Higher emotional distress in female partners of cancer patients: prevalence and patient-partner interdependencies in a 3-year cohort

OBJECTIVE: Assessment and treatment of psychological distress in cancer patients was recognized as a major challenge. The role of spouses, caregivers, and significant others became of salient importance not only because of their supportive functions but also in respect to their own burden. The purpose of this study was to assess the amount of distress in a mixed sample of cancer patients and their partners and to explore the dyadic interdependence. METHODS: An initial sample of 154 dyads was recruited, and distress questionnaires (Hospital Anxiety and Depression Scale, Symptom Checklist 9-Item Short Version and 12-Item Short Form Health Survey) were assessed over four time points. Linear mixed models and actor-partner interdependence models were applied. RESULTS: A significant proportion of patients and their partners (up to 40%) reported high levels of anxiety, depression, psychological distress, and low quality of life over the course of the investigation. Mixed model analyses revealed that higher risks for clinical relevant anxiety and depression in couples exist for female patients and especially for female partners. Although psychological strain decreased over time, the risk for elevated distress in female partners remained. Modeling patient-partner interdependence over time stratified by patients' gender revealed specific effects: a moderate correlation between distress in patients and partners, and a transmission of distress from male patients to their female partners. CONCLUSIONS: Our findings provide empirical support for gender-specific transmission of distress in dyads coping with cancer. This should be considered as an important starting point for planning systemic psycho-oncological interventions and conceptualizing further research.

Motor ability and self-esteem: The mediating role of physical self-concept and perceived social acceptance

Objectives: One important issue in sport and exercise psychology is to determine to what extent sports and exercise can help to increase self-esteem, and what the underlying mechanism might be. Based on the exercise and self-esteem model (EXSEM) and on findings from the sociometer theory, the mediating effect of physical self-concept and perceived social acceptance on the longitudinal relationship between motor ability and self-esteem was investigated. Design: Longitudinal study with three waves of data collection at intervals of ten weeks each. Method: 428 adolescents (46.3 % girls, mean age = 11.9, SD = .55) participated in the study, in which they performed three motor ability tests and completed paper-and-pencil questionnaires for physical self-concept and perceived social acceptance, as well as for self-esteem, at all three measuring points. Results: Using structural equation modelling procedures, the multiple mediation model revealed both physical self-concept and perceived social acceptance to be mediators between motor ability and self-esteem in the case of boys. In girls, on the other hand, the mediation between motor ability and self-esteem only takes place via physical self-concept. Conclusions: Gender differences in the relationship between motor ability and self-esteem suggest gender-specific interventions aimed at promoting self-concept.

A Longitudinal Study of Mental Health in Emerging Adults

Emerging adulthood is a time of instability. This longitudinal study investigated the relationship between mental health and need satisfaction among emerging adults over a period of five years and focused on gender-specific differences. Two possible causal models were examined: (1) the mental health model, which predicts that incongruence is due to the presence of impaired mental health at an earlier point in time; (2) the consistency model, which predicts that impaired mental health is due to a higher level of incongruence reported at an earlier point in time. Emerging adults (N = 1,017) aged 18–24 completed computer-assisted telephone interviews in 2003 (T1), 2005 (T2), and 2008 (T3). The results indicate that better mental health at T1 predicts a lower level of incongruence two years later (T2), when prior level of incongruence is controlled for. The same cross-lagged effect is shown for T3. However, the cross-lagged paths from incongruence to mental health are marginally associated when prior mental health is controlled for. No gender differences were found in the cross-lagged model. The results support the mental health model and show that incongruence does not have a long-lasting negative effect on mental health. The results highlight the importance of identifying emerging adults with poor mental health early to provide support regarding need satisfaction.

