Psychosocial interventions to support partners of men with prostate cancer: a systematic and critical review of the literature

Prostate cancer poses many challenges for both the man and his partner. Partners have reported a range of issues that impact their own mental health following their partner's diagnosis of prostate cancer. The aim of this review is to summarise and critically evaluate the current literature reporting psychosocial intervention studies for partners of prostate cancer patients.

The impact of prostate cancer on partners: a qualitative exploration

Prostate cancer and its treatment can result in numerous physical and psychological morbidities for the patient as well as his partner. This qualitative study aimed to explore the experiences of intimate spouses or partners of men diagnosed and/or treated for prostate cancer to better understand the personal impact of prostate cancer on the partner.

Responses and relationship dynamics of men and their spouses during active surveillance for prostate cancer: health literacy as an inquiry framework

BACKGROUND: Early stage prostate cancer patients may be allocated to active surveillance, where the condition is observed over time with no intervention. Living with a cancer diagnosis may impose stress on both the men and their spouses. In this study we explore whether the scores of and verbal responses to a Health Literacy Questionnaire can be used to identify individuals in need of information and support and to reveal differences in perception and understanding in health related situations within couples. METHODS: We used the nine-domain Health Literacy Questionnaire (HLQ) as a framework to explore health literacy in eight couples where the men were on active surveillance for prostate cancer progression. Scores were calculated for each domain for both individuals. For each couple differences in scores were also calculated and related to the informants' self-reported experiences and reflections in relation to participating in an active surveillance program. Also an inductive analysis was performed to identify themes in the responses and these themes were compared to those of HLQ. RESULTS: The men tended to score higher than their spouses. There was no consistent relation between scores and the reported experiences and reflections. However, some interesting patterns emerged, e.g. in two of the three couples with the largest within couple differences in HLQ scores, responses revealed discrepancies in how the men and their spouses perceived their situation. Also, three themes emerged which related to six of the HLQ domains, i.e. involvement of spouses and other people around the men; support from and interaction with healthcare professionals; and use of the Internet for information retrieval. CONCLUSIONS: Using the HLQ as an interview framework provided insight into the differences within couples and provided new perspectives on their experiences, including their contact with health professionals and the patient-spouse interaction when dealing with prostate cancer. The HLQ used as a dialogue tool may be an adjunct to assist healthcare providers to understand the need for support and information of men with prostate cancer on active surveillance and the dynamics within couples.

The health profile of people living with Parkinson's Disease managed in a comprehensive care setting

Background: Globally there are few reports of the impairments, disabilities and medications used in people living with idiopathic Parkinson’s disease. Caregiver characteristics and caregiver burden have seldom been reported. We examined the health status in a large cohort of people living with Parkinson’s disease and their caregivers managed in a comprehensive health care setting.

Methods/Design: A prospective, cross sectional analysis of impairments, disabilities and Parkinson’s disease medication use was conducted in a sample of 100 people with Parkinson’s disease rated I-IV on the modified Hoehn & Yahr scale. Participants were recruited from the Victorian Comprehensive Parkinson Program in Melbourne, Australia. Their caregivers were invited to provide their views on the burden of care, services provided and support received.

Results: The severity of impairments and disabilities was strongly associated with disease duration (mean of 5.5 years). Those with long standing disease or more severe disease also used more Parkinson’s disease medications and participated in fewer social roles than people who were newly diagnosed or mildly affected. The severity of impairments was strongly correlated with limitations in performing activities of daily living. Limitations in performing daily activities were also found to be a significant contributing factor for health-related quality of life (PDQ-39 SI β=0.55, p=0.000; EQ-5D SI β=0.43, p=0.001). People with Parkinson’s disease lived at home with relatives. The average caregiver was a spouse or child providing approximately 3.5 hours of care per day, with the capacity to provide 9.4 hours per day and had provided care for four years. Additional support was high (63%) for 2.5 hours per day.

