Menopause in Latin America: Symptoms, attitudes, treatments and future directions in Costa Rica.

Similar to their US counterparts, Costa Rican women enter menopause at ∼50 years of age, have similar symptoms, including hot flashes and night sweats, as well as an overall negative attitude toward the menopausal transition. One study of rural women in Monteverde reported that women knew little about the menopausal transition, as the subject was not discussed. Similar to other Latin American women, the use of hormone therapy by Costa Rican women is low and instead they use alternative therapies, including massage, dietary changes and herbal medicines. A wide variety of herbal therapies are used, and some of these herbs have estrogenic activities in vitro. However, clinical data on the safety and efficacy of any of these treatments is lacking. Recently, a disturbing increase in the incidence of human papilloma virus infections in menopausal women has been reported, due in part to more sexual freedom after menopause. Fortunately, the strain of HPV infecting these women is not associated with cervical cancer. Overall, there is a significant lack of scientific and medical research on menopausal women in Costa Rica. Considering the aging population, the high use of herbal medicines by menopausal women and the lack of clinical studies on these treatments, future research should focus on gaining a better understanding of menopause in this population. Furthermore, new educational programs for these women and the health professionals who serve them are necessary, as well as investigations of the safety and efficacy of the herbal supplements women use to manage their menopausal symptoms.

Stress in air traffic personnel: low-density towers and flight service stations.

Stress and anxiety levels were measured in 10 air traffic control specialists (ATCS) at two low traffic-density towers in Fayetteville (FYV), Ar, and Roswell (ROW), NM, and in 24 flight service (FS) specialists at those airports and at Okalhoma City (OKC), Ok. Physiological measurements consisted of heart rate and urine biochemical analysis for 17-ketogenic steroids, epinephrine, and norepinephrine. On-duty arousal in ATCSs and FS specialists was evident both physiologically and psychologically; such arousal was within psychologically normal limits and was generally low physiologically compared to other air traffic control (ATC) facilities studied in the past. Physiological stress levels at these low-density towers and flight service stations were also low compared to other ATC facilities studied previously. Therefore, it is inappropriate to describe all air traffic control work, as is commonly done in the popular press, as unusually stressful. Such accounts in the popular press tend to deal with the exceptional, rather than with the typical, controller or facility.