Midlife and older women: family life, work and health in Jamaica

... This study is essentially one about the family life, work and health of so-called midlife and older women in Jamaica in the early 1990s. Here reference is being made to two groups of women who are usually kept separate in demographic studies. At the point of data collection and in the data analysis these women are recognizble as being in "midlife" (fifty to pfifty-nine years old) and "older" (sixty to seventy-four years old)... The book argues that, while the familial contribution of older women is sometimes acknowledge by the society outside of academic discourse they tended, up to 1991, to have been seen as "carers" rather than "minders' (Rodman 1978). Even in the negative presentation of their sexuality, older women are portrayed as caregivers ... The book covers a range of issues, including family relationships, religion, financial security, migration, loneliness and sexuality. Midlife and Older Women will be of particular interest to sociologist, anthropologists, social workers, and labour, health and welfare workers (AU)

The retiring ophthalmologist - reflections in amber

After all the years of hard work, after all the years of planning and positioning, there comes a time when most ophthalmologists will have to adjust to the inevitable life changes that he or she will face. The preparation for this change will make the difference between contentment and frustration for many. The focus of the eye surgeon changes from decade to decade almost imperceptyibly and, while many react to the changes as they happen, others attempt to manage the change in focus. Knowing what to expect from oneself and understanding how to prepare for the diminishing years, will lead to self realization and self actualization, and for the ophthalmologist on the down slope of his years this knowledge is all important.(AU)

Relationship between stressful life events and pain in young adults age 20-34

Pain (including headache, neckache, backache, chest pain, abdominal pain or pain in the limbs) that is not managed properly in young adults results in decreased productivity and poor work attendance. Multiple diagnostic and therapeutic interventions can cost the health care system excessively and can lead to iatrogenic disease. Negative reactions in caregivers can ensue and overall, individuals can be left with a sense of hopelessness for recovery. Mental and physical health are inextricably linked. Neglect of the psychosocial components in the sea-i-rch for the etiology and management of physical pain at the primary level may be reducing the opportunity for speedy recovery. This study was done to determine the relationship between recent and remote stressful life events and the development of pain. A case-control study was conducted among adults age 20-34 years attending one private, one government and one university clinic in Kingstom, Jamaica. 46 cases with pain and 70 controls who were pain-free were chosen. The findings suggest no relation between the actual number of life events and pain but there is a clear association between the preception of a negative impact of a series of life changes on the development of physical pain. The findings also show that of overriding significance in the development of pain is the perceived lack of social support available to the patient. A significant relationship was also found between the perception of a tumultuous childhood and pain although no relationship was found between specific remote childhood stressors and pain. This study highlights the need for greater attention to the integration of mental health and primary care beginning with the training of health workers and education at policy level, service delivery level and of the public (AU)

An assessment of stress among clinical medical students of the University of the West Indies, Mona Campus

This study looks at sources of stress amomg the medical students of the University of the West Indies at the Mona campus. Students of the classes 1993 through 1995 were asked to fill out a questionnaire which had been developed for a similar study at the University of Texas in 1983. The return rate was 66 percent. The results were compared for differences between males and females and between the different year groups. The two most stressful items were rated the same by men and women, i.e. 1) the amount of material to be learned, and 2) examinations and/or grades. There was no statistically significant difference between stress levels by gender in this study. The penultimate clinical year was most stressful. It is hoped that the findings of this study will be the basis for discussion about whether the identified stressors are inherent and necessary to the medical training experience and, if so, how students can be better prepared to cope with them. (AU)

Coping with retirement: a comparitive and analytic study of retired nurses and dock workers in Jamaica

