Caring for LGBTQ+ nursing home residents in culturally appropriate and inclusive ways

Peer-Reviewed Publication

REGENSTRIEF INSTITUTE

INDIANAPOLIS – There have been few studies of LGBTQ+ older adults residing in nursing homes. A new article from faculty of Regenstrief Institute and Indiana University explores care of the growing number of LGBTQ+ older adults living in these facilities. The paper highlights the experiences and needs of this population, outlines best facility practices and presents valuable resources for culturally appropriate and inclusive care.

Social isolation, limited community supports, dementia, decreased functional abilities, economic limitations and delays in care are among the many reasons an LGBTQ+ individual is admitted to one of the more than 15,000 nursing homes in the United States.

“We think about younger LGBTQ+ individuals and the challenges and risks of their lifestyles, but older adults in this population are often forgotten,” said article corresponding author and geriatrician Jennifer Carnahan, M.D., MPH, M.A., of Regenstrief Institute and IU School of Medicine. “They’ve experienced many health disparities. As these accumulate over a lifetime, we see the potential long-term ill effects of being from a marginalized population.

“To better care for these individuals, who are at increased risk of needing professional care and support, in this paper we shed a light on what we can expect as LGBTQ+ individuals age and reside in nursing homes. More and more LGBTQ+ older adults are comfortable being out with their providers, while many living in nursing homes fear unwanted disclosure of their sexual orientation or gender identity status. Their autonomy should be respected either way so they can age in an environment where they feel safe, where they feel comfortable and where they are able to live with dignity.”

Nursing home residents rely on facility staff and clinicians for day-to-day functions, such as toileting, bathing and eating, as well as medical care. This need increases the vulnerability of members of the LGBTQ+ community. There is a paramount need, Dr. Carnahan notes, for facilities to provide a welcoming and inclusive culture for all residents.

She and article co-author Andrew C. Pickett, MSEd, PhD, of Indiana University School of Public Health – Bloomington, enumerate best practice recommendations to decrease LGBTQ+ residents’ vulnerability to negative outcomes occurring due to system failures or staffing issues compromising care. These recommendations focus on several areas including:

• sexual orientation or gender identity status
• medications
• social isolation
• inclusive culture
• staff training
• advance care planning/surrogate decision making.

Specific examples, notes Dr. Carnahan, might include facility celebration of Pride Month, relevant books in the resident library and time release for staff training.

Drs. Carnahan and Pickett also provide an extensive list of resources for individuals, families and nursing home facilities.

“Postacute care and long-term care for LGBTQ+ older adults,“ an invited article, is published in the peer-reviewed journal Clinics in Geriatric Medicine in a special issue on care for LGBTQ+ older adults. The work was supported by a grant to Dr. Carnahan from the National Institutes of Health’s National Institute on Aging [grant K23AG062797].

Jennifer L. Carnahan, M.D., MPH, M.A. 

In addition to her role as a research scientist with the Indiana University Center for Aging Research at Regenstrief Institute, Jennifer L. Carnahan, M.D., MPH, M.A., is an assistant professor of medicine at Indiana University School of Medicine.

About Regenstrief Institute

Founded in 1969 in Indianapolis, the Regenstrief Institute is a local, national and global leader dedicated to a world where better information empowers people to end disease and realize true health. A key research partner to Indiana University, Regenstrief and its research scientists are responsible for a growing number of major healthcare innovations and studies. Examples range from the development of global health information technology standards that enable the use and interoperability of electronic health records to improving patient-physician communications, to creating models of care that inform clinical practice and improve the lives of patients around the globe.

Sam Regenstrief, a nationally successful entrepreneur from Connersville, Indiana, founded the institute with the goal of making healthcare more efficient and accessible for everyone. His vision continues to guide the institute’s research mission.

About IU School of Medicine

IU School of Medicine is the largest medical school in the U.S. and is annually ranked among the top medical schools in the nation by U.S. News & World Report. The school offers high-quality medical education, access to leading medical research and rich campus life in nine Indiana cities, including rural and urban locations consistently recognized for livability.

About IU School of Public Health-Bloomington 

IU School of Public Health-Bloomington (SPH-B) is one of the largest schools of public health in the United States, offering top-ranked programs in a wide range of health-related fields. Accredited by the Council on Education for Public Health (CEPH), the school aims to promote health among individuals in Indiana, the nation, and the world through integrated multidisciplinary approaches to research and creative activities, teaching, and community engagement.

