"Without Compassion We Don't Have a Social Work Field": A Thematic Analysis Exploring Social Workers' Experiences with Compassion

PURPOSE

Evidence establishing the importance of compassion in the context of social work practice is emerging. Compassion, stemming from the Latin words com and pati, means to suffer with. Given the proximity social workers have to vast experiences of suffering, compassion may play a central role in providing meaningful care to individuals, communities, and systems. The purpose of this qualitative study was to explore social workers' definitions of and experiences with compassion.

METHOD

Participants included 12 social workers working across levels of practice in two Midwestern states in the United States. Data were collected via semi-structured interviews.

RESULTS

Thematic analysis demonstrated three themes present in the data. Consistent with previous conceptual scholarship, the findings illustrated that compassion is a central component of social work practice. Additionally, results from the study demonstrated that social workers find compassion to be an imperative component of ethical practice and suggested that both barriers to and facilitators of compassion are present across levels of social work practice.

DISCUSSION AND CONCLUSION

This study adds to the growing body of social work scholarship exploring compassion and highlights implications for the social work discipline across levels of practice to more overtly center compassion in education, practice, and policy. Further research is needed to better understand multilevel barriers to compassion and develop strategies for overcoming them. Moreover, additional research is needed to holistically understand how to leverage and build upon the facilitators of compassion identified by participants in order to foster compassionate social workers, social work organizations, and systems.

Context-dependent sexual changes during women's midlife transitions

For women, midlife represents an important stage of transition, including shifts in physiological, social, and sexual experiences. Prior research demonstrates that women's sexuality is more dynamic and context-dependent than men's. Most research focused on women's sexuality in mid- to later-life emphasizes physiological changes, while largely ignoring changes stemming from social, psychological, and relational contexts. The present study examined midlife women's diverse sexual experiences within the context of their lives. We conducted semi-structured interviews with 27 women, ages 39-57, and used interpretative phenomenological analysis to investigate perceptions and interpretations of midlife sexual experiences and changes. Themes included changes in sexual engagement, unwanted sexual experiences, body image, and sexual healthcare. Participants reported changes in the frequency of sex and sexual desire within the context of their diverse social roles and identities, prior intimate relationships, and sexual health. Women contrasted perceptions of their own bodies with societal perceptions of sexiness. Frequently reported negative experiences with sexual healthcare informed a distrust of healthcare systems. The diverse and changing nature of participants' experiences supports prior evidence of sexual fluidity and context-dependence. By questioning societal expectations around sexuality and body image, participants illustrated the potential of counternarratives to combat dominant beliefs and stereotypes about midlife women's sexuality. To improve sexual health and education, psychoeducational interventions for women in midlife are needed.

Stress and Resilience among Sexual and Gender Diverse Caregivers

Little is known about caregiving outcomes of sexual and gender diverse, including LGBT, caregivers. Informed by the Health Equity Promotion Model (HEPM) and Pearlin's Stress Process Model, we utilized data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS), to examine perceived stress among a sample of 754 sexual and gender diverse caregivers using regressions on background and caregiving characteristics and risk and protective factors. Among caregivers, 38% were providing care to a spouse or partner and about one-third to a friend (29%). Higher stress was associated with younger age, lower income, higher education, partner/spouse care, personal care provision, longer caregiving hours, and caregiver cognitive impairment. After including the risk and protective factors from HEPM, victimization, social support, and community engagement significantly predicted perceived stress. Findings contribute to emergent research on caregiving in diverse populations.

"Courage to cobble something new": Women's queer and creative narratives of bisexuality and ageing

Critical gerontologists have called for more diverse and inclusive visions of a good old age, and especially for imaginings that do not depend on health, wealth and heterosexuality. They have suggested that LGBTQ people, alongside other marginalized groups, may have particular contributions to make to the project of reimagining ageing. In this paper, we bring together this work with Jose Muñoz's concept of 'cruising utopia' to examine possibilities for imagining a more utopian, queer life course. We present findings from a narrative analysis of Bi Women Quarterly, a grassroots online bi community newsletter with an international readership, analyzing three issues published between 2014 and 2019 that focused on the intersection of ageing and bisexuality. We found several ways in which the authors told counter-narratives that queered normative visions of successful ageing. They queered norms around the stability and reification of sexual and gender identities. They challenged current forms of LGBTQ activism. They embraced and celebrated ageing, through such activities as croning ceremonies, and directly addressed and contemplated death. Finally, they queered the narrative form, by giving accounts of personal experience that were dreamlike, poetic or inconclusive. We conclude that counter-normative spaces, such as activist newsletters, offer valuable resources to progress the wider project of reimagining successful ageing more inclusively.

A qualitative exploration of caregivers' experiences with the Attachment and Biobehavioral Catch-up (ABC) parenting program

In the face of childhood adversity, services and interventions can improve a child's life trajectory by promoting healthy development, enhancing protective factors, and building resilience through stable and supportive relationships. One such service, a specific and highly researched home visiting intervention, Attachment and Biobehavioral Catch-up (ABC), is often provided to families through home visiting service programs. This qualitative descriptive study examines the experiences of caregivers (N = 18) who received ABC as part of a statewide early childhood initiative in one midwestern state. Participants provided insight into the context of their lives before and during the intervention. They described their perspectives of the utility of the program and its influence on their family's behaviors and interactions. Findings demonstrate that coaching support bolstered caregivers' confidence in effective strategies and guided them through caregiving challenges. Caregivers observed growth in their caregiving practices, their infants' and young children's social and emotional skills, and their dyadic caregiver-child relationships, demonstrating the benefits of participating in and completing the ABC intervention.

