Medication management, antidepressant drugs, and the elderly: an overview.

1. Several factors may affect an elderly client's use of medications: polypharmacy, potentially leading to interactions; over-the-counter drugs taken without a physician's knowledge; noncompliance or poor compliance with medication regimens; and ageist beliefs. 2. Psychiatric nurses must be aware that the signs and symptoms they observe may be the result of normal physical or biological aging, psychosocial changes, disease-related changes, medication side effects, or a drug interaction. 3. Nurses must ask two questions when psychotropic drugs are used with elderly clients: What will be the onset, duration, magnitude, and characteristic action of a specific drug in an individual; and What are the characteristics of an "ideal" medication?     

Productive aging: a feminist critique

This essay offers a feminist perspective on the call for a "productive aging" society, and says that the movement provides an answer before we have systematically asked questions about the meaning of old age. An emphasis on productivity, among other things, can devalue relational activities, often inherent in women's roles, and certain older people-older women in particular. The author proposes a number of measures for the short term, so that society can be responsible to older women who need and want jobs, as well as ideas for more far-reaching change.     

Demography and ageing -- a truism highlighted

Since the aging of populations, with its extensive consequences, requires ample planning, demography is the soothsayer of gerontology. The realization that aging is the main demographic event of this century has generated an interdependence among demography, gerontology, and geriatrics, and created a base from which to extrapolate socio-political consequences from population changes. Demography transforms the personal unidimensional experience of aging to a dynamic one which traverses time and geography. Chronological age is not an exclusive criterion; this presents an opportunity to explore avenues grounded in the realms of economics, politics, policy, and culture. The inclusion of demography in international training courses of the International Institute on Aging (United Nations-Malta) has made possible an easier progression toward discussing policy, planning, funding, and social services within a broader context. The dependency of aging upon demography established the collaborative development between the Committee for International Cooperation in National Research in Demography (CICRED) and INIA and the joint hosting of a synthesis meeting on Population Ageing Research Project. In this collection of papers, Don Rowland creates the concept of the Gerontological Transition which interprets aging as a process of cohort flow; Raul Hernandez, through an evaluation of regional data, provides a classic analysis of changing age ratios within the population as a whole; Anthony Warnes, through use of mortality rates, provides a demographic analysis to expose the age-dependent variability in health and welfare payments; Paul Paillat transposes demographic numbers into social consequences; Miroslav Macura focuses on the youth in these population shifts; and the emerging elderly in the never ending cycle of events are viewed. Planning beyond the individual lifetime will become a necessity for mankind.     

Age difference asymmetry and a two-sex perspective

The paper shows that (a) the age difference between spouses can be and has been different for men and women; (b) male and female age differences can exhibit different trends; (c) the discrepancy is due to remarriage; (d) the age difference fluctuates substantially through time; (e) trends in the age difference are not readily interpretable as reflecting change in the relative status of the sexes; and (f) that trends in the age difference may be linked to marriage market conditions. The paper argues that marriage and fertility data for both men and women are increasingly necessary because of rises in marital breakdown and the associated divergence of the experience of men and women.Cet article montre que (a) les différences d'âge entre époux peuvent être et ont été dissemblables pour les hommes et les femmes; (b) les différences d'âge masculines et féminines peuvent présenter des tendances différentes; (c) la divergence est due aux remariages; (d) les différences d'âge varient de façon importante au cours du temps; (e) les tendances dans les différences d'âge ne sont pas simplement interprétables en termes de changements dans le statut relatif des sexes; et (f) les tendances dans les différences d'âge peuvent être reliées aux conditions du marché matrimonial. L'article montre que les données sur le mariage et la fécondité à la fois des hommes et des femmes, sont de plus en plus nécessaires du fait de l'accroissement des ruptures d'unions et de la divergence des expériences masculines et féminines, qui lui est associée.

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An earlier version of this paper, His and her age gap: asymmetry in the age difference between partners, was a contributed paper to Session F27 of the General Conference of the International Union for the Scientific Study of Population, New Delhi, 20–27 September 1989. A longer version appeared as LS Working Paper 70, issued by City University Social Statistics Research Unit, September 1990.     

Working with an executive search firm: Part II--The hiring organization's perspective

This article is the second part in a two-part series on how to work with an executive search firm. The first article, which appeared in the September-October 1992 issue of Physician Executive, focused on executive search from the candidate's perspective. This article focuses on how organizations can work with an executive search firm to recruit and retain top management talent.     

Management training for the physician executive

At conferences of physician managers, the issue almost always arises of whether or not a physician manager needs to obtain a formal management degree. There is no clear answer to such a question, reason enough for its perennial appearance at such meetings. These decisions are the result of both personal and environmental factors, each creating unique situations that will dictate the direction taken. In this article, one such direction is described.     

HIV testing of health care workers

Until recently, nothing much beyond education and the dispensing of condoms was being done to control the spread of AIDS. We have not yet taken sufficient measures to prevent the spread of this disease. Instead, we insist on protecting the privacy of the HIV-positive individual. However, we ignore the right to privacy by mandating testing for syphilis, which is not nearly as serious a disease as AIDS. Now, mandatory testing of health care workers is being proposed more frequently.     

Youth's recreation and drug sensations: is there a relationship?

Adolescents' social behaviors remain a mystery to parks and recreation providers. Adolescence is a "high-risk" time for all youth in terms of experimenting with potentially health-compromising behavior, whether alcohol, drugs, or sex. Most of these antisocial behaviors occur during adolescents' leisure time. These inferences gave impetus to this research effort. The study was designed to ascertain information on adolescents' preferences for pleasure: drugs or recreation. Data were collected from a sample of 100 high school students from a medium-sized college town, and 100 students from a rural town in Florida. Findings revealed four statistically significant associations in the motives or pleasures sought in recreation and in drug behaviors: "enhancement of popularity," "provision of a means for self-discovery," "achievement of personal goal," and means to rebel against parents. In reference to the latter motive, findings revealed that neither drugs nor recreation were used to rebel against parents. Findings also provide documentation of the value of recreation in insulating adolescents against many of the stressors of contemporary life.