Geschlechtsspezifische Berufswünsche und Ausbildungsentscheidungen

Dass es geschlechtstypische Berufe gibt, und dass die Berufsaspirationen und die Wahl der Berufsausbildung nach der Pflichtschulzeit zwischen den Geschlechtern deutlich differieren, ist eine vielfach empirisch belegte Tatsache. Diese geschlechtstypische Segregation bei der Berufswahl und der zum ausgewählten Beruf führenden schulischen und beruflichen Ausbildung wird bei der Erklärung oftmals (pauschal) auf die geschlechtsspezifische Sozialisation und darin vermittelte Geschlechterstereotype zurückgeführt. Im vorliegenden Beitrag werden aus strukturell-individualistischer Sicht Mechanismen der geschlechtstypischen Berufsaspiration und Berufsbildungsentscheidung beschrieben, die theoriegeleitet empirisch aufgedeckt werden sollen. Für die Analysen werden Daten der drei Wellen des DAB-Panels verwendet, die für die Deutschschweiz Informationen von 203 Schulklassen mit rund 3.300 Schülerinnen und Schüler zur Verfügung stellen. Mittels dieser Paneldaten wird für Jugendliche der Deutschschweiz gezeigt, dass der sozioökonomische Status des Elternhauses, das damit einhergehende Motiv des intergenerationalen Statuserhalts sowie der Lebenslaufplanungen wichtige Beiträge zur Erklärung der Segregation der Berufswahl nach Geschlecht liefern. Diese mit dem Sozialstatus des Elternhauses verbundenen Mechanismen sind weitaus einflussreicher als die geschlechtsspezifische Sozialisation.

Genetic predictors of bladder cancer with an emphasis on methylation-related genes

Although tobacco exposure remains the prevailing risk factor for bladder cancer (BC), only a small percentage of exposed individuals develop cancer, suggesting that tobacco-related carcinogenesis is modulated by genetic susceptibility and possibly by DNA methylation-related events. Methylation patterns established by DNA methyltransferases (DNMTs) are influenced by dietary folate and genetic polymorphisms in the methylene-tetrahydrofolate reductase gene (MTHFR). Therefore, we hypothesized that DNA methylation-related genes, such as DNMT3B and MTHFR, might modulate BC risk. ^ In a study of 514 Caucasian BC cases and 498 healthy Caucasian controls examining the DNMT3B C46359T polymorphism, CC genotype was found to be a risk factor in women (Odds Ratio (OR) = 1.79), but not in men. This risk was further increased among women who were never smokers, consumed low dietary folate, and had adverse variants of MTHFR. In addition, higher DNMT3B expression among smokers was a risk factor (OR = 4.27) and correlated with genetic variants of the DNMT3B C46359T polymorphism, providing salient evidence for the risk associated with the CC variant. This suggests that the DNMT3B CC variant may confer a predisposition toward aberrant de novo methylation of CpG islands in critical tumor suppressor genes. ^ The convergence of alterations in DNMT3B, associated with promoter methylation, and reduced dietary folate consumption, accompanying global hypomethylation and genetic instability, may act synergistically to promote bladder carcinogenesis, especially in women. The results of this study unveiled new gender-specific paradigms of BC risk for women and demonstrated that this risk can be modified by folate consumption as well as polymorphisms in the folate pathway. ^

The association of food sources of calcium with weight class in adolescent girls

To determine the association of food sources of calcium with weight class in adolescent girls, the major food sources of calcium were determined for 718 sixth grade girls at three different time periods during an 18 month school-based health intervention program using a FFQ. To determine weight class, the BMI of each girl was stratified using CDC age and gender specific criteria at each time period. The percent contribution of the major food sources of calcium to total calcium intake was compared among the different weight classes at each time period, among those girls who had changed weight class at the different time periods and for those girls who did not change weight class at the different time periods. The mean total calcium intake increased by 20% between the first two time periods and by 12% between the first and last time periods with the intervention despite baseline total calcium intake already being greater than the recommended 1300 mg/day. The percent contribution of the major food sources of calcium were highly correlated among the weight classes that were compared throughout the study. Those girls who remained in the normal weight class throughout the study had the most consistent intake of food sources of calcium. Their top four food sources of calcium were different types of milk which provided greater than 50% of their total calcium intake. Despite there being no significant differences in the major food sources of calcium among the different weight classes, these data show a successful intervention for increasing calcium intake among adolescent girls. ^

The cost of insuring the uninsured in the U.S.