"Weight of the World" and "I Want Them to Know": Skilled Nursing Facility Administrators' Perspectives on COVID-19 in Research Poems

COVID-19 has had a drastic, long-lasting impact on skilled nursing facilities (SNFs), forcing communities to continuously adapt to rapidly changing guidelines, restrictions, and challenges. In spring 2020, we conducted a sequential mixed-methods study with administrators of SNFs in the Midwest to understand the experience of administrators, staff, and residents during the pandemic. We collected 60 surveys with open-ended items related to the impact of the pandemic on communities as a whole, staff, and residents. Survey findings informed supplemental interviews with six administrators working in diverse regions. Due to the affective nature of the data, we present the findings in two found poems, which emphasize the lyrical, emotional, and poignant aspects of the participant voices. The first poem, Weight of the World, captures the struggle to adapt during the transition into the pandemic and its negative impacts on the lives of residents and their families. The second, I Want Them to Know, describes the resiliency with which administrators and staff responded to adversity while maintaining motivation to continue the work in the midst of unprecedented challenges. The two poems offer contrasting or balancing narratives of struggle and survival during the pandemic era.

POLICIES AND PERSPECTIVES AROUND SEXUAL ACTIVITIES AMONG RESIDENTS WITH COGNITIVE IMPAIRMENT OR DEMENTIA IN LTC

Many older adults remain sexually interested and active in later life. However, little is known about how sexual policies and practices in skilled-nursing facilities (SNF) address sexual activities of residents with cognitive impairment and dementia. This study seeks to identify the current sexual policies and staff’s perspectives related to residents with cognitive impairment or dementia in SNFs in Kansas. Online surveys and mailed surveys were distributed to administrators from all 364 SNFs in Kansas in June 2020. 60 long-term care facilities (16.5%) answered the survey. Of 60 survey respondents, 22 facilities (36.7%) have a policy addressing sexual expression and 19 of those policies (94.7%) address issues related to cognitive impairment, competency, or dementia. 77.4% had trained their staff on the impact on sexual expression for those with cognitive impairment or dementia once or more than once during the past year. 73.3% of administrators stated that their staff would respond differently to sexual expression among individuals with dementia or cognitive impairment compared to other residents, often noting issues related to consent and capacity. 55.2% reported any sexual expression among residents with dementia within the past year. Findings indicated that there is a lack of overall sexual policies, but those that exist are likely to address residents with cognitive impairment or dementia. Although there is evidence of training and attention to issues related to sexual expression in individuals with dementia or cognitive impairment, there is a need for further efforts to establish practice norms and policies around more complex or nuanced situations.

IMAGINING QUEER FUTURES BEYOND BOUNDARIES: A NARRATIVE ANALYSIS OF CREATIVE WRITING

Scholars have called for “queering aging futures” beyond normative assumptions or scripts (Sandberg & Marshall, 2019), which is well-aligned with queer theory’s Cruising Utopia which suggests “cruising ahead” toward a queer utopian future that is not yet possible (Muñoz, 2009). Due to emphasis on form rather than content, narrative analyses enable the reimagining of queer futures not bound by material realities. This study presents a narrative analysis of 40 pieces of creative writing in Bi Women Quarterly (BWQ) that examine aging. Authors used writing to queer stories of relationships, activism, and aging. Many used incoherent, non-linear, and dreamlike or omnipotent storytelling to queer narratives, allowing them to “cruise” across time and versions of themselves, imagining futures that were new and unscripted. Narrative analysis allowed researchers to examine choices authors made in taking agency through storytelling. Findings indicate that queer people are well positioned to queer expectations of successful old age.

CONTEXT-DEPENDENT SEXUAL CHANGES DURING WOMEN’S MIDLIFE TRANSITIONS

For women, midlife represents an important stage of transition, including shifts in physiological, social, and sexual experiences. Prior research demonstrates that women’s sexuality is more dynamic and context-dependent than men’s. Most research focused on women’s sexuality in mid- to later-life emphasizes physiological changes, while largely ignoring changes stemming from social, psychological, and relational contexts. The present study examined midlife women’s diverse sexual experiences within the context of their lives. We conducted semi-structured interviews with 27 women, ages 39-57 and used interpretive phenomenological analysis to investigate perceptions and interpretations of midlife sexual experiences and changes. Themes included changes in sexual engagement, unwanted sexual experiences, body image, and sexual healthcare. Participants reported changes in frequency of sex and sexual desire within the context of their diverse social roles and identities, prior intimate relationships, and sexual health. Women contrasted perceptions of their own bodies with societal perceptions of sexiness. Frequently reported negative experiences with sexual healthcare informed a distrust of healthcare systems. The diverse and changing nature of participants’ experiences supports prior evidence of sexual fluidity and context-dependence. By questioning societal expectations around sexuality and body image, participants illustrated the potential of counternarratives to combat dominant beliefs and stereotypes about midlife women’s sexuality. To improve sexual health and education, psychoeducational interventions and improved training for healthcare professionals are needed.

