Urinary tract infection (UTI) is a common bacterial infection in women of all ages but the incidence and prevalence increase with age. Despite the high incidence of UTI, little is known about its impact on morale or subjective wellbeing and daily life in old women. UTI in older people can be a complex problem in terms of approach to diagnosis, treatment and prevention because in these patients it frequently presents with a range of atypical symptoms such as delirium, gastrointestinal signs and falls. Even if UTI has been shown to be associated with delirium it has frequently been questioned whether UTI can cause delirium or if it is only accidentally detected when people with delirium are assessed. The main purpose of this thesis was to describe the prevalence of UTI, to identify factors associated with UTI among very old women and to illuminate the impact of a UTI on old women’s health and wellbeing.  This thesis is based on two main studies, the GErontological Regional DAtabase (GERDA) a cross-sectional, population-based study carried out in the northern parts of Sweden and Finland during 2005-2007 and a qualitative interview study in western Sweden 2008-2009. Data were collected from structured interviews and assessments made during home visits, from medical records, care givers and relatives. UTI was diagnosed if the person had a documented symptomatic UTI, with either short- or long-term ongoing treatment with antibiotics, or symptoms and laboratory tests judged to indicate the presence of UTI by the responsible physician or the assessor. One hundred and seventeen out of 395 women (29.6%) were diagnosed as having suffered from at least one UTI during the preceding year and 233 of these 395 (60%) had had at least one diagnosed UTI during the preceding 5 years. These old women with UTI were more dependent in their activities of daily living, and had poorer cognition and nutrition. In these women, UTI during the preceding year was associated with vertebral fractures, urinary incontinence, inflammatory rheumatic disease and multi-infarct dementia. Eighty-seven of 504 women (17.3%), were diagnosed as having a UTI with or without ongoing treatment when they were assessed, and almost half (44.8%) were diagnosed as delirious or having had episodes of delirium during the past month. In all, 137 of the 504 women (27.2%) were delirious or had had episodes of delirium during the past month and 39 (28.5%) of them were diagnosed as having a UTI. Delirium was associated with Alzheimer’s disease, multi-infarct dementia, depression, heart failure and UTI. Forty-six out of 319 women (14.4%) were diagnosed as having had a UTI with or without ongoing treatment and these had a significantly lower score on the Philadelphia Geriatric Center Morale Scale (PGCMS), (10.4 vs 11.9, p=0.003) than those without UTI, indicating a significant impact on morale or subjective wellbeing among very old women. The medical diagnoses significantly and independently associated with low morale were depression, UTI and constipation. The experience of suffering from repeated UTI was described in interviews conducted with 20 old women. The interviews were analysed using qualitative content analysis. The participants described living with repeated UTI as being in a state of manageable suffering and being dependent on alleviation. Being in a state of manageable suffering was described in terms of experiencing physical and psychological inconveniences, struggling to deal with the illness and being restricted regarding daily life. Being dependent on alleviation was illustrated in terms of having access to relief but also experiencing receiving inadequate care. In conclusion, UTI is very common among old and very old women and is a serious health problem. UTI seems to be associated with delirium and to have a significant impact on the morale or subjective wellbeing of old women and those affected suffer both physically and psychologically and their social life is limited. UTI was also associated with vertebral fractures, urinary incontinence, inflammatory rheumatic disease and multi-infarct dementia which might raise the suspicion that UTI can have serious medical effects on health in old women. / Embargo t o m 2011-11-11

This thesis explores the remarkable dearth of old woman narrators in British fiction between 1790 and 1860, both documenting their under-representation and explaining it as, in part, a product of a wave of medical discourse disparaging the physical and mental vitality of post-menopausal women. Regarding methodology, I perform a random sample upon a corpus of first-person novels published in the period and categorize each according to the gender and age of the narrator. This analysis exhibits, unsurprisingly, that most narrators in the dataset are either in the first half of their life, male, or both. Old women represent only a fraction of the narrators in the set. Regarding explanation, I point to widely cited and republished writings of physicians from the late eighteenth- and early nineteenth-century. These documents suggested that menopause, though often occurring in what we today would consider middle age, marked the onset of female senescence. After this "change of life," as it was euphemistically termed, women who did not mellow and recede as expected were seen as transgressing biological "laws" that prohibited their bodies from biological reproduction. And as the biological was often conflated with the social, post-menopausal women were also, by extension, sometimes thought unfit for creative or literary production. Though such medical discourse is by no means the only influence on this era's marginalization of older women, it is a significant one that merits further study. By investigating how gyno-gerontological discourse came to bear on the inclusion--or rather, exclusion--of old female narrators within nineteenth-century fiction, this thesis contributes to a growing body of works within literary gerontology. The hope is that as literary gerontology continues to expand as a field of study, more scholars, students, and eventually general readers will become more conscious of the obstacles and frustrations faced by older generations--especially older women--in a world that, even by means of institutions as apparently disinterested as medicine and health care, is constantly overlooking, demeaning, or sidelining their experiences in favor of those of the young.

