Meredith Tavener

Transforming Retirement: New Definitions of Life After Work

This quantitative research study uses survey data of women born between 1946 and 1951 in Australia. It follows earlier work that identified the importance of transitions from work for women of the baby boomer generation. We provide important insights into the lives of women who have partially or fully retired and the changing nature of womens work and retirement. For many women, retirement is characterized by newfound freedoms, opportunities, career change, and evolving identities, yet others view retirement as a continuation of previous occupational and gendered roles and commitments. This study has important implications for retirement policies for women.

Memory Complaint Questionnaire performed poorly as screening tool: validation against psychometric tests and affective measures

OBJECTIVE This study examined the internal and external validity of the Memory Complaint Questionnaire (MAC-Q), a brief measure of subjective memory complaint in people with normal cognitive function. STUDY DESIGN AND SETTING The Study of Health Outcomes in Aircraft Maintenance Personnel was a retrospective cohort study investigating the association between aircraft fuel tank deseal/reseal activities and health status in Royal Australian Air Force personnel. Cross-sectional comparison tests included measures of executive functioning, psychomotor speed, attention/working memory, new learning/memory, depression, and anxiety. An adjusted regression analysis accounted for confounders including age, dates of posting, rank, education, alcohol use, tobacco use, and affective status. RESULTS Eight hundred seventy-nine participants completed the MAC-Q. Although the MAC-Q tested as highly reliable and internally valid, it was highly associated with affective status and was only associated with Digit Symbol Coding after adjustment for depression/anxiety. CONCLUSION The MAC-Q is greatly influenced by affective status but not memory performance. It is probably not useful as a specific screen of memory complaint for general population research.

Hearing impairment in F-111 maintenance workers: The study of health outcomes in aircraft maintenance personnel (SHOAMP) general health and medical study

BACKGROUND We sought to examine hearing loss in a group from the Royal Australian Air Force who undertook fuel tank maintenance on F-111 aircraft, with exposure to formulations containing ototoxins, relative to two different comparison groups. METHODS Using pure-tone audiometry, hearing thresholds were assessed in 614 exposed personnel, 513 technical-trade comparisons (different base, same job), and 403 non-technical comparisons (same base, different job). We calculated percentage loss of hearing (PLH) and used regression models to examine whether there was an association between PLH and F-111 fuel tank maintenance, adjusting for possible confounders. In addition, the difference between the observed hearing thresholds and the expected thresholds based on an otologically normal population (ISO-7029-2003) was determined. RESULTS The PLH ranged from nil to 96 (median 1.5, quartiles 0.3, 5.5). A logistic regression model showed no statistically significant difference in PLH among the three exposure groups (exposed vs. non-technical controls 1.1: 95% CI 0.7, 2.0 and exposed vs. technical OR 0.9: 95% CI 0.6, 1.3). The model also highlighted a number of other risk factors for PLH including age, tinnitus, smoking, depression, and use of depression medications. However, at all eight frequencies measured, all populations had lower than expected hearing thresholds based on published ISO-7029 medians. CONCLUSIONS Although there was no difference in PLH between the three exposure groups, the study did reveal a high degree of hearing loss between the 3 groups and a normal population.

Mental health in F-111 maintenance workers: the study of Health Outcomes in Aircraft Maintenance Personnel (SHOAMP) general health and medical study.

Objective: We sought to contrast mood disorder symptoms in F-111 aircraft Deseal/Reseal maintenance personnel with appropriate comparisons. Methods: Participants completed a comprehensive health assessment, including measures of mood disorder, self-reported mood symptom questionnaire items, and review of anxiolytic and depression medication. Multiple logistic regression was conducted for each outcome using exposure group and potential confounders as explanatory variables. Results: There was high agreement between self-reported mood disturbance and objective tests. The exposed group was more likely to self-report previous diagnoses of depression/anxiety, had higher use of antidepressant medications, and had increased risk of diagnosis of depression/anxiety. Results were consistently strong against both comparison groups, with the exposed more likely to have mental distress and social dysfunction when compared with the Australian population. Conclusions: There is robust evidence for an association between F-111 Deseal/Reseal exposure and impaired mental health.

Retirement, age, gender and mental health: Findings from the 45 and Up Study

Objectives: To examine the relationships of retirement and reasons for retirement with psychological distress in men and women at the age of 45–79 years. Method: Data from 202,584 Australians participating in the large-scale 45 and Up Study was used. Psychological distress was measured by the Kessler psychological distress scale. Associations between different work status and reasons for retirement with psychological distress were assessed for men and women at different ages using logistic regression. Results: Being fully retired or unemployed was associated with the high levels of psychological distress compared to being in paid work for men and women aged 45–64 (p < 0.0001), and for men aged 65–74 years (p ≤ 0.0014). At the age of 75–79 years, there was no difference in psychological distress between different work statuses. Among retirees, retirement due to ill health, being made redundant or caring duty was associated with the high level of psychological distress. Conclusion: The association between work and mental health underscores the importance of policies and strategies to encourage and enable people to continue in the workforce after age 55, particularly for men. Important reasons for retirement with worse mental health outcomes include redundancy, ill health and needing to care for family or a friend. These circumstances will affect whether a person can continue working and their risk of poor mental health, and both considerations should be addressed in developing approaches for maintaining older workers or assisting them with their retirement transition.