Representations of older adults in COVID-related newspaper articles: A comparison between the perspectives of older and younger adults

During the COVID-19 pandemic, media sources discussed diverse perspectives on aging and older adults, providing opportunities to examine representations of older adults during times of crisis. This study aims to explore representations of older adults during the first month of the pandemic in the U.S. by comparing the perspectives of older and younger adults in national newspapers. A systematic search identified 115 articles published in four major newspapers in the U.S. between March 11 and April 10, 2020, in which older and younger adults were quoted on topics related to the intersection of COVID-19 and aging. Quotes were inductively reviewed using content and thematic analytic strategies. A total of 265 quotes were identified from older adults (n = 104, 39%) and younger adults (n = 161, 61%). We identified three primary themes: impacts on "vulnerable" older adults, debates over the value of older adults' lives, and a counternarrative of resiliency. Older adults were represented as a vulnerable group during the pandemic, in need of protection and support, while debates over the value of their lives similarly evoke images of frailty and dependency. Such depictions frame older adults as a burden on society and reduce their agency and subjectivity. Ageist biases were not only present in quotes from public figures and professionals, but also evident in quotes from older adults themselves. However, older adults also spoke to their own resiliency, survival, and strengths, thereby positioning themselves as elders worthy of respect and able to share wisdom with younger generations. These findings highlight the importance of listening to older adults' voices in order to understand their experiences from their own perspectives through their own agentive positioning and promoting intentionally age-positive and nuanced representations of older adults in public discourse.

Key Determinants of Physical and Psychological Health-Related Quality of Life over Time among Midlife and Older LGBTQ and Sexual and Gender Diverse Caregivers

Background and Objectives

Prior research has shown informal caregiving among older adults can negatively impact the caregiver’s physical and psychological health. However, little is known about protective and risk factors associated with the health-related quality of life (HRQOL) of lesbian, gay, bisexual, transgender, and queer (LGBTQ) caregivers.

Research Design and Methods

Informed by the Health Equity Promotion Model and Caregiver Stress Process Model and utilizing longitudinal data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study, this analysis examined modifiable risk and protective factors associated with psychological and physical HRQOL over time among 754 LGBTQ caregivers aged 50-98.

Results

Psychological and physical HRQOL declined over a three-year period. After controlling for background characteristics, mastery, social support, socialization, LGBTQ community engagement, and physical activity were positively associated with psychological HRQOL while day-to-day discrimination, identity stigma, and insufficient food intake were negatively associated. Steeper declines were observed for older and with no physical activity. Mastery, social support, socialization, and physical activity were positively associated with physical HRQOL while day-to-day discrimination and insufficient food intake were negatively associated. Steeper declines were found for those with high mastery and no physical activity.

Discussion and Implications

Although generalized factors including mastery, socialization, and social support, are protective for HRQOL among LGBTQ caregivers, factors including day-to-day discrimination and identity stigma are more unique to historically disadvantaged populations and should be considered in future research and practice. Caregiving interventions incorporating physical activity are promising given its buffering effect for decreased physical and psychological HRQOL over time.

Historical and generational forces in the Iridescent Life Course of bisexual women, men, and gender diverse older adults

PURPOSE

Little is known about the life course of bisexual older adults. This study examines life events and experiences of bisexuals by generation: Pride Generation, born 1950-1964; Silenced Generation, born 1935-1949; and Invisible Generation, born 1934 or earlier, as well as by gender among women, men, and gender diverse older adults.

METHODS

Aging with Pride: National Health, Aging, and Sexuality/Gender Study is the first national longitudinal study of LGBTQ older adults in the US. We utilize the Iridescent Life Course to examine the life events and life course experiences of bisexual older adults (N = 216) using 2014 survey data. The Iridescent Life Course frames this study for comparing generational and gender differences in five key areas: identity development; work; kin and social relationships; bias-related experiences; and physical and mental health.

FINDINGS

The Invisible Generation, the oldest generation, compared to the two younger generations, reports significant risks related to social relationships, the lowest levels of openly disclosing, and fewer bias-related experiences. They also demonstrate important signs of resilience and better mental health. Bisexual men and gender diverse older adults report higher rates of bias-related experiences and fewer social resources than bisexual women.

CONCLUSION

Based on the Iridescent Life Course, we document important differences in the heterogeneity and intersectionality in bisexual lives, particularly for those in late life and those gender diverse. It is essential to document the distinct nature of bisexuals' life course, as it provides both historical and contemporary insights into aging and the reframing of future research.

Sexual Expression, Policies, and Practices in Skilled Nursing Settings Serving Older Adults: An Updated Assessment in the State of Kansas

Doll assessed sexual expressions, policies, and practices in Skilled Nursing Facilities (SNFs) in the state of Kansas. This study provided an updated and expanded assessment. A mixed-methods survey was distributed to administrators of all SNFs in the state of Kansas. Among 60 administrations, 84% reported any sexual expression among residents in their community within the past year and 55% reported expressions involving an individual with cognitive impairment. In response to sexual expressions, 70% of administrators believe staff would treat residents with dignity and respect and about 40% anticipated staff discomfort. About 40% of administrators reported having a policy related to sexual expression. Attitudes and responses of staff and administrators appear to be shifting in a sex-positive direction. While policies related to sexuality are more common than a decade ago, there is room for additional uptake, standardization, and infusion of person-centered language and practices.

