out with four research participants all identifying as transgender and having experienced accessing Irish mental health services. Results: Three themes emerged: affirmative experiences, non‐affirmative experiences and clinician relationship. Conclusion: Lack of information and non‐affirmative experiences are contributing to poor clinician–patient relationships with transgender populations and impacting attrition. Implications for Nursing Management: Nurse managers have a central role in supporting a transgender‐positive organisational approach to care by ensuring policies, care practices and the environment are supportive of sexual and gender expression by role modelling attitudes of respect and inclusivity. In order to provide appropriate and responsive services to transgender people, there needs to be in place strategies to enable the development of confident, competent and knowledgeable staff. [ABSTRACT FROM AUTHOR]

Aim: To explore the barriers to accessing mental health services in the Republic of Ireland from the perspectives of young LGBT + people aged 14–25. Background: Significant mental health disparities exist between LGBT + young people and their cisgender and heterosexual peers, yet they do not have equitable access to mental health services. Limited research has explored barriers, which exist for LGBTI + young people in accessing services, particularly from their perspectives. Method: An anonymous online survey design, consisting of closed and open questions, was used. The study was advertised through local and national organisations and media. 1,064 LGBT + participants aged 14–25 opted to complete the survey. Results: Most participants reported several barriers to them accessing mental health services that were interlinked across three levels: individual; sociocultural; and mental health system. Conclusion: Cultural competency training for practitioners, which address issues and concerns pertinent to LGBT + young people, is key to addressing many of the barriers identified. Implications for Nursing Management: Nurse managers can use the findings to advocate for practice and organisational change within their services to ensure that care and support is responsive and sensitive to the particular needs of LGBT + young people. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this paper is to report the specific views and experiences of lesbians and identify their distinct mental health issues and concerns. Design and methods: A mixed-methods design with surveys and individual interviews was utilized. The data were thematically analyzed. Findings: The key themes were (a) enabling service access, (b) person-centered support, (c) models of care, (d) community presence and participation, and (e) future aspirations for mental health services. Practice implications: The study results inform and develops the understanding of the issues that impact upon the mental health and well-being of lesbians. The implications for mental health practice are discussed. [ABSTRACT FROM AUTHOR]