Conclusion: The comprehensive care setting of this cohort describes a relatively benign condition despite a wide range of disease duration and severity. This report provides a baseline with which to compare other delivery models.

One Health approach to controlling a Q fever outbreak on an Australian goat farm

A recent outbreak of Q fever was linked to an intensive goat and sheep dairy farm in Victoria, Australia, 2012-2014. Seventeen employees and one family member were confirmed with Q fever over a 28-month period, including two culture-positive cases. The outbreak investigation and management involved a One Health approach with representation from human, animal, environmental and public health. Seroprevalence in non-pregnant milking goats was 15% [95% confidence interval (CI) 7–27]; active infection was confirmed by positive quantitative PCR on several animal specimens. Genotyping of Coxiella burnetii DNA obtained from goat and human specimens was identical by two typing methods. A number of farming practices probably contributed to the outbreak, with similar precipitating factors to the Netherlands outbreak, 2007-2012. Compared to workers in a high-efficiency particulate arrestance (HEPA) filtered factory, administrative staff in an unfiltered adjoining office and those regularly handling goats and kids had 5·49 (95% CI 1·29–23·4) and 5·65 (95% CI 1·09–29·3) times the risk of infection, respectively; suggesting factory workers were protected from windborne spread of organisms. Reduction in the incidence of human cases was achieved through an intensive human vaccination programme plus environmental and biosecurity interventions. Subsequent non-occupational acquisition of Q fever in the spouse of an employee, indicates that infection remains endemic in the goat herd, and remains a challenge to manage without source control.

Inequality and economic growth in Latin

Latin America is the region that bears the highest rates of inequality in the world. Deininger and Squire (1996) showed that Latin American countries achieved only minor reductions in inequality between 1960 and 1990. On the other hand, East Asian countries, recurrently cited in recent literature on this issue, have significantly narrowed the gap in income inequality, while achieving sustained economic growth. These facts have triggered a renewed discussion on the relationship between income inequality and economic growth. According to the above literature, income inequality could have an adverse effect on countries’ growth rates. The main authors who spouse this line of thinking are Persson and Tebellini (1994), Alesina and Rodrik (1994), Perotti (1996), Bénabou (1996), and Deininger and Squire (1996, 1998). More recently, however, articles were published that questioned the evidence presented previously. Representatives of this new point of view, namely Li and Zou (1998), Barro (1999), Deininger and Olinto (2000) and Forbes (2000), believe that the relation between these variables can be positive, i.e., income inequality can indeed foster economic growth. Using this literature as a starting point, this article seeks to evaluate the relation between income inequality and economic growth in Latin America, based on a 13-country panel, from 1970 to 1995. After briefly reviewing the above articles, this study estimates the per capita GDP and growth rate equations, based on the neoclassical approach for economic growth. It also estimates the Kuznets curve for this sample of countries. Econometric results are in line with recent work conducted in this area – particularly Li and Zou (1998) and Forbes (2000) – and confirm the positive relation between inequality and growth, and also support Kuznets hypothesis.

O Instituto das Súmulas Vinculantes e sua cogente alteração legislativa: a análise do verbete nº 13