Sexual Expression, Policy, and Practices in Skilled Nursing Facilities: An Updated Assessment in the State of Kansas

Prior studies have reported barriers to meeting the sexual needs of older adults within skilled-nursing facilities, such as a lack of privacy, lack of supportive practices and policies, and judgement or discomfort on the part of the staff (Doll, 2013; Hajjar & Kamel, 2003). In 2008, Doll and colleagues assessed the scope of sexual behaviors, staff perceptions of and responses to such behaviors, and whether facilities had a sexual policy in place in SNFs in the state of Kansas (Doll, 2013). In the present study, an online survey was distributed to the same population to provide an updated assessment of sexual behaviors, policies, and practices. Of 60 survey respondents, 62.7% reported knowledge of individual sexual acts (e.g., masturbation) within the past year and 34.5% reported interactional (between two or more residents) sexual acts. When encountering a sexual event, staff were most likely to report the incident to an administrator (76.7%) and treat residents with respect (70.0%), while 35.0% and 41.7% were expected to respond with embarrassment and discomfort, respectively. Only 40% of administrators reported having a policy related to sexual expression. Findings indicate that staff are likely to respond differently to LGBTQ residents due to discomfort and those living with cognitive impairment due to concerns related to consent. The proportion of facilities in Kansas with policies related to sexual expression has increased from 26% to 40% in the past 12 years, but there remains a need for greater specificity of sexuality-related policies and trainings.

Representation of Older Adults in COVID-Related Newspaper Coverage

Based on clinical and epidemiological evidence, COVID-19 infection can occur in people of all ages; however, the media typically focuses its attention on the vulnerability of older adults and individuals with chronic illnesses. This study aims to explore the representation of older adults during the first month of the pandemic in the U.S. by comparing the narratives of older adults and younger adults in national media sources. A systematic search identified 115 articles published in four major newspapers in the U.S. included USA Today, The New York Times, Los Angeles Times, and The Washington Post between March 11 and April 10, 2020 in which older adults and younger adults were quoted on topics related to the intersection of COVID-19 and aging. Quotes were inductively reviewed using thematic content analysis. In 115 articles, there were 265 quotes from older adults (n=104, 39%) and younger adults (n=161, 61%). When comparing patterns that were common or distinctive between older and younger individuals quoted, three key themes emerged: 1) impacts of COVID-19 on older adults and resulting vulnerability, 2) debated perspectives over the value of older adults’ lives, and 3) a counternarrative of resiliency among older adults. This study provides the opportunity to understand how the pandemic may impact representations of older adults and findings emphasize the importance of voice among older adults to combat ageist messaging and promote counternarratives to assumptions of vulnerability. Also, it suggests for policymakers and practitioners to insight into how the representation of older adults is disseminated by media.

Ageism in COVID-Related Newspaper Coverage: The First Month of a Pandemic

Objectives

Media sources have consistently described older adults as a medically vulnerable population during the coronavirus disease 2019 (COVID-19) pandemic, yet a lack of concern over their health and safety has resulted in dismissal and devaluation. This unprecedented situation highlights ongoing societal ageism and its manifestations in public discourse. This analysis asks how national news sources performed explicit and implicit ageism during the first month of the pandemic.

Method

Using content and critical discourse analysis methods, we analyzed 287 articles concerning older adults and COVID-19 published between March 11 and April 10, 2020, in 4 major U.S.-based newspapers.

Results

Findings indicate that while ageism was rarely discussed explicitly, ageist bias was evident in implicit reporting patterns (e.g., frequent use of the term “elderly,” portrayals of older adults as “vulnerable”). Infection and death rates and institutionalized care were among the most commonly reported topics, providing a limited portrait of aging during the pandemic. The older “survivor” narrative offers a positive alternative by suggesting exceptional examples of resilience and grit. However, the survivor narrative may also implicitly place blame on those unable to survive or thrive in later life.

Discussion

This study provides insight for policy makers, researchers, and practitioners exploring societal perceptions of older adults and how these perceptions are disseminated and maintained by the media.

"Thanks for hearing me out": Voices of social work students during COVID-19

As social work educators and students, the COVID-19 pandemic impacted our teaching and learning in challenging ways. We embarked on a qualitative research study to better understand the ways in which the pandemic was affecting the social work students in our program. Three faculty mentors worked collaboratively with five social work students across BSW, MSW, and PhD programs to interview 66 BSW and MSW students about their experiences, challenges, and hopes during the early months of the pandemic. BSW and MSW students led the analysis and early dissemination for the project. This essay describes the unique experiences of social work students by using a research poem to capture the emotional and experiential aspects of the students we interviewed.

Courage to Cobble Something New: Creative Representations of Bisexuality and Aging

There are few cultural representations or scripts available for LGBTQ aging. Among bisexual and otherwise non-monosexual (bi+) women, stereotypes of hypersexuality exclude older adults while the contrasting experience of invisibility obscures the existence of bi+ aging. In this discourse analysis, we examined three issues of the Bi Women Quarterly (BWQ) newsletter published between 2014-2019 which were devoted to the intersection of aging and bisexuality. Data include 42 narratives, personal reflections, interviews, poems, letters, advice columns, and photos which were analyzed to identify linguistic tools, visual imagery, and broader discourses used to construct and convey the meaning and experience of bisexual aging. Themes include: 1) lacking a “blueprint” for bisexual lives, 2) significant “turning points,” 3) intergenerational (dis)connections across history, and 4) life-long patterns of discovery and disclosure. More visible and diverse narratives for bisexual aging might better enable bi+ individuals to envision and effectively plan for their own aging futures.

