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AIM: This study aims to investigate the possible association between digit ratio (2D:4D) and match-play success (MPS) in junior tennis players. In addition, we consider the possible explanatory pathways of these associations in relation to psychological, strength, power, and hormonal parameters. METHODS: We performed a cross-sectional study, with a sample comprised of 64 male junior tennis players (11-18 years old). Digit ratio was calculated from direct finger measurements. In addition, we measured the ratio of wins by number of matches played in 5 years of official competition (MPS), handgrip strength (HGS), standing long jump (SLJ), training (in weekly hours), and expertise (number of years in official competition). Salivary testosterone and cortisol levels were measured before and after physical "challenge" tests. RESULTS: The 2D:4D correlated negatively with HGS and SLJ. MPS was also negatively associated with 2D:4D, but was positively correlated to HGS, expertise, training, and self-confidence (SC). Multiple linear regression showed 2D:4D and expertise were associated with MPS (43%-54%). None of the physical, or hormonal variables tested explained the links between 2D:4D and MPS. CONCLUSION: Therefore, the specific fitness components influenced by prenatal androgenization that moderate sports success remain unknown. Future studies should explore the interaction of 2D:4D, with tennis exercises as a challenge to induce hormonal change, the effect of pubertal stage, and the influence of aerobic endurance in determining MPS.
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Tênis , Gravidez , Feminino , Humanos , Masculino , Criança , Adolescente , Força da Mão , Estudos Transversais , Dedos , Aptidão Física/fisiologia , Testosterona/metabolismoRESUMO
Objectives: The aim of this study was to explore unpaid carers' experiences of supporting people with dementia to use social media.Methods: Unpaid carers (n = 234) responded to an online survey about their attitudes towards people with dementia using social media and any experiences supporting this usage. Responses to closed questions were analysed using frequency analysis; qualitative data were analysed thematically.Results: Fifty-five carers (23.5%) cared for someone with dementia who used social media. Thematic analysis produced four themes: (1) carers as social media navigators; (2) social media supports care; (3) carers as social media guardians; and (4) labour-intensive work. Carers valued the social connectivity and stimulation social media provided but remained vigilant about online safety. They carefully managed the online experiences of people with dementia, balancing perceived benefits with safety, security, and caring demands.Conclusions: These findings shed light on the complexities of caring in the digital age. Many carers are supporting people with dementia in using social media, but there is little guidance on how best to do this. As older adults continue to embrace social media, carers, support organisations, and policymakers must adapt and work with technology developers to ensure safe and supportive online experiences.
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Cuidadores , Demência , Mídias Sociais , Humanos , Cuidadores/psicologia , Demência/enfermagem , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Adulto , Apoio Social , Pesquisa Qualitativa , Inquéritos e Questionários , Idoso de 80 Anos ou maisRESUMO
BACKGROUND: Technologies such as the Internet, smartphones, and sex toys have demonstrated the capacity to facilitate and enhance sexual and intimate practice by offering new ways to meet sexual partners, maintain and establish intimate connections, and providing access to sexual education and exposure to new ways of engaging in sex. They have also afforded novel risks to safety, privacy, and sexual autonomy. Understanding how people perceive and experience both the risks and benefits of using technology to facilitate sex and intimacy is important to understanding contemporary sexual practice, health, and pleasure. However, research in this space is currently hampered by a lack of quantitative measures to accurately and holistically assess both the risks and benefits in the context of technologised sexual practices. METHODS: To facilitate a nuanced quantitative exploration of these concepts, we present the psychometric properties of the newly developed Risks and Benefits of Technologised Sexual Practice Scale . RESULTS: Using an exploratory (Study 1, n =445) and confirmatory factor analysis (Study 2, n =500), this paper presents evidence for a 6-factor scale (Benefits (3): 'sexual gratification', 'connection', and 'access to information and culture'; Risks (3): 'concerns', 'worries', and 'knowledge of rights and ownership'). CONCLUSION: This scale may be used to contribute to research areas including sexual health, sexual behaviour, sexual education, online connection, online safety, and digital literacy with the aim to contribute to a sex- and technology-positive framework for understanding sexual health and pleasure.