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JOURNAL

Clinics in Geriatric Medicine

DOI

10.1016/j.cger.2023.10.005 

ARTICLE TITLE

Postacute care and long-term care for LGBTQ+ older adults

Hungarian scientists prove that senescence can accelerate evolution

Peer-Reviewed Publication

ÖKOLÓGIAI KUTATÓKÖZPONT

The mystery of aging has fascinated people for millennia, with many willing to do anything to halt or reverse this process, because aging is typically associated with gradual deterioration of most body functions. While senescence is a natural part of life, biologists understand surprisingly little about the emergence of this process during evolution. It is not clear whether aging is inevitable, because there are organisms that seemingly do not age at all, moreover, the phenomenon known as negative aging, or rejuvenation, does exist: some turtles’ vital functions improve with age.

Researchers of the Institute of Evolution led by Academician Eörs Szathmáry have endeavoured to prove the validity of a previously proposed but still unproven theory of aging. The theory suggests that under the right circumstances, evolution can favour the proliferation of genes controlling senescence.

To test the hypothesis, the researchers used a computer model they had developed. This model is an algorithm capable of simulating long-term processes in populations of organisms and genes under circumstances controlled by the scientists. Essentially, with such models, evolutionary scenarios can be run, yielding results in a few hours rather than over millions of years. Modern evolutionary research would be inconceivable without computer modelling.

The fundamental question of the research was simple: Is there any meaning of aging? Does it serve any evolutionary function, or is it indeed a bitter and fatal by-product of life? “Aging can have an evolutionary function if there is a selection for senescence. In our research, we aimed to uncover this selection”, says Eörs Szathmáry. “According to classical explanations, aging emerges in the populations even without selection. That is because individuals would die sooner or later without aging as well (as a consequence of illness or accidents), therefore the force of natural selection in the population would get weaker and weaker. This creates an opportunity for the genes which have an adverse effect for chronologically old individuals (thus causing senescence) to accumulate. Which would mean aging is only a collateral consequence of evolution and has no adaptive function.”

During the last century, using different biological mechanisms, several evolutionary theories were formulated for the explanation of inevitable aging, which has no positive function. Several scientists accepted this assumption as fact, but when non-aging organisms were discovered, more and more researchers questioned the inevitability of senescence, and suggested perhaps aging could have some advantages as well.

“It has become accepted in the evolutionary biology community that the classical non-adaptive theories of aging cannot explain all the aging patterns of nature, which means the explanation of aging has become an open question once again”, says Szathmáry. “Alternative adaptive theories offer solutions for this problem by suggesting positive consequences of senescence. For example, it is possible that in a changing environment, aging and death are more advantageous for individuals, because this way the competition, which hampers the survival and reproduction of the more adaptable progeny with better gene compositions, can be decreased.”

However, this scenario holds true only if individuals are predominantly surrounded by their relatives. Otherwise, during sexual reproduction the non-aging individuals “steal” the better (that is better suited for changed environment) genes from the members of the aging population, and therefore the significant senescence disappears.

After running the model, the Hungarian biologists found that aging can indeed accelerate evolution. This is advantageous in a changing world because the faster adaptation can find the adequate traits more quickly, thereby supporting the survival and spread of descendent genes. This means that senescence can become a really advantageous characteristic and be favoured by natural selection.

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JOURNAL

BMC Biology

DOI

10.1186/s12915-023-01716-w 

METHOD OF RESEARCH

Computational simulation/modeling

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Directional selection coupled with kin selection favors the establishment of senescence

AVIAN 2SPIRIT ANDROGEN

Incredibly rare half-male, half-female bird spotted in South America

 Dec 13 2023
JOHN MURILLO

Extremely rare half female, half male Green Honeycreeper spotted by an Otago professor in rural Columbia.

It’s only the second such sighting in more than 100 years; a half-male, half-female bird.

Kiwi professor Hamish Spencer was holidaying in Colombia when his fellow bird watcher pointed to a distinct half green and half blue bird. He knew it was the most “unusual bird sighting in his life.”

Spencer, a Sesquicentennial Distinguished Professor in University of Otago’s Department of Zoology, was holidaying in rural Manizales of Colombia in January, when amateur ornithologist John Murillo pointed out wild Green Honeycreeper.

“It was a wow moment. It is a common bird in Columbia, but this 

phenomenon is incredibly rare. It has only been seen twice [in 100 years].”

The sighting was only the second recorded example of gynandromorphism [an organism that contains both male and female characteristics] in the species in more than 100 years.