Ageism in COVID-19-Related Media Coverage: Examining Publications During the First Month of the Pandemic

The media has consistently described older adults as the population most vulnerable to COVID-19. Anti-ageism critics have taken issue with the oft-repeated statement that “only” older adults are at risk, a construction that dismisses and devalues the nuances within this population. The purpose of this study was to analyze instances of ageism in national media sources during the first month of the COVID-19 pandemic. A systematic search returned 287 articles concerning older adults and COVID-19 published in four major newspapers in the United States—USA Today, The New York Times, Los Angeles Times, and The Washington Post—between March 11 and April 10, 2020. Combining the strengths of content analysis and critical discourse analysis, we deductively and inductively reviewed the articles for patterns related to implicit and explicit forms of ageism. While ageism was rarely discussed explicitly, ageist bias was evident in implicit reporting patterns, such as frequent use of the phrase the elderly, which was often paired with statements describing older adults as vulnerable. Infection and death rates among older adults, as well as institutionalized care practices, were among the most commonly reported topics, providing a limited portrait of aging during the pandemic. While some authors utilized a survivor narrative by portraying older adults as having survived hardships, this construction implicitly places blame on those unable to do so. Older adults, when quoted directly, produced more complex and nuanced narratives of aging during the COVID-19 pandemic. Such narratives can combat societal ageism and promote self-determination and -definition.

"You'll See": Younger Women Interviewing Older Women in Qualitative Research

Understanding the co-construction of the interview process between older adult research participants and relatively younger interviewers requires a nuanced analysis of positioning, reflexivity, and power within interviewing dynamics, accounting for differences in historical context and lived experience. Guided by a feminist life span approach, this study examined interviewing dynamics between a younger woman interviewer and older women research participants, ages 57-93 (mean = 65.3), in two qualitative studies completed five years apart. Four themes emerged: 1) contrasting experiences drew explicit attention to discrepancies in historical context, age, and life experience between participants and the interviewer. Similarities often arose in the theme of 2) invoking expertise in which participants oriented to or invoked their own expertise in their life story and experiences and the interviewer's expertise in research, sexuality studies, and social services. Participants enacted 3) demonstrating care, by prioritizing the researcher's goals, offering advice, and expressing hopes for younger generations. Finally, 4) the participants and researcher used distinctive conversational strategies when addressing challenging or sensitive topics. This paper contributes a needed analysis of age-related dynamics in qualitative research as well as indicating potential strategies to inform reflexive cross-generational conversations in gerontological research and practice more broadly.

How Intimate Partner Violence and Intersectional Identities Converge to Influence Women's Sexual Health across Environmental Contexts

In this qualitative study, authors examine women's sexual risk and protective factors based on their experiences of intimate partner violence (IPV) and positioning within society relative to power. This analysis examines sexual risk and protective factors across intersectional identities-including gender, race, socioeconomic conditions, and age-among women survivors of IPV. The sample (N = 28) included women of diverse ages (range = 22-60 years) and races (57 percent White, 14 percent African American, 11 percent Hispanic, 7 percent Native American, 7 percent multiracial, and 4 percent South Asian). Findings demonstrated that IPV experiences differentially affect women's sexual health according to intersectional identities and across various levels of environmental context by influencing the (in)stability of their lives and their experiences of (dis)empowerment. This analysis offers a nuanced understanding of how social workers can support women in planning for their own sexual health and safety and shows how an intersectional feminist framework enriches our understanding of the grand challenge to "build healthy relationships to end violence."

"It feels like home": Transgender youth in the Midwest and conceptualizations of community climate

Community climate toward sexual and gender minority (SGM) youth is associated with higher rates of victimization and poorer health and wellbeing-related outcomes such as depression and suicidal ideation. However, this field of research has underemphasized the experiences of transgender youth, particularly within the Midwestern context which is marked by vast rurality and characterized as sociopolitically conservative. Using qualitative and community-based methods, this study identified factors that impact community climate from the perspective of transgender youth (n = 19) in the Midwest and situated them within the Ecological Systems Theory (EST). Thematic analysis of interviews revealed four themes: resources, visibility, policies, and ideologies. Themes often crossed levels within the EST, indicating the complexity and interrelated nature of climate across local, regional, and national contexts. Implications for theory, research, and practice are discussed.

YOU’LL SEE: YOUNGER RESEARCHERS INTERVIEWING OLDER PARTICIPANTS

In qualitative research, similarities and differences between the participant and researcher influence the research process and dynamics. Specifically, the age difference between older participants and relatively younger qualitative researchers is a common, but under-examined dynamic requiring nuanced, reflexive analysis. Using a life course conceptual framing, this study explored age-related participant-researcher dynamics in interviews from two qualitative studies of older women’s sexual experiences in later life. Participants included 25 women whose ages ranged from 55 to 93 and both studies were completed by the same researcher, a relatively younger woman (age 23 and 28 at times of data collection). A thematic analysis revealed three primary themes: 1) taking care - participants took care of the researcher by offering advice, asking about the researcher’s life, and expressing hopes for a positive future, 2) expertise – varied expertise was demonstrated by the researcher (e.g. substantive and scholarly) and participants (e.g. life experience), and 3) researcher growth - the researcher’s interviewing tactics shifted between the two studies (e.g. use of validation rather than consolation in response to aging-related concerns), indicating a shift in perceptions of aging and later life. Findings indicate that older women participants and younger women researchers are bound together through the life course, by shared gendered experiences, the fact that one will eventually become the other, and the mutual sharing of expertise and caring. Gerontology researchers must actively reflect on the impact of their own identities and aging perceptions on the interviewing process in order to enhance rigor in qualitative research.