Objectives: This study included two overarching objectives. Through a systematic review of the literature published between 1990 and 2012, the first objective aimed to assess whether insuring the uninsured would result in higher costs compared to insuring the currently insured. Studies that quantified the actual costs associated with insuring the uninsured in the U.S. were included. Based upon 2009 data from the Medical Expenditure Panel Survey (MEPS), the second objective aimed to assess and compare the self-reported health of populations with four different insurance statuses. The second part of this study involved a secondary data analysis of both currently insured and currently uninsured individuals who participated in the MEPS in 2009. The null hypothesis was that there were no differences across the four categories of health insurance status for self-reported health status and healthcare service use. The alternative hypothesis was that were differences across the four categories of health insurance status for self-reported health status and healthcare service use. Methods: For the systematic review, three databases were searched using search terms to identify studies that actually quantified the cost of insuring the uninsured. Thirteen studies were selected, discussed, and summarized in tables. For the secondary data analysis of MEPS data, this study compared four categories of health insurance status: (1) currently uninsured persons who will become eligible for Medicaid under the Patient Protection and Affordable Care Act (PPACA) healthcare reforms in 2014; (2) currently uninsured persons who will be required to buy private insurance through the PPACA health insurance exchanges in 2014; (3) persons currently insured under Medicaid or SCHIP; and (4) persons currently insured with private insurance. The four categories were compared on the basis of demographic information, health status information, and health conditions with relatively high prevalence. Chi-square tests were run to determine if there were differences between the four groups in regard to health insurance status and health status. With some exceptions, the two currently insured groups had worse self-reported health status compared to the two currently uninsured groups. Results: The thirteen studies that met the inclusion criteria for the systematic review included: (1) three cost studies from 1993, 1995, and 1997; (2) four cost studies from 2001, 2003, and 2004; (3) one study of disabilities and one study of immigrants; (4) two state specific studies of uninsured status; and (5) two current studies of healthcare reform. Of the thirteen studies reviewed, four directly addressed the study question about whether insuring the uninsured was more or less expensive than insuring the currently insured. All four of the studies provided support for the study finding that the cost of insuring the uninsured would generally not be higher than insuring those already insured. One study indicated that the cost of insuring the uninsured would be less expensive than insuring the population currently covered by Medicaid, but more expensive to insure than the populations of those covered by employer-sponsored insurance and non-group private insurance. While the nine other studies included in the systematic review discussed the costs associated with insuring the uninsured population, they did not directly compare the costs of insuring the uninsured population with the costs associated with insuring the currently insured population. For the MEPS secondary data analysis, the results of the chi-square tests indicated that there were differences in the distribution of disease status by health insurance status. As anticipated, with some exceptions, the uninsured reported lower rates of disease and healthcare service use. However, for the variable attention deficit disorder, the uninsured reported higher disease rates than the two insured groups. Additionally, for the variables high blood pressure, high cholesterol, and joint pain, the currently insured under Medicaid or SCHIP group reported a lower rate of disease than the two currently insured groups. This result may be due to the lower mean age of the currently insured under Medicaid or SCHIP group. Conclusion: Based on this study, with some exceptions, the costs for insuring the uninsured should not exceed healthcare-related costs for insuring the currently uninsured. The results of the systematic review indicated that the U.S. is already paying some of the costs associated with insuring the uninsured. PPACA will expand health insurance coverage to millions of Americans who are currently uninsured, as the individual mandate and insurance market reforms will require. Because many of the currently uninsured are relatively healthy young persons, the costs associated with expanding insurance coverage to the uninsured are anticipated to be relatively modest. However, for the purposes of construing these results, it is important to note that once individuals obtain insurance, it is anticipated that they will use more healthcare services, which will increase costs. (Abstract shortened by UMI.)^