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Comportamento Sexual , Parceiros Sexuais , Humanos , Orgasmo , Psicometria , Medição de RiscoRESUMO
PURPOSE: Twenty five percent of practicing physicians in the US are International Medical Graduates (IMGs) - physicians who completed their medical school training outside of the United States and Canada. There are multiple studies demonstrating higher socio-economic background is associated with medical school matriculation in the US. However, despite a substantial prevalence of IMGs in the American healthcare system, studies of the association between demographics, socio-economic background, and securing a residency position in the match are lacking. METHODS: We created a survey with questions on residency match-related data and information on personal socio-economic background. An invitation to participate in the study was sent to all IMGs that applied to the included residency programs after the conclusion of the 2022 residency match. We used multivariable logistic regression to compare survey responses to the odds of securing a residency match. RESULTS: The total number of survey respondents was 744 (response rate 15.1%). We found that younger age, higher United States Medical License Examination (USMLE) scores, higher-income country of origin (including the United States), fewer match attempts, applying to fewer specialties, having parents with college degree or higher, and coming from higher-than-average or lower-than-average family income were independently associated with increased odds of matching. Gender, personal income, and visa status did not demonstrate significant associations with residency match. CONCLUSIONS: Residency match is a significant expense for IMGs, especially for those from lower-income countries. International applicants from higher socio-economic backgrounds might have advantages in securing medical residency positions in the United States when controlling for other variables.
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Internato e Residência , Médicos , Humanos , Estados Unidos , Médicos Graduados Estrangeiros , Escolaridade , DemografiaRESUMO
Mild cognitive impairment is a prodromal phase of Alzheimer's disease and related dementias. Cognitive and/or neuropsychiatric symptoms that could worsen over time cause challenges for patients and romantic partners, who often assume the role of informal caregivers. Although physical activity is beneficial, older adults with mild cognitive impairment and their romantic care partners are generally physically inactive. Our 16-week study was performed to see whether physical activity together is feasible to increase physical activity among four dyads (individuals with mild cognitive impairment and their spouses). Our dyadic intervention was feasible given more than 70 % of participants self-reported adherence to physical activity based on the guidelines for adults in the United States. In exit interviews, togetherness was highlighted as one of the biggest strengths of this study. Future studies with more representative samples are needed, as well as adopting a more tailored approach that accounts for individuals' levels of physical fitness.
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Doença de Alzheimer , Disfunção Cognitiva , Humanos , Idoso , Estudos de Viabilidade , Disfunção Cognitiva/psicologia , Exercício Físico , Cuidadores/psicologiaRESUMO
We applied Andersen's Behavioral Model of Health Services Use to investigate the health needs and use of digital health resources among sexual and/or gender minority (SGM) caregivers. Data were from the Caregiving in the U.S. 2020 survey. Regression analyses were used to describe associations between predisposing, enabling, and need factors and usage of digital health resources. SGM caregivers provided more hours of care per week, reported higher levels of care intensity, and reported higher physical, emotional, and financial strain compared with non-SGM caregivers. Regression analyses indicated SGM status was a significant predictor of overall use of digital health resources. Younger caregivers, racial minority caregivers, those providing higher levels of care, and those reporting a poorer health status were more likely to use digital health resources. Digital health resources may be useful tools for SGM caregivers of older adults. More research is needed to investigate the reasons SGM caregivers use these resources.
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Cuidadores , Minorias Sexuais e de Gênero , Humanos , Idoso , Cuidadores/psicologia , Saúde Digital , Comportamento Sexual , Identidade de GêneroRESUMO
INTRODUCTION: Exposure to pesticides may be related to overweight and associated comorbidities. The aim of this work was to evaluate occupational exposure to pesticides, overweight and associated comorbidities among farmers in Southern Brazil. METHODS: This cross-sectional study included a random sample of 257 farmers, living in the municipality of Mafra and Planalto, southern Brazil. Data on pesticide use and overweight prevalence from farmers were collected using an in-person interview questionnaire, followed by blood collection and biochemical analyses. RESULTS: Pesticide exposure was positively correlated with body mass index, waist circumference, waist-to-hip ratio, triglycerides and glucose levels, presence of hypertension and metabolic syndrome. Besides that, the fact of being exposed to pesticides represents a decrease of no protein thiol groups. Furthermore, the main pesticides used by farmers have hepatic toxicity. CONCLUSION: These findings suggest that exposure to pesticides may be associated with overweight and associated comorbidities. Further studies are required to validate our findings and elucidate the specific mechanisms by which these pollutants contribute to the development of overweight.