O Supremo Tribunal Federal entregou ao ordenamento jurídico brasileiro, em 21 de agosto de 2008, a súmula vinculante nº 13. O referido verbete trata da vedação a nomeações de cônjuge, companheiro ou parente em linha reta, colateral ou por afinidade até o terceiro grau, no âmbito da administração pública direta e indireta, em todas as esferas. Antes da vigência da súmula vinculante nº 13, o nepotismo era praticado de forma nebulosa, tendo em vista a ausência de uma fiscalização eficaz e eficiente. Os Estados e Municípios, através de legislação própria, buscaram o combate a essa prática em momento anterior à edição do verbete, o país carecia de uma regra geral. A partir do início da vigência da súmula vinculante nº 13, o que se verificou, no âmbito da administração pública brasileira, como será demonstrado adiante, foram diversas exonerações de servidores por simples suposição de que determinada situação jurídica configuraria nepotismo, cenário totalmente contrário àquele então proposto.. O STF manifesta-se face aos casos concretos apenas em sede de reclamação. Têm-se, atualmente, uma situação de grave insegurança jurídica, onde servidores públicos não sabem se podem ou não ser nomeados ou se podem continuar exercendo suas funções. O presente exame, pautado no direito comparado e em estudo de casos, analisou algumas situações hipotéticas que, supostamente, configurariam nepotismo, e outras já decididas pela Suprema Corte e propõe uma alteração de natureza legislativa ao instituto das súmulas vinculantes: a criação de incisos a incluídos no corpo do enunciado após cada decisão em sede de reclamação, cujos efeitos não possuem efeito vinculante. Dessa forma, a administração pública direta e indireta poderá aplicar a súmula vinculante nº 13 de forma eficaz, sem interpretações equivocadas, de modo a permitir uma sintonia entre a segurança jurídica e a moralidade.

Tax filing choices for the household under separable spheres bargaining

If household choices can be rationalized by the maximization of a well defined utility function, allowing spouses to file individually or jointly is equivalent to offering the envelope of the two tax schedules. If, instead, household ’preferences’ are constantly being redefined through bargaining, the option to file separately may affect outcomes even if it is never chosen. We use Lundberg and Pollak’s (1993) separate spheres bargaining model to assess the impact of filing options on the outcomes of primary and secondary earners. Threat points of the household’s bargain are given for each spouse by the utility that he or she attains as a follower of a counter-factual off-equilibrium Stackelberg game played by the couple. For a benchmark tax system which treats a couple’s average taxable income as if it were that of a single individual, we prove that if choices are not at kinks, allowing couples to choose whether to file jointly or individually usually benefits the secondary earner. In our numeric exercises this is also the case when choices are at kinks as well. These findings are, however, quite sensitive to the details of the tax system, as made evident by the examination of an alternative tax system.

Planejamento sucessório na empresa familiar

Apresentação do conceito e características do planejamento sucessório, destacando a sua importância para a sobrevivência de um segmento típico da economia mundial; a Empresa Familiar. Analise das interpretações doutrinarias e jurisprudências das regras de concorrência entre cônjuge e descendentes, a luz do Novo Código Civil. Aplicação da teoria de planejamento sucessório em analise de caso prático, utilizando instrumentos do direito sucessório e do direito Societário.

Sintomatologia depressiva e avaliação de níveis de TNFα IL-2 em indivíduos idosos e com doença pulmonar obstrutiva crônica

The aim of the present study was to assess the presence of depressive symptomatology among elderly residents in long-stay institutions (LSI) and in the community of Recife, Brazil. In total, 81 long-stay elderly patients (mean age of 75.55 ± 9.18 years) and 132 elderly (mean age of 73.14 ± 8.27 years) individuals from the community were evaluated. Depressive symptomatology was assessed by the Geriatric Depression Scale (GDS-15), cognitive status by the Mini Mental State Examination (MMSE) and capacity to perform the activities of daily living (ADL) by the Katz Index. Comorbities and the use of medication were recorded. The LSI elderly exhibited more depressive symptoms (p < 0.001) and more dependency (p< 0.001). We observed no differences in MMSE (p = 0.058). The elderly in the community displayed more comorbidities and the LSI elderly consumed more medication (p < 0.001 and p < 0.001, respectively). According to multivariate analysis (logistic regression), being male, having no spouse and having a low schooling level are risk factors for depressive symptoms. In conclusion, most elderly with depressive symptoms received no medication fordepression.

