The role of gender in compliance and attendance at an outpatient clinic for type 2 diabetes mellitus in Trinidad

OBJECTIVES. To explore the association between gender and (1) attendance and (2) compliance with treatment in a population of patients with diabetes who attended outpatient clinics in the island of Trinidad (Trinidad and Tobago). METHODS. A cross-sectional study was conducted with a sample of 360 patients who met the selection criteria. Simple consecutive sampling and a questionnaire were used to interview clinic attendees at two urban clinics in east and south Trinidad. RESULTS. 74.2 percent (267) of the participants were women. A higher percentage of women than men were unemployed (79.4 percent vs. 59.1 percent, P less than 0.001). Men were more likely to consume alcohol(26.9 percent vs. 11.6 percent, P less than 0.001) and smoke cigarettes (20.4 percent vs. 5.6 percent , P less than 0.001). Women were more compliant than men regarding diet (39.3 percent vs. 22.6 percent, P percent 0.005) and prescribed medication (71.9 percent vs. 65.6 percent, P less than 0.04). Women were more satisfied than men with dispensary (81.3 percent vs. 71.0 percent, P less than 0.04) and clinic conditions (92.1 percent vs. 84.9 percent, P less than 0.05). CONCLUSIONS. More women attended the clinic, and their compliance with the treatment regimen was better than in men. The latter were more likely to engage in health risk behaviors such as drinking and smoking. Efforts focused on men with diabetes mellitus in Trinidad and Tobago are needed to encourage greater compliance.

Many voices: sociocultural results of the ethnocultural communities facing AIDS study in Canada

This paper presents the results of Phase 11 of the Ethnocultural Communities facing AIDS Study, the sociocultural investigation of factors contributing to risk behaviour associated wih HIV/AIDS in six ethnocultural communities in Canada in three urban sites. In Vancouver, the South Asian and Chinese communities were studied, the Horn of Africa and English-speaking Caribbean communities in Toronto and the Latin American and Arab-speaking communities in Montreal. Results demonstrated that there are common elements across these ethnocultural communities that increase the risk for HIV transmission. HIV/AIDS awareness and prevention in ethnocultural communities must address sociocultural differences, particularly sex role differences between men and women in terms of power within relationships to negotiate for safer sexual practices (AU).

The challenge for women with a drug-abusing family member: the Jamaican perspective

The abuse of alchol and other drugs presents a multiplicity of problems for the abuser, family members and the wider community. The psychosocial, as well as the economic, probelms can produce an environment of chaos and misery. Women in families in which there is an abuser are challenged in a variety of ways and, depending on the severity of the situation and their capacity to cope, they may confront the problem, seek help or withdraw from it. The present article reviews the impact of drug abuse within the family on Jamaican women from the viewpoint of treatment and rehabilitation specialists and the women themselves and on the basis of case histories and the work experience of the author. Although there have been efforts through demand reduction strategies and culturally relevant treatment and rehabilitation programmes to control the epidemic of drug abuse, the specific needs of women have been left largely unattended. Both men and women are however critical in the fight against drug abuse and women have skills and experience that can contribute to making such programmes achieve their desired objectives. Addressing their needs would not only help them, but also the family and the wider community. In order to address these needs effectively with the limited resources available, however, a credible basis for action has to be established, which can only be done by research and analysis so that the issues can be clearly defined and a plan of action developed.(AU)

Machismo in two cultures: relation to punitive child-rearing practices

The relationship of culture, personality traits, and punitive child-rearing practices to machismo was examined in 40 Guyanese and 40 Caucasian parents with children aged four to 12 years. Guyanese parents were found to adhere more strongly to machista attitudes and beliefs and to employ controlling, authoritarian, and punitive child-rearing techniques more often than did Caucasian parents (AU)

Epidemiology of behavioral and emotional problems among children of Jamaica and the United States: parents reports for ages 6 to 11

Research on child behavior problems requires standardized methodology in order to compare parent-reported behavior problems of 360 Jamaican and 946 U.S. children aged 6 to 11. It revealed few differences in individual, total, internalizing (e.g., depression), and externalizing (e.g., fighting) problem scores as a function of nationality, gender, or age. Findings from this and other studies indicate the feasibility of a common methodology in cross-national studies of children's problems, but also the need for further refinement. (AU)