Spencer said what made the bird unusual was that it exhibited typical male plumage on its right side and female plumage on the left.

A rare phenomenon called Bilateral Gynandromorphy is a condition in which one side of an animal/bird exhibits male characters and the other female.


JOHN MURRILO/SUPPLIED
The striking Green Honeycreeper has half green and half blue plumage – an extremely rare phenomenon in birds.

“Many birdwatchers could go their whole lives and not see a bilateral gynandromorph [an animal half him and half her] in any species of bird.

“The phenomenon is extremely rare in birds, I know of no examples from New Zealand ever.”

“I don’t expect to see one again in my life.”

Photographs of the bird make the discovery even more significant as they are “arguably the best of a wild bilateral gynandromorphic bird of any species ever”.

Professor Spencer explained gynandromorphs – animals with both male and female characteristics in a species that usually have separate sexes – were important for understanding of sex determination and sexual behaviour in birds.

JOHN MURRILO/SUPPLIED
Professor Hamish Spencer’s report on the find, only the second recorded example of gynandromorphism in the species in more than 100 years, has been published in the Journal of Field Ornithology.

He hoped the novel discovery would inspire people to “treasure exceptions” as they always revealed something interesting.

“Be always on the lookout for oddities – who will find the first New Zealand example of a bilateral gynandromorph in a bird?”

The finding was published in the Journal of Field Ornithology last Friday.

Extremely rare bird captured on film

Peer-Reviewed Publication

UNIVERSITY OF OTAGO

 

IMAGE: 

PHOTOS OF A BILATERALLY GYNANDROMORPHIC GREEN HONEYCREEPER NEAR MANIZALES, COLOMBIA, 20 MAY 2022. CREDIT: JOHN MURILLO

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CREDIT: CREDIT: JOHN MURILLO

A striking and extremely rare half female, half male bird has been spotted by a University of Otago zoologist.

 

Sesquicentennial Distinguished Professor Hamish Spencer was holidaying in Colombia when an amateur ornithologist John Murillo pointed out a wild Green Honeycreeper with distinct half green, or female, and half blue, male, plumage.

 

“Many birdwatchers could go their whole lives and not see a bilateral gynandromorph in any species of bird. The phenomenon is extremely rare in birds, I know of no examples from New Zealand ever.

 

“It is very striking, I was very privileged to see it,” Professor Spencer says.

 

Photographs of the bird make the discovery even more significant as they are “arguably the best of a wild bilateral gynandromorphic bird of any species ever”.

 

A report on the find, only the second recorded example of gynandromorphism in the species in more than 100 years, has just been published in the Journal of Field Ornithology.

 

Professor Spencer says gynandromorphs – animals with both male and female characteristics in a species that usually have separate sexes – are important for our understanding of sex determination and sexual behaviour in birds.

 

The main groups in which the phenomenon has been recorded include animal species which feature strong sexual dimorphism; most often insects, especially butterflies, crustaceans, spiders, even lizards and rodents.

 

“This particular example of bilateral gynandromorphy – male one side and female the other – shows that, as in several other species, either side of the bird can be male or female.

 

“The phenomenon arises from an error during female cell division to produce an egg, followed by double-fertilization by two sperm,” he explains.

 

He hopes the novel discovery will inspire people to “treasure exceptions” as they always reveal something interesting.

 

“Be always on the lookout for oddities – who will find the first New Zealand example of a bilateral gynandromorph in a bird?”

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DOI

10.5751/JFO-00392-940412 

ARTICLE TITLE

Report of bilateral gynandromorphy in a Green Honeycreeper (Chlorophanes spiza) from Colombia

Joanna (z-lib.org).pdf

DocDroid

https://www.docdroid.net › female-man-by-russ-joann...

The Female Man Joanna Russ CONTENTS • Part 1 • Part 2 • Part 3 • Part 4 • Part 5 • Part 6 • Part 7 • Part 8 • Part 9. This book is dedicated to Anne, ...

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Jul 8, 2020 — Female Man by Russ, Joanna (z-lib.org).pdf · Twitter · Facebook · Embed. Download.

(PDF) Joanna Russ: The Female Man | Jeanne Cortiel

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This article analyzes Joanna Russ's The Female Man (1975) within the frame of science-fiction genre and her feminist concerns. Being a science-fiction writer ...

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This article analyzes Joanna Russ's The Female Man (1975) within the frame of science-fiction genre and her feminist concerns. Being a science-fiction ...

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PDF | The present article focuses on Judith Butler's theory of 'gender performativity' and its application to Joanna Russ's science fiction, The Female.