Mulher chefe de família, na cidade de Aracaju:dominação e poder

The research was focada in the feminine head of family, the City of Aracaju and its impacts in the nuclear familiar nucleus. Considering that, the papers of the men are in general, not valued and rewarded that the papers of the women in almost all the cultures. The women generally load the responsibility to take care of of the children and the domestic work, while the men traditionally are born with the responsibility to support the family. However, we find changes in this mainly north-eastern scene and, where through quantitative research, already one evidenced that they are majority as family support, therefore, we observe the construction of social identities of the women family heads and uncurling of the adaptativos aspects, the existing mechanism between domination and power, in the familiar nucleus. The impacts in the family if had change in the social relation for them to be family heads. One is about qualitative research that has left of the construction of a theoretical landmark, analyzing given of bibliographical sources and from interviews with women family heads, power to observe the forms of joints in the nuclear families, as they deal with the power to decide power, the financial power, the fragility, the domination and the influences of the traditional models. Analyzing the familiar relations between the woman, the children and the spouse, searching the excellent questions for the briefing of the thematic one, demystifying the dichotomy between the mother/wife and woman head of family in the residential environment

Mãe-esposa e professora: educadoras no final do século XIX

This text is organized through discussions undertaken in the area of the History of Education in Rio Grande do Norte, circumscribed to the History of Women from the first decades of the Brazilian Republic, and to the analysis of what was expected of this education. We examined representations of women in Natal, between 1889 and 1914, with the goal of configuring relations between the sexes with the emphasis on moral, intellectual and pedagogical aspects required of these women. As documental sources we utilized the educational, civil and criminal Legislation, on a National scope, as well as on a State and Municipal scope. We circumscribed our search to the newspaper A República, in which we found literature that circulated in Natal in the form of pamphlets, short stories and poetry, as well as other texts by authors that were part of the corpus of analysis of this study, located in public and private archives in Rio Grande do Norte, such as the Historical and Geographic Institute of Rio Grande do Norte (IHGRN) and the State Public Archive of Rio Grande do Norte (APE-RN). The use of the indexing method and the propositions of Cultural History were the appropriate theoretical-methodological framework to complete studies of this nature. This operational perspective permitted us to elaborate nuances about this time of transition from the 19th to the 20th Century, and to spotlight the fire of the women from this period. The basis of the argument that related women to maternity and domesticity, and within the ideals of abnegation and religious leadership, aligned to a demand coming from the increase in the quantity of schools for women, allocated women as the most appropriate for superior in educational performance in the country, based on its foundations: primary education. Beyond the universe of formal education, the other side of women appeared in republican politics. The mother-spouse and the institutionalization of domestic education associated the female gender with the role of educator at home as well. Be it in the public sphere, as a teacher, or in private, as mother-spouse, female care is perceived in this configuration, as an educational base that the Republic, and in transition, bequeathed to the Brazilian 20th Century