Salud e interculturalidad : un estudio en una población migrante en Mendoza

Los objetivos propuestos en la investigación han posibilitado identificar y documentar las barreras de acceso y los factores de riesgo en los cuidados de salud en ginecología y obstetricia y evaluar la situación sociofamiliar en la población migrante instrumentando acciones de inclusión en el sistema de salud de la provincia en aquellas pacientes que requirieron una atención de mayor complejidad. La experiencia de trabajo interdisciplinario en una comunidad ha posibilitado estudiar a 99 mujeres en edad fértil, en un 45% de origen boliviano, con alta vulnerabilidad social que habitan en el Distrito Belgrano de Guaymallén. Se realizó un estudio protocolizado, descriptivo y observacional con entrevistas semiestructuradas y control ginecológico, con toma de muestras para Papanicolaou y colposcopía en un consultorio que se instaló en el jardín maternal. Se aplicó un consentimiento informado a todas las mujeres antes de la realización de los estudios. La lectura de las muestras y los estudios específicos incluyeron mamografías y ecografías que se realizaron en los servicios de anatomía patológica y rayos del Hospital Universitario. El equipo del Hospital Universitario que concurrió a terreno estuvo formado por ginecólogos, trabajadores sociales, enfermeros y alumnos de las carreras de grado.

Y te llevaste en andas al ángel de los perdedores : El nómos de Antígona en su discurso final a partir del vocabulario legal en Antígona de Sófocles

Abordamos en Antígona la voz nómos utilizada por la protagonista en los vv. 908 y 914 de su último discurso. Con ese término califica la razón de su proceder, según la cual nunca habría realizado un entierro por un hijo o un esposo muerto pues la gente sensata justificaría sólo la sepultura de su hermano ya que un esposo y un hijo podría volver a tener pero nunca un hermano, con su padre y madre muertos. Pese a su uso, observa Etxabe (2009: 61), tales palabras no han sido articuladas con un argumento legal. No obstante, a un estudio con tales propósitos pareciera poder objetarse el hecho de que el léxico jurídico implica ante todo generalidad, lo que entraría en contradicción con la particularidad y excepcionalidad que caracteriza aquello que Antígona califica como nómos. Revisamos entonces qué implica para Antígona el entierro de su hermano y luego abordamos el asunto desde los estudios más recientes sobre la legalidad griega. En un contexto histórico en el cual tiene lugar un ordenamiento del sistema jurídico, que implica un cambio de actitud con respecto a las leyes no escritas frecuentemente asociadas a Antígona, la expresión nómos de este pasaje requiere la integración del trabajo filológico y los estudios del derecho griego, de la familia y de las relaciones de género en la Atenas del siglo V a.C.

Y te llevaste en andas al ángel de los perdedores : El nómos de Antígona en su discurso final a partir del vocabulario legal en Antígona de Sófocles

Abordamos en Antígona la voz nómos utilizada por la protagonista en los vv. 908 y 914 de su último discurso. Con ese término califica la razón de su proceder, según la cual nunca habría realizado un entierro por un hijo o un esposo muerto pues la gente sensata justificaría sólo la sepultura de su hermano ya que un esposo y un hijo podría volver a tener pero nunca un hermano, con su padre y madre muertos. Pese a su uso, observa Etxabe (2009: 61), tales palabras no han sido articuladas con un argumento legal. No obstante, a un estudio con tales propósitos pareciera poder objetarse el hecho de que el léxico jurídico implica ante todo generalidad, lo que entraría en contradicción con la particularidad y excepcionalidad que caracteriza aquello que Antígona califica como nómos. Revisamos entonces qué implica para Antígona el entierro de su hermano y luego abordamos el asunto desde los estudios más recientes sobre la legalidad griega. En un contexto histórico en el cual tiene lugar un ordenamiento del sistema jurídico, que implica un cambio de actitud con respecto a las leyes no escritas frecuentemente asociadas a Antígona, la expresión nómos de este pasaje requiere la integración del trabajo filológico y los estudios del derecho griego, de la familia y de las relaciones de género en la Atenas del siglo V a.C.