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Exposição Ocupacional , Praguicidas , Humanos , Praguicidas/toxicidade , Fazendeiros , Estudos Transversais , Brasil/epidemiologia , Sobrepeso/epidemiologia , Sobrepeso/etiologia , Exposição Ocupacional/análise , AgriculturaRESUMO
BACKGROUND: Multiple anaphylaxis mediators have been demonstrated to provoke migraine-like attacks following intravascular infusion, suggesting that anaphylaxis could cause headache; however, headache is rarely noted in anaphylaxis and is not included among diagnostic criteria. OBJECTIVE: Our study objectives were to estimate the frequency of headache among prospectively enrolled emergency department (ED) patients with anaphylaxis and assess the association of headache with patient and anaphylaxis characteristics. METHODS: A cross-sectional study of ED patients aged ≥5 years who met anaphylaxis diagnostic criteria from January 8, 2020 to September 9, 2022 was conducted. The primary outcome of interest was headache frequency among patients who met at least one anaphylaxis criterion. We explored the association of headache with patient characteristics and anaphylaxis characteristics. RESULTS: We included 63 patients with anaphylaxis. In all, 17 (27%, 95% confidence interval [CI] 17%-40%) patients reported the presence of a headache. Female patients had more than a nine times increased odds of having headache (odds ratio [OR] 9.3, 95% CI 1.14-77.1, p = 0.016). Presentation with headache was associated with the presence of dyspnea (OR 5.5, 95% CI 1.56-19.7, p = 0.006). CONCLUSION: Headache in anaphylaxis may be more common than previously recognized, especially in females. Larger prospective studies are needed to characterize headache as a marker of neurological involvement in anaphylaxis.
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Anafilaxia , Transtornos de Enxaqueca , Humanos , Feminino , Anafilaxia/complicações , Anafilaxia/epidemiologia , Anafilaxia/diagnóstico , Estudos Transversais , Cefaleia/epidemiologia , Cefaleia/diagnóstico , Transtornos de Enxaqueca/diagnóstico , Serviço Hospitalar de EmergênciaRESUMO
Many lesbian, gay, bisexual, trans or gender diverse, or queer-identifying (LGBTQ) people provide informal support to peers experiencing mental ill health. This reflects both the high prevalence of mental ill health in their communities - often a product of discrimination - and barriers to accessing formal services. In this article, we explore how LGBTQ people who help peers with their mental health seek to cope with the stress of providing such support. Drawing on interviews with 25 LGBTQ people in Melbourne, Australia, we consider how community members being 'leant on' engage in self-care practices and seek help from their communities to cope with the stress of their support roles. We demonstrate that participants' ways of coping, even when similar, can vary in effectiveness and often come with limitations. Thus, we conclude that LGBTQ people providing informal support to peers should be better assisted to do so, in ways that acknowledge the diversity of support provided in LGBTQ communities.
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Saúde Mental , Minorias Sexuais e de Gênero , Feminino , Humanos , Comportamento Sexual , Bissexualidade/psicologia , Adaptação PsicológicaRESUMO
Many members of lesbian, gay, bisexual, trans and gender diverse, and queer (LGBTQ) communities provide informal mental health support to peers. This type of support is valuable for people who receive it - even helping to prevent suicide. It is also meaningful to those who provide it. In this article, we focus on how LGBTQ people derive meaning from their experiences of supporting peers. In-depth interviews with 25 LGBTQ people in Melbourne, Australia, indicate that those providing informal mental health support to fellow community members recognise their roles as meaningful in three main ways: in terms of self, relationships and communities. Recognising the meanings that LGBTQ caregivers derive from helping fellow community members provides useful information service providers and policymakers seeking to better address mental distress in LGBTQ communities and support caregivers. It is useful to understand this meaningful work in an LGBTQ context as caregiving that challenges gendered and heteronormative assumptions about what care is, and who provides it.