Daily singing workout keeps songbird males attractive

Peer-Reviewed Publication

UNIVERSITY OF SOUTHERN DENMARK

Every year in the Christmas season it becomes clear again that some people are amazingly skilled singers, like Mariah Carey and George Michael. Their singing can stir strong emotions.

Singing involves probably the most complex, and mostly hidden, movements humans and animal can make. To become a good singer, you need to learn how to coordinate the movements of hundreds of muscles in your body with extreme precision. Therefore, you need a lot of talent, and practice.

We all know that athletes invest a lot of time exercising their limb and body muscles, but how about training the muscles in your voice box?

“Surprisingly we know very little about effects of exercise on these muscles and if they even react to training in humans,” says Professor Coen Elemans from the University of Southern Denmark, expert on sound production, “No singer will let you come even near their precious voice box”.

Now a new study in the prestigious journal Nature Communications reports that male songbirds need to sing daily to exercise their vocal muscles and produce pretty songs. And the females notice if they didn’t.

 “Singing is crucial for songbirds. They sing to impress future partners, to defend their territories and to maintain social bonds,” says Dr. Iris Adam, lead author of the study.

The researchers show that training is necessary to keep songbird vocal muscles at top performance. And it is not just any training, it specifically is singing exercise that matters.

The study was conducted by an international team of researchers from the University of Southern Denmark, Leiden University, University of Umea and the University of Vermont and was led by Assistant Professor Iris Adam and Professor Coen Elemans at the Department of Biology University of Southern Denmark.

Vocal muscles need exercise, too

“It has long been known that songbird singing is controlled by fast vocal muscles, but until now we only had very little knowledge if and how these muscles might respond to exercise, like our leg muscles do”, says Iris Adam.

In their study, the researchers show that if songbirds don’t use their vocal muscles at all, they get much slower and weaker already within days. But even when the birds only skip singing, after 7 days the vocal muscles already lost 50% of their strength.

“This was very surprising”, says Dr. Adam, “First that these muscles reacted so strongly, but also how incredibly fast they lost performance. Indeed, it’s use it or lose it!”

Partners can hear the difference

When analyzing the songs sung, the team found that the birds sang differently before and after exercise.

“You and I could barely hear a difference between the songs, but we saw clear effects when we analyzed our song recordings”, says Dr. Adam.

As the ultimate test if this difference was important to the birds, the team next played songs to female zebra finches to ask them if they could hear a difference between before or after exercise, and which song they liked more.

"The female zebra finches in the playback experiment could directly hear the difference and 75 percent preferred the songs from the well exercised male", says Katharina Riebel, author on the study and expert in animal behaviour. 

The daily dawn chorus, an alternative explanation

“Interestingly, these results provide an alternative reason why birds sing so much and every day”, says Elemans.

Around the world, in spring and summer time, birds sing every morning in the daily dawn chorus. Why they do this is still puzzling to scientists.

“A lot of that singing seems out of context. They sing when they don’t need to,” says Adam.

“Our results now show that if they don’t exercise every day, their muscle performance decreases”, says Elemans, “On top of that, the lack of exercise is audible in their song and the females prefer song from exercised males”.

Thus, songbirds may need to invest lots of time and energy in singing every day to remain attractive.

And this may be true for all animals.

Vocal muscles need training programs different from leg muscles

When studying the zebra finch vocal muscles, the team made another very important discovery.

“When we humans go to the gym to exercise leg and arm muscles, they typically get slower with exercise,” says Per Stål, author on the study and expert in muscle exercise physiology in humans.

However, in songbirds vocal muscles don’t get stronger and slower with exercise, like limb muscles, but weaker and faster. This is opposite from normal limb and body muscles.

“This reversed training may be a unique feature for vocal muscles, that we think might be true for all vertebrates, including humans, because all vocal muscles are developmentally related”, says Iris Adam.

“Therefore, these findings can have major consequences for speech therapy and vocal training in humans”, says Coen Elemans.

Because it’s so challenging to study the physiology of human larynx muscles, therapeutic intervention is based on what we know from exercise physiology of leg muscles.

“However, training vocal muscle may thus work very differently”, says Elemans, adding that “Songbirds may be our best allies to study the physiology of vocal muscle to further improve voice training and rehabilitation in humans”. 

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JOURNAL

Nature Communications

DOI

10.1038/s41467-023-43592-6 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

n/a

ARTICLE PUBLICATION DATE

12-Dec-2023