HARDWIRED BIOLOGY AND LIGHT-BULB MOMENTS: DIVERGENT DISCOURSES AND LIFE TRAJECTORIES OF OLDER BISEXUAL WOMEN

Older bisexual women report a less positive sense of their sexual identity, less belonging in LGBTQ communities, and worse mental health outcomes compared to lesbian counterparts. These patterns are consistent with those identified among younger bisexual cohorts and appear to be connected to how bisexual identities are perceived and experienced; however, sexual identities take on unique meaning by gender and age and across historical contexts. To explore how older bisexual women construct and make meaning out of bisexual identities, this study applied a Foucauldian discursive and critical feminist conceptual framing to examine semi-structured interviews with bisexual women ages 60 and older (N=13). Findings reveal two divergent groups of women, the Early Emergers and Mature Migrators, who differ in their constructions of bisexuality and the timing of their first experienced attractions to other women. While the Early Emergers construct bisexuality as a stable, “hardwired” biological concept, the Mature Migrators challenge this narrative by emphasizing the fluidity of sexuality through discourses of migration spurred by “light bulb” moments in which they first recognized their attractions to women. This study illustrates the contributions of discourse analysis in revealing nuanced constructions of life course histories as well as the need for acknowledgment of life context in research and practice with older bisexual individuals. Scholars and practitioners must intentionally critique and contribute to discourses of bisexuality in later life.

The State of Theory in LGBTQ Aging: Implications for Gerontological Scholarship

Social research in lesbian, gay, bisexual, transgender, and queer (LGBTQ) aging is a rapidly growing field, but an examination of the use of theory has not yet been conducted for its impact on the field's direction. We conducted a systematic review of empirical articles published in LGBTQ aging in the years 2009-2017 ( N = 102). Using a typology of theory use in scholarly articles, we analyzed these articles for the types of theories being used, the degree to which theories were used in each article, and the analytical function they served. We found that 52% of articles consistently applied theory, 23% implied or partially applied theory, and 25% presented as atheoretical. A wide range of theories were used and served multiple analytical functions such as concept development and explanation of findings. We discuss the strengths and weaknesses of theory use in this body of literature, especially with respect to implications for future knowledge development in the field.

Bisexual Lives and Aging in Context: A Cross-National Comparison of the United Kingdom and the United States

Research on bisexual histories and identities in later life is limited and reflects only single-nation studies. This article compares findings from two independently conducted studies of bisexual aging, in the United Kingdom and the United States, using a discourse analytic and life course perspective. The goals were to compare how participants narrated and made sense of their bisexual experiences in later life and to examine ways in which historical and cultural contexts shaped their accounts. Findings indicate that similar histories around lesbian separatism and the HIV/AIDS epidemic enabled shared discursive resources, while differing ethnic and racial relations enabled distinctive discursive possibilities. In both studies intersectional experiences, particularly including being a person of color and having a transgender history, profoundly affected individual narratives. Future research will benefit from creative conceptualizations of bisexuality, applying the life course perspective in research and practice, and supporting the diverse and resilient ways bisexual older adults use language.

Iridescent Life Course: LGBTQ Aging Research and Blueprint for the Future - A Systematic Review

BACKGROUND

LGBTQ* (lesbian, gay, bisexual, trans, and queer) older adults are demographically diverse and growing populations. In an earlier 25-year review of the literature on sexual orientation and aging, we identified four waves of research that addressed dispelling negative stereotypes, psychosocial adjustment to aging, identity development, and social and community-based support in the lives of LGBTQ older adults.

OBJECTIVES

The current review was designed to develop an evidence base for the field of LGBTQ aging as well as to assess the strengths and limitations of the existing research and to articulate a blueprint for future research.

METHODS

Using a life course framework, we applied a systematic narrative analysis of research on LGBTQ aging. The review included 66 empirical peer-reviewed journal articles (2009-2016) focusing on LGBTQ adults aged 50 years and older, as well as age-based comparisons (50 years and older with those younger).

RESULTS

A recent wave of research on the health and well-being of LGBTQ older adults was identified. Since the prior review, the field has grown rapidly. Several findings were salient, including the increas-ed application of theory (with critical theories most often used) and more varied research designs and methods. While -existing life course theory provided a structure for the investigation of the social dimensions of LGBTQ aging, it was limited in its attention to intersectionality and the psychological, behavioral, and biological work emerging in the field. There were few studies addressing the oldest in these -communities, bisexuals, gender non-binary older adults, intersex, -older adults of color, and those living in poverty. -Conclusions: The Iridescent Life Course framework highlights the interplay of light and environment, creating dynamic and fluid colors as perceived from different angles and perspectives over time. Such an approach incorporates both queering and trans-forming the life course, capturing intersectionality, fluidity over time, and the psychological, behavioral, and biological as well as social dimensions of LGBTQ aging. Work is needed that investigates trauma, differing configurations of risks and resources over the life course, inequities and opportunities in representation and capital as LGBTQ adults age, and greater attention to subgroups that remain largely invisible in existing research. More depth than breadth is imperative for the field, and multilevel, longitudinal, and global initiatives are needed.