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AIMS: To explore whether gait and/or balance disturbances are associated with the onset of Alzheimer's dementia (AD) among older adults with amnestic mild cognitive impairment (MCI). DESIGN: This study employed a longitudinal retrospective cohort design. METHODS: We obtained data from the National Alzheimer's Coordinating Center's Uniform Data Set collected from 35 National Institute on Aging Alzheimer's Disease Research Centers between September 2005 and December 2021. The mean age of participants (n = 2692) was 74.5 years with women making up 47.2% of the sample. Risk of incident AD according to baseline gait and/or balance disturbances as measured using the Postural Instability and Gait Disturbance Score, a subscale of the Unified Parkinson's Disease Rating Scale Motor Score, was examined by the Cox proportional hazards regression models adjusting for baseline demographics, medical conditions and study sites. The mean follow-up duration was 4.0 years. RESULTS: Among all the participants, the presence or the severity of gait and/or balance disturbances was associated with an increased risk of AD. The presence or the severity of gait and/or balance disturbances was associated with a higher risk of Alzheimer's dementia among the subgroups of female and male participants. CONCLUSION: Gait and/or balance disturbances may increase the risk of developing AD, regardless of sex. IMPACT: Gait and/or balance disturbances among community-dwelling older adults with amnestic MCI may need to be frequently assessed by nurses to identify potential risk factors for cognitive decline. NO PATIENT OR PUBLIC CONTRIBUTION: Given the secondary analysis, patients, service users, caregivers or members of the public were not directly involved in this study.
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Doença de Alzheimer , Disfunção Cognitiva , Humanos , Masculino , Feminino , Idoso , Doença de Alzheimer/complicações , Estudos Retrospectivos , Disfunção Cognitiva/psicologia , Estudos Longitudinais , Marcha , Progressão da DoençaRESUMO
OBJECTIVE: To systematically review existing research exploring the effectiveness of psychological interventions in reducing symptoms of distress amongst refugee and asylum-seeker children. METHOD: Six databases were searched to identify English studies presenting original empirical quantitative data (published before September 2022) testing the efficacy of psychological interventions for children from refugee and asylum-seeking backgrounds. Quality of studies were assessed through the Appraisal Tool for Cross-Sectional Studies as well as the Cochrane Risk of Bias Tool. Relevant data were extracted to facilitate a narrative synthesis. RESULTS: Seventy-one eligible articles were identified (n > 10,000). A number of cognitive-behavioral, psychosocial, and trauma-focused interventions that catered specifically to children and their families were identified. A synthesis of these results suggest that interventions may assist in the reduction of various psychopathologies, although the effects were mixed across intervention types. CONCLUSIONS: While the review yielded promising findings, most findings were derived from small pilot and empirical studies, leading to difficulties with drawing conclusions. There remains a need for studies using more rigorous research methodologies to expand and ratify this valuable knowledge base. CLINICAL SIGNIFICANCE: Forced displacement is at an all-time high. Many children are being forced to seek asylum and refuge, and they become vulnerable to the development of poor mental health, with limited understanding surrounding how to appropriately intervene. This review aims to equip clinicians with increased knowledge and confidence in working therapeutically alongside clients from refugee or asylum-seeking background, with the goal of fostering positive mental health and wellbeing.
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Angústia Psicológica , Refugiados , Humanos , Criança , Refugiados/psicologia , Estudos Transversais , Saúde MentalRESUMO
The extent to which culture moderates the effects of need for approval from others on a person's handling of interpersonal conflict was investigated. Students from 24 nations rated how they handled a recent interpersonal conflict, using measures derived from face-negotiation theory. Samples varied in the extent to which they were perceived as characterised by the cultural logics of dignity, honour, or face. It was hypothesised that the emphasis on harmony within face cultures would reduce the relevance of need for approval from others to face-negotiation concerns. Respondents rated their need for approval from others and how much they sought to preserve their own face and the face of the other party during the conflict. Need for approval was associated with concerns for both self-face and other-face. However, as predicted, the association between need for approval from others and concern for self-face was weaker where face logic was prevalent. Favourable conflict outcome was positively related to other-face and negatively related to self-face and to need for approval from others, but there were no significant interactions related to prevailing cultural logics. The results illustrate how particular face-threatening factors can moderate the distinctive face-concerns earlier found to characterise individualistic and collectivistic cultural groups.