Violência contra a mulher : estudo de caso em uma instituição de ensino

The study research case with a quantitative approach and prospective data, carried out between December 2010 and February 2011 with the aim of identifying the profile of women in the study, to characterize the acts of violence in the type, frequency, location occurrence and aggressor, analyze the steps taken after the occurrence of acts of violence and the main consequences on the victims. The population consisted of 285 workers in a tertiary institution in Rio Grande do Norte. The results showed that 99 (34.74%) have between 51 to 60 years of age, 78 (27.37%) of 41 to 50 and 62 (21.75%) between 20 and 30 years, are considered color white, 162 (56.84%) have completed higher education, 171 (60.00%) and of these 97 (56.73%) reported having some post-graduate degrees, are married, 141 (49.47%) and have from zero to one child, 148 (51.93%) reside in the south of the city of Natal, 146 (51.23%) have a monthly income of three to five minimum wages, 171 (60.00%) and are mostly in the Technical Administrative Sciences 152 (53.33%), 77 (27.02%) reported having experienced violence, 60 (62.50%) episodes of verbal aggression, 26 (27.08%) of bullying , 05 (5.21%) of physical abuse and 05 (5.21%) sexual harassment; 05 (100.00%) assaults were made by the spouse or partner of the victims and co-workers is another profession were responsible for 18 (30.00%) verbal aggression, 15 (57.69%) bullying and 03 (60.00%) sexual harassment, 02 (40.00%) of victims of physical aggression and 18 (30.00 %) of verbal abused only once, 10 (38.46%) of bullying and 02 (40.00%) of sexual harassment experienced four or more times 05 (100.00%) assaults occurred at domestic and work stood out with 36 (60.00%), verbal abuse, 22 (84.62%), moral harassment and 04 (80.00%) sexual harassment, 35 (36.46%) told colleagues work and 31 (32.29%) for family and friends in 75 (78.13%) cases there was no intervention, 07 (7.29) were unable to respond if something had been done and 14 (14.58% ) have been reported intervention of these, 09 (64.29%) were taken by the heads of the victims, 26 (32.10%) did not notify the fact on the ground that no action would be taken, 62 (80.52%) felt stress , 5 (1.76%) of women turned away from work after the episode of violence, accounting for 198 days of absenteeism. It is concluded that there is a high rate of violence against women, even when they have a good socioeconomic status, and in this sense is important to establish bases of new proposals for improving control of cases of health professionals, especially nurses, to approach patients with a more investigative, and that by identifying a case of violence, be instructed about the paths to be followed for notification while providing psychological support to victims.

Saúde física e emocional de cuidadores da cidade de Santa Cruz-RN: perfil epidemiológico e fatores associados

Taking care for an impaired elderly is a hard and costly task that could affect directly the caregiver health. The purpose of this study was to evaluate the physical and mental health of elderly caregivers from the city of Santa Cruz-RN and analyze the potential correlated factors through an observational analytic design of a crosssectional. A multidimensional questionnaire was used to evaluation of the social demographics characteristics and those related to the care activity, as well as the caregivers´ physical and mental health. It was realized a descriptive analyze using frequency distribution and measures of the central tendency and dispersion to description of the caregivers. To verify the magnitude of the association between the variables was used the bivariate analysis through the Pearson and Spearman correlations and qui-square test. To evaluation of the association of the correlated factors to the adverse outcome with the caregivers´ physical and mental health was made a multivariate analysis by logistic binary regression and multiple linear regression models. The final sample was constituted by 304 persons, mostly women with a mean age of 50.3 ±16.8 years. The principal factors related to the physical health were age, stress and life satisfaction. Be a male caregiver, caring for a little while the elderly with cognitive deficit and not been spouse were related to worse mental health. Have worse physical health, high stress, depressive symptomatology, burden and low levels of satisfaction were also related to the mental health. After adjust through multiple linear regression was observed R2 values of R2=0,21 for Stress, R2 =0,17 for Depressive Symptomatology, R2 =0,21 for Burden and R2 =0,16 for Satisfaction. The attainment of the factors associated with caregiver´s health can help in the elaboration of specifics politics witch the goal is the integral attention to the elderly and his caregiver. The inability of continuous taking care could result in adverse outcomes such as institutionalization, impairment and death

Relacionamento conjugal, problemas de comportamento e habilidades sociais de pré-escolares

Variáveis do relacionamento conjugal e relacionamento pais-filhos podem afetar o comportamento das crianças. O objetivo deste trabalho é comparar relatos de pais e mães de pré-escolares com e sem problemas de comportamento, quanto ao relacionamento conjugal. Participaram 48 casais, distribuídos em dois grupos: pais biológicos de crianças com problemas de comportamento e pais biológicos de crianças socialmente habilidosas, segundo avaliação de professores. Os pais foram entrevistados, individualmente, sobre expressão de carinho, comunicação conjugal, características positivas e negativas do cônjuge e qualidade do relacionamento conjugal. Foram encontrados alguns resultados na direção esperada. Os casais com criança socialmente habilidosa foram mais positivos quanto à comunicação e características do cônjuge. Não foram encontradas diferenças na expressão de carinho.