Socioeconomic related inequality in depression among young and middle-adult women in Indonesia׳s major cities

PURPOSE Difficult living conditions in urban areas could result in an increased risk of developing depression, particularly among women. One of the strong predictors of depression is poverty, which could lead to inequality in risk of depression. However, previous studies found conflicting results between poverty and depression. This study examines whether depression was unequally distributed among young and middle-adult women in Indonesia׳s major cities and investigate the factors contributed to the inequality. METHODS Data from 1117 young and middle-adult women in Indonesia׳s major cities (Jakarta, Surabaya, Medan, and Bandung) were analysed. Concentration Index (CI) was calculated to measure the degree of the inequality. The CI was decomposed to investigate the factor contributing most to the inequality. RESULTS The prevalence of depression was 15% and more concentrated among lower economic group (CI=-0.0545). Compared to the middle-adult group, the prevalence of depression among women in the young-adult group was significantly higher (18% vs 11%, p<0.05) and more equally distributed (CI=-0.0343 vs CI=-0.1001). Household consumption expenditure was the factor that contributed most to inequality in both group. Other factors contributing to inequality were smoking in young-adult group and marital status in middle-adult group. Contribution of education to inequality varied for different age groups. CONCLUSION Depression is more concentrated among the lower economic groups, with household expenditure being the major factor contributing to the inequality. This finding emphasises the importance of primary care level mental health services, particularly in poorer urban communities. LIMITATION This study is based on a cross-sectional data, and only assesses social determinants of depression. These determinants are important to address in addition to biological determinants and other factors.

Loss to follow-up was used to estimate bias in a longitudinal study: a new approach

OBJECTIVES To examine bias arising from loss to follow-up due to lack of contact. STUDY DESIGN AND SETTING The 1973-1978 cohort of Australian Longitudinal Study on Womens Health was first surveyed in 1996 and followed up in 2000, 2003, 2006, and 2009. At the 2000 survey, 9,688 women responded (responders), 2,972 could not be contacted, of whom 1,515 responded subsequently (temporary no contact) and 1,457 did not (permanent no contact). Characteristics were compared for these groups at baseline and follow-up in 2003, 2006, or 2009. Relative risk ratios were used to estimate bias. RESULTS No-contacts were younger, more likely to live in cities, to be less educated and stressed about money than responders. No-contacts were more likely to be in de facto relationships, separated, divorced, or widowed, to have experienced partner violence and be smokers. Compared with temporary no contact, permanent no contact were less educated, less likely to be studying or employed. Despite differences in prevalence estimates, relative odds ratios were close to one and had confidence intervals that included one, indicating little effect of bias. CONCLUSION Although various characteristics were related to loss to follow-up, the relative risks estimates did not indicate serious bias due to loss to follow-up in this cohort of young women.

Impairment of color vision in aircraft maintenance workers

PurposeThe purpose of the study was to examine possible persisting effects to color vision in a group from the Royal Australian Air Force who had exposure to formulations containing neurotoxins during F-111 fuel tank maintenance, relative to two contemporaneous comparison groups.MethodsColor vision was tested in 512 exposed personnel, 458 technical-trade comparisons, and 330 non-technical comparisons using the Ishihara test plates and the Lanthony D-15 Desaturated Color disk arrangement test. Participants were excluded if they failed the Ishihara test as this indicates congenital color blindness. From the Lanthony results, the type of color deficient vision (CDV) was diagnosed, and additionally, the Bowman’s color confusion index (CCI) was calculated. Regression models were used to examine whether there was an association between color vision deficiencies and F-111 fuel tank maintenance, adjusting for possible confounders.ResultsThe CCI ranged from 1 to 2.8 (median 1.2, quartiles 1.1, 1.4) in the 2,600 eyes tested. Forty five percent of all participants had blue-yellow CDV in at least one eye. Deficiencies of this nature are caused by environmental exposures. Logistic regression demonstrated statistically significant differences in CCI category in the exposed group versus technical group (odds ratio 1.7: 95% CI 1.3–2.0) and a blue-yellow confusion in the exposed group versus technical group (odds ratio 1.4: 95% CI 1.1–1.7). No differences were observed between the exposed group and the non-technical group.ConclusionThe results indicate reduced color discrimination among the exposed subjects compared to one of two control groups. The findings may be due to previous exposure to solvents among the air force personnel.

Older Australian women's use of dentists: a longitudinal analysis over 6 years

Aim:  To identify factors associated with dentist consultation by older Australian women.

A checklist for comprehensive health assessment for the over 70's

Objectives: To describe the development and performance of an instrument for health assessment of older Australian veterans and war widows, including: (a) the underlying dimensions of the assessment instrument, (b) problems identified and (c) associations with health related quality of life. Method: Participants were randomly selected veterans and war widows aged 70 years and over, living independently in 10 regions of NSW and QLD. The intervention consisted of a series of preventive care home visit health assessments by health professionals using a specially developed 113‐item screening checklist, together with targeted health education materials, telephone follow‐up and computer generated reports to the veterans local medical officer. Main outcome measures were underlying facets of the checklist, and associations with self reported quality of life. Results: 904 home visit assessments were conducted using the checklist. Problems identified included having no recent hearing check, poor rate of vaccination against pneumonia and tetanus vaccination, and problems with feet. Exploratory factor analysis of the checklist reported four main factors, explaining 31% of the variance. Three out of four checklist scales were significantly associated with both physical and mental component scores of the SF‐36 quality of life measure.