Y te llevaste en andas al ángel de los perdedores : El nómos de Antígona en su discurso final a partir del vocabulario legal en Antígona de Sófocles

Abordamos en Antígona la voz nómos utilizada por la protagonista en los vv. 908 y 914 de su último discurso. Con ese término califica la razón de su proceder, según la cual nunca habría realizado un entierro por un hijo o un esposo muerto pues la gente sensata justificaría sólo la sepultura de su hermano ya que un esposo y un hijo podría volver a tener pero nunca un hermano, con su padre y madre muertos. Pese a su uso, observa Etxabe (2009: 61), tales palabras no han sido articuladas con un argumento legal. No obstante, a un estudio con tales propósitos pareciera poder objetarse el hecho de que el léxico jurídico implica ante todo generalidad, lo que entraría en contradicción con la particularidad y excepcionalidad que caracteriza aquello que Antígona califica como nómos. Revisamos entonces qué implica para Antígona el entierro de su hermano y luego abordamos el asunto desde los estudios más recientes sobre la legalidad griega. En un contexto histórico en el cual tiene lugar un ordenamiento del sistema jurídico, que implica un cambio de actitud con respecto a las leyes no escritas frecuentemente asociadas a Antígona, la expresión nómos de este pasaje requiere la integración del trabajo filológico y los estudios del derecho griego, de la familia y de las relaciones de género en la Atenas del siglo V a.C.

Remediation of crude oil contaminated soils by means of bitumen emulsions

Effective remediation of contaminated sites with oils, heavy metals and other chemical agents is one of the most important environmental problems all over the world. Contaminated soils by petroleum from different sites and origins, might contaminate groundwater aquifers and then be spread by rain. Many years and the requirement of remedial techniques may be needed to remediate them. However, previous experiences show the uselessness of these methods for the solution of all problems. As any case of soil contamination is different, specific studies with relevant factors at financial aspects, legal limits and waste and soil characteristics are needed. In this work, a study of the use of bitumen asphalt emulsion to remediate contaminated soils by crude oils is exposed. By means of the soil stabilization technology, using the contaminated soils as aggregates and the tailor made emulsion as binder, the feasibility of the mix application to produce stable and resistant pavements is demonstrated

Seismicity and seismic risk in Spain = Sismicite et risque sismique en Espagne

The spanish seismic norm has a direct application in building construction but it recomends specific studies in the case of important public works such us large dams or bridges. For this reason, and to establish specifical criteria in its field of activity, the Dirección General de Obras Hidráulicas of the spanish Ministerio de Obras Públicas y Urbanismo commissioned us a seismotectonical and seismic risk study applicable to Spain, materialized on a series of maps of inmediate and direct use. In this paper we explain the methodology pursued to obtain these maps. It has required, firstly, investigations with the aim to improve the seismic information corresponding to the historical or preinstrumental period, that allowed more precise cuantifications. Secondly, these data have been processed by probabilistic methods, using de intensity as foundamental parameter. The corresponding maps have been developed. Finally, other maps of seismic accelerations have been compiled. La normative sismorresistent espagnole á une application directe dans 1'edification, mais elle recommend la realitation des etudes especifiques dans le cas des travaux publics importants telles que ponts ou barrages. Pour cette raison et pour etablir des criteres especifiques dans son camp dáctivité, la Direccion General de Obras Hidraulicas du Ministerio de Obras Publicas y Urbanismo espagnol a commande un etude sismotectonique et de risque sismique applicable a l'Espagne, materialise en une serie de cartes de utilization directe et inmediate. Dans cette communication on explique la methodologie a suivre pour la realization de cettes cartes. Celá a fait necessaire, d'abord, des recherches pour amelliorer l'information concernant le periode historique ou preinstrumental, ce qui permet des cuantifications plus precises. En second lieu ces faits ont ête traités avec des methodes probabilistes, employant l'intensité come parametre fondamental. En consequence nous avons developpe des cartes d'intensite et d'acceleration sismique.