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Comparação Transcultural , Relações Interpessoais , Humanos , Conflito Psicológico , Negociação , IndividualidadeRESUMO
Prosociality is often considered as quintessential in coping with the threats of health emergencies. As previous research has suggested, prosocial behaviors are shaped by both dispositional factors and situational cues about the helping situation. In the present research, we investigated whether "bonding" types of prosociality, helping directed towards close others within one's social network, and "bridging" types of prosociality, helping directed towards vulnerable people across group boundaries, are predicted by basic individual values and threat appraisals concerning COVID-19. During the pandemic, we conducted a cross-sectional study in the US and India (Ntotal = 954), using the Schwartz value inventory and a multifaceted measure of threat assessment to predict prosocial helping intentions. After controlling for other value and threat facets, self-transcendence values and threat for vulnerable groups uniquely predicted both bonding and bridging types of prosociality. Furthermore, threat for vulnerable groups partially mediated the effect of self-transcendence on prosocial helping intentions: People who endorsed self-transcendent values were particularly concerned by the effect of the pandemic on vulnerable groups, and thus willing to engage in prosocial behaviours to help those in need. Our findings support the idea that prosociality is stimulated by empathic concerns towards others in need and underline the importance for future research to consider the broad spectrum of threats appraised by people during health emergencies. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-023-04829-1.
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Worldwide, it is estimated that around 50 million older adults have Alzheimer's disease and related dementias (ADRD). Cognitive deficits associated with ADRD may affect a driver's perception and decision-making and potentially cause safety concerns. Despite much research, there lacks a comprehensive cognitive evaluation to determine the driving capability of a person with ADRD and it is unclear what are the most effective training and interventions that help to enhance driving performance for these individuals. The purpose of this article is to conduct a comprehensive literature survey to review and summarize studies of driving performance evaluation and intervention for people with ADRD and discuss perspectives for future studies. Although many studies have investigated the correlations between driving behaviors and cognitive performances for people with ADRD, it remains unclear how driving behaviors and cognitive performances are associated with psychophysiological measures. We discussed the need to develop regular driving evaluation and rehabilitation protocol for people with ADRD. We also highlighted the potential benefit to combine driving tests with psychophysiological measures to assist in characterizing personalized cognitive evaluation in the behavioral evaluation process.
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Doença de Alzheimer , Disfunção Cognitiva , Idoso , Humanos , Doença de Alzheimer/psicologiaRESUMO
The number of diagnoses of developmental disorders is on the rise and the use of labels for developmental disorders, such as attention-deficit/hyperactivity disorder and autism spectrum disorder, is widening. Diagnostic labels can play an important role in helping those who display atypical behaviour and their caregivers to cope with associated challenges and, possibly, to get treatment. But these labels are increasingly contested and associated with a variety of harmful effects. In this paper, we analyze the role diagnostic labels can play in four different contexts (scientific, therapeutic, social, and administrative) and identify what various stakeholders stand to gain or lose with continued, expanded, or abolished use of those labels. Our analysis reveals labels serve different purposes in each of these contexts, benefitting different stakeholders. Any overall evaluation, critique, or defence of labels needs to consider the interests of all stakeholders in these contexts.
QUEM SE BENEFICIA DOS RÓTULOS DIAGNÓSTICO PARA TRANSTORNOS DO DESENVOLVIMENTO?: O número de diagnósticos de transtornos do desenvolvimento está aumentando e o uso de rótulos para transtornos do desenvolvimento, como transtorno de déficit de atenção/hiperatividade e transtorno do espectro autista, está se ampliando. Os rótulos diagnósticos podem desempenhar um papel importante para ajudar aqueles que apresentam comportamento atípico e seus cuidadores a lidar com os desafios associados e, possivelmente, a obter tratamento. Mas esses rótulos são cada vez mais contestados e associados a uma variedade de efeitos nocivos. Neste artigo, analisamos o papel que os rótulos diagnósticos podem desempenhar em quatro contextos diferentes (científico, terapêutico, social e administrativo) e identificamos o que várias partes interessadas podem ganhar ou perder com o uso contínuo, expandido ou abolido desses rótulos. Nossa análise revela que os rótulos atendem a diferentes propósitos em cada um desses contextos, beneficiando diferentes públicos. Qualquer avaliação geral, crítica ou defesa de rótulos precisa considerar os interesses de todas as partes interessadas nesses contextos.