Cognitive Impairment, Alzheimer's Disease, and Other Dementias in the Lives of Lesbian, Gay, Bisexual and Transgender (LGBT) Older Adults and Their Caregivers: Needs and Competencies

Cognitive impairment, Alzheimer's disease, and other dementias are important health concerns for older adults. As a marginalized and growing segment of the older adult population, lesbian, gay, bisexual, and transgender (LGBT) older adults face distinct risk factors related to cognitive impairment and dementias, including social isolation, discrimination, barriers to health care access, limited availability of and support for caregivers, and higher rates of certain chronic illnesses. We examine cognitive impairment and dementias among LGBT older adults, describe their unique risk factors, and outline key competencies for health care and human service providers to ensure culturally relevant care for LGBT older adults experiencing cognitive impairment, Alzheimer's disease, or other dementias, as well as their caregivers, families, and communities. Implications include developing an awareness of the context of LGBT older adults' lives and relationships, the importance of early detection and support, and the development of policies and practices that promote community-level advocacy and education.

The Unfolding of LGBT Lives: Key Events Associated With Health and Well-being in Later Life

PURPOSE OF THE STUDY

Life events are associated with the health and well-being of older adults. Using the Health Equity Promotion Model, this article explores historical and environmental context as it frames life experiences and adaptation of lesbian, gay, bisexual, and transgender (LGBT) older adults.

DESIGN AND METHODS

This was the largest study to date of LGBT older adults to identify life events related to identity development, work, and kin relationships and their associations with health and quality of life (QOL). Using latent profile analysis (LPA), clusters of life events were identified and associations between life event clusters were tested.

RESULTS

On average, LGBT older adults first disclosed their identities in their 20s; many experienced job-related discrimination. More had been in opposite-sex marriage than in same-sex marriage. Four clusters emerged: "Retired Survivors" were the oldest and one of the most prevalent groups; "Midlife Bloomers" first disclosed their LGBT identities in mid-40s, on average; "Beleaguered At-Risk" had high rates of job-related discrimination and few social resources; and "Visibly Resourced" had a high degree of identity visibility and were socially and economically advantaged. Clusters differed significantly in mental and physical health and QOL, with the Visibly Resourced faring best and Beleaguered At-Risk faring worst on most indicators; Retired Survivors and Midlife Bloomers showed similar health and QOL.

IMPLICATIONS

Historical and environmental contexts frame normative and non-normative life events. Future research will benefit from the use of longitudinal data and an assessment of timing and sequencing of key life events in the lives of LGBT older adults.

Race/Ethnicity and Health-Related Quality of Life Among LGBT Older Adults

PURPOSE OF THE STUDY

Few existing studies have addressed racial/ethnic differences in the health and quality of life of lesbian, gay, bisexual, and transgender (LGBT) older adults. Guided by the Health Equity Promotion Model, this study examines health-promoting and health risk factors that contribute to racial/ethnic health disparities among LGBT adults aged 50 and older.

DESIGN AND METHODS

We utilized weighted survey data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study. By applying multiple mediator models, we analyzed the indirect effects of race/ethnicity on health-related quality of life (HRQOL) via demographics, lifetime LGBT-related discrimination, and victimization, and socioeconomic, identity-related, spiritual, and social resources.

RESULTS

Although African Americans and Hispanics, compared with non-Hispanic Whites, reported lower physical HRQOL and comparable psychological HRQOL, indirect pathways between race/ethnicity and HRQOL were observed. African Americans and Hispanics had lower income, educational attainment, identity affirmation, and social support, which were associated with a decrease in physical and psychological HRQOL. African Americans had higher lifetime LGBT-related discrimination, which was linked to a decrease in their physical and psychological HRQOL. African Americans and Hispanics had higher spirituality, which was associated with an increase in psychological HRQOL.

IMPLICATIONS

Findings illustrate the importance of identifying both health-promoting and health risk factors to understand ways to maximize the health potential of racially and ethnically diverse LGBT older adults. Interventions aimed at health equity should be tailored to bolster identity affirmation and social networks of LGBT older adults of color and to support strengths, including spiritual resources.

Who Says I Do: The Changing Context of Marriage and Health and Quality of Life for LGBT Older Adults

PURPOSE OF THE STUDY

Until recently, lesbian, gay, bisexual, and transgender (LGBT) adults were excluded from full participation in civil marriage. The purpose of this study is to examine how legal marriage and relationship status are associated with health-promoting and at-risk factors, health, and quality of life of LGBT adults aged 50 and older.

DESIGN AND METHODS

We utilized weighted survey data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS) participants who resided in states with legalized same-sex marriage in 2014 (N = 1,821). Multinomial logistic regression was conducted to examine differences by relationship status (legally married, unmarried partnered, single) in economic and social resources; LGBT contextual and identity factors; health; and quality of life.

RESULTS

We found 24% were legally married, and 26% unmarried partnered; one-half were single. Those legally married reported better quality of life and more economic and social resources than unmarried partnered; physical health indicators were similar between legally married and unmarried partnered. Those single reported poorer health and fewer resources than legally married and unmarried partnered. Among women, being legally married was associated with more LGBT microaggressions.