Mineração oceânica: uma alternativa sustentável para o aproveitamento de areias quartzosas.

Este estudo apresenta ao Departamento de Engenharia de Minas e Petróleo (PMI) da Escola Politécnica da USP, e também a toda a sociedade, a importância que os oceanos têm com relação às suas riquezas minerais. Pretende ainda mostrar a grande responsabilidade que um empreendimento mineiro no fundo do mar precisa ter, com relação aos impactos ambientais, sendo possível minerar em regiões profundas no oceano promovendo a sustentabilidade. A ideia da mineração oceânica/submarina está ainda sendo amadurecida, este é o momento adequado para se propor metodologias de trabalho submarino sustentáveis; mitigar seus impactos. Este trabalho abrange o tema de maneira ampla, abordando o aspecto histórico, legal, ambiental, bem como questões técnicas de engenharia de minas, como sondagem submarina, caracterização tecnológica, lavra submarina, beneficiamento de minério oceânico e descarte de rejeitos. O trabalho apresenta os passos e resultados de um caso real de exploração oceânica. Trata-se de um estudo para viabilizar economicamente a extração e o beneficiamento de areia marinha, para fins industriais, proveniente da Baía de Guanabara (RJ). O trabalho apresenta desde o planejamento da amostragem no fundo do mar, execução destes trabalhos, caracterização tecnológica, simulação de processo e estudos específicos do uso industrial da areia após beneficiamento. Apresenta ainda uma proposta de rota de processo para a areia marinha e questões ligadas à lavra e ao descarte de rejeitos.

Aceptabilidad de la vacuna contra el VPH en estudiantes universitarios españoles durante la etapa pre-vacunal: un estudio transversal

Introducción. El cáncer de cuello de útero (CCU), segunda causa de mortalidad por cáncer en mujeres, está asociado a la infección por virus de papiloma humano (VPH), cuya máxima prevalencia se sitúa entre los 20 y 24 años de edad. Desde 2006 se dispone de una vacuna contra el VPH. El objetivo de este estudio es evaluar los conocimientos sobre CCU, la infección por VPH y su vacuna, valorando su aceptabilidad en población universitaria. Métodos. Estudio transversal sobre 1.750 estudiantes de la Universidad de Alicante (2008) seleccionados al azar, proporcional por sexo y estudios, mediante un cuestionario ad-hoc validado. Se calcularon porcentajes, intervalos de confianza, tablas de contingencia según sexo, edad y tipo de estudios, calculando odds ratios ajustadas (OR). Resultados. Muestra con 58,6% mujeres y 6,6% de estudiantes biosanitarios. Un 87,3% dispuestos a vacunarse frente al VPH, el 94,3% vacunaría a sus hijas, un 48,0% había oído hablar de la vacuna. El 90,6% tiene bajos conocimiento sobre la infección por VPH y un 82,2% sobre la vacuna. Un 22,4% manifiesta conocer la asociación entre VPH y CCU. Las mujeres registran OR mayores en conocimientos y predisposición a vacunarse. La aceptabilidad de la vacuna contra VPH se asocia con el sexo y la confianza en las vacunas como método preventivo, la influencia de los conocimientos previos es escasa sobre la predisposición vacunal. Conclusiones. Alta aceptabilidad de la vacuna en el periodo estudiado. Aumentar la confianza hacia las vacunas puede influir en una mejor predisposición a vacunarse.