The populations of the world are aging especially those of developing countries like the Caribbean and specifically Jamaica where life expectancy at birth is 74 years. This study looked at retired public sector registered nurses and compared the findings with those of a similar study done concurrently on retired dock workers in Jamaica [Cumbertbatch, E. 1996]. The studies examined the coping strategies and assessed the two groups paying special attention to their health and social status. The data gleaned from the studies showed that the majority of retired nurses found were in the age group 60-64 years, only 5 percent of those over 75 years were found instead of the expected 39 percent. Sixty three percent lived in rural areas and thirty-seven percent lived in Kingston and St. Andrew, while most of the dock workers lived in Kingston and St. Andrew. The majority owned a house. The perceived health status of the groups was good and they are all mentally and physically self-supporting. The three main diseases affecting them, were hypertension, arthritis and diabetes. However, the incidence of these diseases among the groups was slightly lower than the national figures with the exception of arthritis which was more common among dock workers (30 percent) and was higher than in the nurses (25 percent) and the national population of elderly (40 percent). The majority of them said they had no difficulty acessing health care and more than 50 percent got most of their health care from private practitioners, while an average of twenty percent said that they were unable to finance their health care. More than 70 percent of both groups said that their pensions were inadequate to meet financial needs. They therefore depend on other sources of income such as : present employment, investment and support from family. Hence 70 percent of the nurses and 5 percent of the dock-workers were presently employed. The main coping strategies employed were close links with family and friends and active involvement in church and community groups. The nurses expressed a high level of satisfaction about themselves and life, more so than dock workers. These findings raise questions such as "how will the retired nurses and dock-workers of the future cope with retirement?" It is therefore necessary for their employers and professional associations to develop and implement retirement plans for them with urgency. (AU)

Coping with retirement: a comparitive study among retired dockworkers and retired nurses

Populations across the world are ageing in terms of life after age 60 and the section of the population referred to as the elderly is growing at a rapid rate. This study seeks to examine the strategies adopted for coping with the phenomena of retirement among a sample of retired dockworkers and retired nurses; and to compare the findings of the two groups. The population comprised of 62 dockworkers between the ages 65 years to over 75 years from urban and rural areas. Overall they were relatively healthy. The chronic diseases suffered in this population was arthritis, hypertension and diabetes as the leading three. The study substantiated the view that pensioners were the ones who felt the pressures of inflation because they were not productive employees and that the money needed to purchase necessary foods was never enough since they needed to purchase at the same prices as the rest of the population; hence the importance for persons to begin preparing for retirement long ahead of the scheduled time. It is therefore necessary for employers to take the initiative and introduce seminars which will inform their employees as to retirement plans that will enable them to invest wisely during their working life and so earn from those investments during retirement. This study is part of a comparative study done simultaneously with one done among retired nurses by fellow Masters in Public Health student Marjorie Ming. (AU)

Alzheimer's disease: the care givers' concerns, knowledge, coping ability and views of a support system

Alzheimer's disease affects the aged population worldwide. Initially it was considered rare and was believed to occur in people under 60, now research findings indicate that it is seen mostly in the older population. The incidence increases further with age; approximately 20 percent are aged over 80 years. It is a leading cause of death in the United States and studies indicate that up to 50 percent of nursing home population is afflicted with Alzheimer's disease although many may not have been diagnosed. Patients will need constant help when they develop cognitive, physical, emotional or social disabilities. The care-giving role can be demanding and the ability of public health practitioners and community groups to offer support can help to create a positive emotional climate for caregivers. This study was carried out in the Kingston and St. Andrew parishes of Jamaica during the period January to April 1995. Information collected examined Alzheimer's disease and the knowledge and attitude of caregivers. Caregivers identified were family doctors, registered nurses, practical nurses, a house mother, domestic helpers and family members. Findings revealed Alzheimer's disease was more common over age 60. The incidence is higher in females, and the disease knows no socio-economic boundary. Main caregivers are health workers and the majority of patients are cared for in nursing homes. Major fears of doctors was the patients hyperactivity, while for nurse managers it was the increase stress for the caregiver, and communication difficulties the patient may experience. Families are concerned about finding a cure and the safety of the patient. Caregivers were not found to be unduly stressed but there was a knowledge gap about the disease. All categories of caregivers identified the need for support systems. The primary function for an Alzheimer's disease association as seen by the caregivers would be education of all persons. (AU)