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Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Espectro Autista , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Espectro Autista/diagnóstico , Criança , Deficiências do Desenvolvimento/diagnóstico , HumanosRESUMO
BACKGROUND: Food insecurity is a pressing public health problem. Lesbian, gay, and bisexual (LGB) people are at increased risk for food insecurity, yet this issue remains grossly understudied among this population. The purpose of this study was to add to the existing literature surrounding food insecurity and the use of federal food assistance programs (SNAP) among LGB people. METHODS: This study used publicly available, de-identified data from the 2017 National Health Interview Survey (NHIS). Primary variables were sexual orientation, food security status, and receipt of SNAP. Food security was assessed using the 10-item USDA Family Food Security measure. RESULTS: In our sample, people who identified as bisexual had the highest rates of food insecurity (23.8%, n = 76). Female sexual minorities were 52% more likely to experience food insecurity (aOR = 1.518, 95% CI 1.105-2.087, p = .01) and 44% more likely to report household SNAP assistance than their heterosexual counterparts (aOR = 1.441, 95% CI 1.025-2.028, p = .03). SNAP partially mediated the association between sexual orientation and food insecurity for LGB females. CONCLUSIONS: Our findings add to the growing empirical evidence documenting food insecurities among sexual minority adults. Our results reiterate the need for sexual orientation to be included in nationally representative federal food security measures.
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Homossexualidade Feminina , Minorias Sexuais e de Gênero , Adulto , Bissexualidade , Feminino , Insegurança Alimentar , Heterossexualidade , Humanos , Masculino , Comportamento SexualRESUMO
BACKGROUND: Digital technologies play a significant role in people's sexual and intimate lives via smart phones, cameras, dating apps and social media. Although there is a large body of research on the potential risks posed by these technologies, research on benefits and pleasures is limited. METHODS: This study explored digital sexual practices, including perceptions of risks and benefits among a sample of Australian adults (n =445). Data were collected in 2020 via an online survey. Descriptive and bivariate analyses were undertaken to identify significant relationships between demographic variables and the use of technologies in relation to perceived risks and benefits. The mean age of participants was 42 years, over half were women (58.5%) and identified as heterosexual (61.1%). RESULTS: Findings reveal that use of digital media was common in participants' sex lives and relationships; 60.3% of participants had viewed pornography online, 34.9% had used dating apps, and 33.9% had sent sexual or naked self-images to another person. Over one in three reported positive outcomes from this: 38.2% felt emotionally connected to their partners due to online communication; 38.0% agreed that digital technologies facilitated closer connections;however, the majority of participants were aware of potential risks associated with online sexual engagement, particularly non-consensual exposure of their sexual or naked images, with women expressing greater concern. CONCLUSIONS: Policy, legal and educational responses should be based on holistic understanding of digital sexual engagement, acknowledging the ways in which technologies can support sexual relationships while also building people's knowledge and capacity to manage risks.
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Internet , Comportamento Sexual , Adulto , Austrália , Feminino , Humanos , Masculino , Medição de Risco , Comportamento Sexual/psicologia , Parceiros SexuaisRESUMO
As the health care and well-being of sexual and gender minority (SGM; i.e., lesbian, gay, bisexual, and/or transgender or gender non-binary) people in the United States receive federal and local-level attention, SGM older adults and caregivers continue to be left out of important health policy and care conversations. The current article describes policy issues and affirmative strategies related to inclusive care practices among SGM older adults and caregivers. In addition to the broader policies considered related to health and well-being, we include a discussion of local-level policy strategies to mitigate discrimination and promote inclusive care for SGM older adults and caregivers. [Journal of Gerontological Nursing, 48(12), 6-15.].
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Enfermagem Geriátrica , Minorias Sexuais e de Gênero , Pessoas Transgênero , Feminino , Idoso , Humanos , Comportamento Sexual , Política de SaúdeRESUMO
The current article presents results of a scoping review of international research on the health and health care needs of sexual and gender minority (SGM) older adults. Electronic databases and related resources were used to identify empirical and review studies published during the past 10 years. We reviewed 33 peer-reviewed articles from 19 countries. Findings were organized using the SGM Health Disparities Research Framework, which highlights factors at individual, interpersonal, community, and societal levels that impact health. Overall, historic and current environmental factors, including stigma, discrimination, and social exclusion, played an important role in SGM older adults' health, health care access, and use of related aging and social services. There is a critical need for training and future research, and health professionals are needed to advance gerontological health and health care research and improve the health and care of SGM older adults globally. [Journal of Gerontological Nursing, 48(4), 13-20.].