Perceptions of gender roles: attitudes toward family life and sexual behaviour in urban Jamaica

Looks at the extent to which there is rigidity in the perception of gender roles in Jamaica. The survey was administered to 400 persons aged 12 to 15 years, 61.5 per cent were female; the median age was 16 years, most were single and unemployed and has a post primary education; and 53 per cent were raised by their mothers only and 7.1 per cent by fathers only. Responses were solicited about attitudes towards sex and relationships, ideal family size, sexuality and family life, and roles and responsibilities eg. for child-rearing and domestic duties. Concludes that while men and women are seen as having particular traditional roles, perceptions of gender roles within Caribbean society are flexible and changing. Evidence from the data indicates that people do not think rigidly about male and female roles. (AU)

Report of the sixth disciplinary seminar on women and health at the Island Inn Hotel, Barbados, Oct. 12-16, 1992

Women and Health was the sixth in a series of Disciplinary Seminars funded by the Ministry of Development and Cooperation of the government of the Netherlands, as part of the project of cooperation in Teaching and Research in Women and Development Studies between the Institute of Social Sudies (ISS) at the Hague and the UWI. The seminar aims were :(1) To sensitize persons to gender and gender issues in the medical curriculum and in the medical specialities. (2) To encourage the inclusion of gender and gender issues in the medical curriculum and in the medical specialities. (3) To expose participants to current research issues. (4) To bridge the gap between academics and practitioners in the medical field on the one hand and governmental organizations with an interest in health issues

Effects of parental presence/absence on size of children's human figure drawings

The effects of parental presence or absence in the home on the size of male and female human figure drawing were examined for a sample of 480 Barbadian children ages 7 to 13 yrs. Most children of both sexes drew larger female than male figures, but significant effects relating to mother-absence and father-absence were found for boys and girls, respectively. Findings were not entirely consistent with those of previous research but would seem to reflect the matrifocality of Caribbean households. (AU)

Poor and pregnant: perinatal ganja use in rural Jamaica

This paper reports the ethnographic findings from a study of cannabis use by pregnant women in rural Jamaica. The perceived functions of ganja in reducing the physiological symptoms of pregnancy and associated psychological stress are described in relation to the sociocultural context of pregnancy in low-income rural communities. The data suggest that distinguishing life-style characteristics of cannabis-smoking women may actually mitigate the potentially harmful effects of marijuana. (AU)

Jamaican family structure: the paradox of normalcy

The relationship between basic research, theory, and clinical work with families is conceptualized during a discussion of Jamaican family structure and the application of change theory to a clinical case of depression in a Jamaican woman. It was found that three types of family structures are prevalent in Jamaica. The European ideal of a patriarchal-patrifocal structure creates problems for working-class Jamaicans. General system theory provides support for a different model. Change theory is applied to resolve the paradox created by the European model (AU)

Psychological dependency among students in a "cross-roads" culture - abstract

Sociological and anthropological studies describe cultural pluralism and social disintegration a pathological burdens of the "cross-roads" experience of the West Indies. A retrospective analysis of 169 undergraduate students seen over three and a half years was carried out. Correlation and cross tabulation studies of different life stresses and emographic variables were performed comparing dependent and non-dependent students. These linked dependency with male-female problems, being female and with being non-graduating. Passive dependent personality traits predisposed to psychiatric morbidity, (i.e. actual psychoneurosis). Unsatisfactory parental relationships were significantly greater in dependent and other patients than in a general sixty per cent (60 percent) sample of students who graduated in 1976. It is suggested that in the West Indian family poor parental binding, as well as the inadequate identification of males with a consistent father or husband role, lead to oedipal conflicts and stress-producing dependency in the offspring of both sexes. But the social expectations of passivity on the part of women, and the demands on them to be the greatest functioning family member, leads to an introjection (rather than ventilation or projection) of frustrated feelings on their part, as well as to greater articulation of conflicts in help seeking behaviour. These findings can inform further enquiry in transcultural psychiatry and the direction needed for student health services to be of greater help to the young adult in a troubled, changing culture, seeking a future (AU)