No description available.

Submitted to the Facu1ty of Arts in fulfilment of the requirements for the degree of Doctor of Philosophy in the department of Anthropology and Development Studies at the University of Zululand, 1982. / Old age is a neglected area of anthropological research despite the widespread interest in the human life cycle that has characterized much work within the discipline.- With the notable exception of the early pioneering work of Simmons, the anthropological literature on old age in preliterate cultures is sparse, with little attention having been devoted either to the collection of ethnographic data or to the formulation of gerontological theory. As Clerk observes: 'If one is to judge from typical anthropological accounts, the span of years between the achievement of adult status and one's funerary rites is either an ethnographic vacuum or a vast monotonous plateau of invariable behavior. Maxwell & Silverman hold the same opinion: 'Anthropologists have not, on the whole, shown much interest in ageing. With few exceptions, ethnographic reports seem to mention the. aged only in passing, if at all, and then only in the context of quite general statements. One of the reasons to which they attribute this neglect is the distaste with which old age is viewed in our culture. The aged tend to suffer from physical or mental disabilities which are unpleasant to contemplate; death is imminent; and the role of the aged in culture is ostensibly less distinctive than that of younger men and women.

有鑑於臺灣地區已在民國八十二年步入「老人國」之列，顯示老年人的經濟問題已不容忽視。尤其是女性老人，更是最易落入貧窮的一個族群，因此，本研究即在探討老年婦女陷入貧窮之因素及困境，研究目的有三： 1.探討婦女在老年陷入貧窮困境的因素。 2.探索貧窮的老年婦女之生活困境，以及她們如何適應。 3.依據研究結果提出政策上的建議。 本研究採取女性主義者對女性陷入貧窮因素的解釋，輔以生命週期的觀點，來探討在女性的一生中，累積經濟資源（主要是工作薪資及財產繼承）的能力與機會如何影響到其在老年期的經濟地位。另外，也探討年滿65歲的老年婦女一旦陷入貧窮，她們所面臨在經濟上、健康醫療上、住屋上、心理適應及社會疏離的困境，以及她們如何適應。 本研究係採「質化研究法」，深入訪談十二位領取中低收入戶老人生活津貼的老年婦女，藉以勾勒出其生活狀況，及其一生中面臨的困境與難關。研究結果顯示，由於女性身為經濟依賴者的身份，因此，陷入貧窮最大的因素在於被依賴者無法提供充足的經濟生活。而女性的被依賴者包含丈夫、子女及自己（含娘家）。由女性的一生看起來，她們先是生在不甚富裕的家庭裡，於是無法對她們做人力投資，再加上勞力市場的性別歧視，使她們無法靠自己的力量賺取薪資。除此之外，娘家的困窘也無法提供任何財產的繼承。而後，在婚姻市場上也找不到條件較佳的丈夫，經濟生活得不到保障。而在這種貧困的條件下，對所生育的子女自也無法做良好的投資，培育其人力資本，影響到在勞力市場的表現，再加上子女若無撫養之意願，「養兒防老」的期待自然落空。 更深一層去探究老年婦女陷入貧窮的因素，其實是受到「父權主義」操縱的影響。由父權主義延伸的「性別勞力分工」的概念，形塑了「男主外，女主內」的分工方式，於是女性擔負起無酬的家務工作及照顧工作的責任，再加上女性在教育、財產繼承、勞力市場等所受到的不平等待遇，使她們要靠自己的力量賺取薪資是相當不容易的，於是她們的經濟生活只能依賴男性，而當男性無法支持時，就無可避免的陷入貧窮。 歸納起來，受訪者正式進入社會救助體系的導火線不外三種：健康、住屋、以及工作中斷。這些事件的發生使得她們原本即不充裕的經濟生活更是陷入困境，在沒有其他支持體系的情況下，唯有進入社會救助中低或低收入戶的體系，以獲得生活上的補助。面對貧窮這項事實，大多的受訪者都抱持宿命論的態度。而在適應的方法上，受訪者多是參與宗教活動、運動、與鄰居聊天等方式來調適自己的心情。但由她們所從事的活動看來，侷限於自家附近，並很明顯的偏向從事免費的活動，形成了社會疏離的現象。會造成這種現象的因素即是因為受訪者受限於經濟狀況、教育程度以及自卑心理，使她們與外界聯繫的程度不高。 根據研究結果，研究者提出幾點建議： 1.減少就業市場的性別歧視。 2.減少因家務照顧責任的損失。 3.合理計算貧窮線之基準，並規劃相關的補助措施。 4.鼓勵低收入戶老人參與文康休閒活動，及加強對低收入戶獨居老人的問安服務。 5.規劃國民年金制度。 本研究之研究限制有二： 1.無法推論及概化。 2.信度與效度的問題。