Gender stress: a preliminary survey with specific reference to female physicians

Practising female physicians in Trinidad and Tobago were studied to identify major casual factors of negative stress. Results indicated that major stressors were as follows: job (36 percent), finance (32 percent), children (20 percent) relationships (20 percent). The minor stressors identified were: children (48 percent), finance (36 percent), relationships (36 percent), job (32 percent), and health (20 percent). The physicians showed the ability to cope with the stress and this was attributed to, inter alia, self-sufficiency, empowerment, self-fulfilment and gender. (AU)

Life-stress events, depression and purpose-in-life in first-admission alcoholics and members of Alcoholics Anonymous

The relationship between alcoholism, depression, life-stress events and purpose-in-life is a very complex one. Thirty-five first admission alcoholics and an equal number of members of Alcoholics Anonymous were assessed, using objective measures of alcoholism, depression, stress and purpose-in-life. The results indicate that there were significant differences between the two groups on drinking behaviour, depression and purpose-in-life. No differences were found between the groups on the stress questionnaire. Positive correlations were found between drinking behaviour and depression, life events and purpose-in-life (AU)

The psychophysiological mediators of stress as it relates to oncology in humans and animals

This study was designed to investigate the effect of stress on cancer development and treatment, and also to determine whether there is any cancer association personality profile. Human studies were supplemented by controlled animal studies. Twenty-nine male and female cancer subjects were studied along with twenty-nine controls. The animal study comprised ninety female Sprague-Dawley rats, which were divided into nine groups of ten. One group was treated with noise stress alone, while another group received no treatment at all. Three groups received the carcinogen 7,12-Dimethylbenz(a)anthracene together with either noise stress, cortisone acetate or 6-mercaptopurine and the rate of tumour growth in these animals was compared to a group that received only the carcinogen, and after tumour growth these animals were subjected to chemotherapy. In addition to the chemotherapy, one of these groups received noise stress and another cortisone acetate. The stress level of the humans and animals was determined by physiological and psychological tests where applicable. The results of the human study revealed that the level of stress among the cancer subjects was higher than among the controls. Even though in some cases cancer development occured after an event that may be considered stressful, it was not easy to conclude whether stress occurred before or after the cancer development. The controlled animal studies revealed, though, that stress alone could not induce tumour development in the observation period of 280 days. Stress, however, influenced tumour growth when the rats were treated with the carcinogen. The findings of this study also suggested that immunosuppression might play a vital role in cancer development. A cancer associated personality profile, depicting among other things a schizophrenic character, was also detected among the human cancer subjects. The treatment of the cancer subjects who had high stress levels was less successful, and this was substantiated by the results of the animal study, which showed that stressed decreased the life span of the animals receiving chemotherapy and stress. The findings of this study suggest that even though stress may not initiate tumour growth, stress influences the growth of potential tumour cells, and may interfere with the response to treatment (AU)

Association between stress and blood pressure variation in a Caribbean population

Based on the work of Selye (The Stress of Life, New York: McGraw Hill, 1976) it is hypothesized that stress can produce physiological abnormalities, i.e. elevated blood pressure, and that social variables can be used as indicators or risk factors for diseases. It is theorized that deviations from acceptable social patterns or traditional life-styles can produce stressful conditions that are associated with disease and that these situations can be demonstrated by examination of certain social characteristics. This association is examined among the Black Caribs of St. Vincent, West Indies. The social variables included in this analysis are marital status (single, married, widowed, or separated), frequency of church attendance (frequently, sometimes, seldom, or never), years of education, and number of children (for women only). The findings show that single individuals have higher pressures than married subjects and that males who never attended church have higher pressures than men who frequently attend church; a relationship was not demonstrated for females. Among males, as the years of education was increased, blood pressure also increased, but for females, increased education was associated with lower pressures. Family size was not associated with systolic or diastolic pressure. The analysis of these selected social variables suggest that these variables influence male systolic and diastolic pressures, but only female diastolic pressure. (AU)