IMPLICATIONS

LGBT older adults, and practitioners serving them, should become educated about how legal same-sex marriage interfaces with the context of LGBT older adults' lives, and policies and protections related to age and sexual and gender identity. Longitudinal research is needed to understand factors contributing to decisions to marry, including short- and long-term economic, social, and health outcomes associated with legal marriage among LGBT older adults.

A Collaboration for Health and Wellness: GRIOT Circle and Caring and Aging with Pride

Despite growing racial and ethnic diversity among lesbian, gay, bisexual, transgender, and queer (LGBTQ) older adults in the United States, LGBTQ older adults of color largely are invisible in aging services, research, and public policy. GRIOT Circle and Caring and Aging with Pride are pioneering efforts in community-based services and research. This article describes innovative and effective ways to reach and serve LGBTQ older adults of color, how research can be designed collaboratively to address strengths and disparities in social, health, and economic well-being, and barriers to accessing aging services in these populations.

Impact of SAW device passivation on RF performance

Passivation layers consisting of sputtered A12O3 have been deposited onto SAW devices for the purpose of reducing the incidence of shorts. A coupling-of-modes model was used with one-port resonators, coupled resonator filters (CRF), and test structures. The passivation layer stiffens the surface with a velocity increase proportional to tau/lambda, where tau is the passivation layer thickness. Attenuation is increased slightly, producing a 0.25-dB increase in the loss of a one-port resonator at 314 MHz. The effect on reflectivity is minimal and of much lesser importance to the designer.

T cell expression cloning of a Mycobacterium tuberculosis gene encoding a protective antigen associated with the early control of infection

Infection of C57BL/6 mice with Mycobacterium tuberculosis results in the development of a progressive disease during the first 2 wk after challenge. Thereafter, the disease is controlled by the emergence of protective T cells. We have used this infection model in conjunction with direct T cell expression cloning to identify Ags involved with the early control of the disease. A protective M. tuberculosis-specific CD4 T cell line derived from mice at 3 wk postchallenge was used to directly screen an M. tuberculosis genomic expression library. This screen resulted in the identification of a genomic clone comprising two putative adjacent genes with predicted open reading frames of 10 and 41 kDa, MTB10 and MTB41, respectively (the products of Rv0916c and Rv0915c, respectively, in the TubercuList H37Rv database). MTB10 and MTB41 belong to the PE and PPE family of proteins recently identified to comprise 10% of the M. tuberculosis genome. Evaluation of the recombinant proteins revealed that MTB41, but not MTB10, is the Ag recognized by the cell line and by M. tuberculosis-sensitized human PBMC. Moreover, C57BL/6 mice immunized with MTB41 DNA developed both CD4- (predominantly Th1) and CD8-specific T cell responses to rMTB41 protein. More importantly, immunization of C57BL/6 mice with MTB41 DNA induced protection against infection with M. tuberculosis comparable to that induced by bacillus Calmette-Guérin. Thus, the use of a proven protective T cell line in conjunction with the T cell expression cloning approach resulted in the identification of a candidate Ag for a subunit vaccine against tuberculosis.

Cloning of a Mycobacterium tuberculosis gene encoding a purifed protein derivative protein that elicits strong tuberculosis-specific delayed-type hypersensitivity

The purified protein derivative (PPD) skin test has been used for the diagnosis of tuberculosis for more than 75 years. However, the test lacks specificity because all mycobacteria share antigens present in PPD. Therefore, sensitization with nontuberculous pathogenic or with environmental nonpathogenic mycobacteria can lead to positive skin tests. This communication describes a novel PPD protein present only in tuberculous complex mycobacteria. A recombinant protein was obtained and named DPPD on the basis of the first 4 amino acids of its N-terminus sequence. DPPD elicited delayed-type hypersensitivity (DTH) in 100% of Mycobacterium tuberculosis-infected guinea pigs but in no animals sensitized with several organisms representative of all members of the Mycobacterium genus. Preliminary results indicate that DPPD induces strong and specific DTH in humans. This work points to the definition of a single recombinant M. tuberculosis protein that may be an alternative to the PPD test.

Cloning, characterization and serological evaluation of K9 and K26: two related hydrophilic antigens of Leishmania chagasi

We report here the molecular cloning and characterization of two related hydrophilic antigens of Leishmania chagasi. These two antigens have predicted molecular weights of approximately 9 and 26 kDa and detect antibodies in sera of patients with kala-azar (k). Thus, to maintain consistency with nomenclature of the previously described 39 kDa diagnostic antigen of L. chagasi (k39 [1]), these antigens are being referred to as k9 and k26. A significant difference between k9 and k26 is the presence of 11 copies of a 14 amino acid repeat in the open reading frame of k26. The region flanking the repeats of k26 shares a 69% identity with the open reading frame of k9. The recombinant proteins encoded by both antigens are very hydrophilic and show aberrant migration on SDS PAGE. Results of Southern blot analysis reveal that k9 and k26 are conserved to varying degrees among various Leishmania species. Interestingly, the repeat region of k26 is specific to L. chagasi and L. donovani while the flanking region is conserved among several other species. Transcript levels of k26 are significantly upregulated in the amastigote stage of the parasite. Our results show that recombinant K26 is specific in detecting antibodies in infection sera from visceral leishmaniasis (VL) patients. Thus rK26 may complement rK39 in a more accurate diagnosis of VL in the old and the new world.