Excessive alcohol consumption in young men: is there an association with their earlier family situation? A baseline-analysis of the C-SURF-study (Cohort Study on Substance Use Risk Factors).

AIMS: To determine whether parental factors earlier in life (parenting, single parent family, parental substance use problem) are associated with patterns of alcohol consumption among young men in Switzerland. METHODS: This analysis of a population based sample from the Cohort Study on Substance Use Risk Factors (C-SURF) included 5,990 young men (mean age 19.51 years), all attending a mandatory recruitment process for the army. These conscripts reported on parental monitoring and rule-setting, parental behaviour and family structure. The alcohol use pattern was assessed through abstention, risky single occasion drinking (RSOD), volume drinking and dependence. Furthermore, the impact of age, family socio-economic status, educational level of the parents, language region and civil status was analysed. RESULTS: A parental substance use problem was positively associated with volume drinking and alcohol dependence in young Swiss men. Active parenting corresponded negatively with RSOD, volume drinking and alcohol dependence. Single parent family was not associated with a different alcohol consumption pattern compared to standard family. CONCLUSION: Parental influences earlier in life such as active parenting (monitoring, rule-setting and knowing the whereabouts) and perceived parental substance use problem are associated with alcohol drinking behaviour in young male adults. Therefore, health professionals should stress the importance of active parenting and parental substance use prevention in alcohol prevention strategies.

Pregnancy-related low back pain and pelvic girdle pain approximately 14 months after pregnancy : pain status, self-rated health and family situation

Background: Pelvic girdle pain (PGP) in pregnancy is distinct from pregnancy-related low back pain (PLBP). However, women with combined PLBP and PGP report more serious consequences in terms of health and function. PGP has been estimated to affect about half of pregnant women, where 25% experience serious pain and 8% experience severe disability. To date there are relatively few studies regarding persistent PLBP/PGP postpartum of more than 3 months, thus the main objective was to identify the prevalence of persistent PLBP and PGP as well as the differences over time in regard to pain status, self-rated health (SRH) and family situation at 12 months postpartum. Methods: The study is a 12 month follow-up of a cohort of pregnant women developing PLBP and PGP during pregnancy, and who experienced persistent pain at 6 month follow-up after pregnancy. Women reporting PLBP/PGP (n = 639) during pregnancy were followed up with a second questionnaire at approximately six month after delivery. Women reporting recurrent or persistent LBP/PGP at the second questionnaire (n = 200) were sent a third questionnaire at 12 month postpartum. Results: A total of 176 women responded to the questionnaire. Thirty-four women (19.3%) reported remission of LBP/PGP, whereas 65.3% (n = 115) and 15.3% (n = 27), reported recurrent LBP/PGP or continuous LBP/PGP, respectively. The time between base line and the 12 months follow-up was in actuality 14 months. Women with previous LBP before pregnancy had an increased odds ratio (OR) of reporting 'recurrent pain' (OR = 2.47) or 'continuous pain' (OR = 3.35) postpartum compared to women who reported 'no pain' at the follow-up. Women with 'continuous pain' reported statistically significant higher level of pain at all measure points (0, 6 and 12 months postpartum). Non-responders were found to report a statistically significant less positive scoring regarding relationship satisfaction compared to responders. Conclusions: The results from this study demonstrate that persistent PLBP/PGP is a major individual and public health issue among women 14 months postpartum, negatively affecting their self-reported health. However, the perceived relationship satisfaction seems to be stable between the groups.

Une étude sur le rôle modérateur de la situation familiale sur la relation entre les conditions de l'organisation du travail et la détresse psychologique

L’objectif principal de ce mémoire est de vérifier l’effet modérateur de la situation familiale sur la relation entre les conditions de l’organisation du travail et la détresse psychologique dans la main d’œuvre canadienne. De façon secondaire, nous nous intéressons également à l’effet direct que peut entretenir chacune des variables sur le risque de rapporter de la détresse psychologique. Pour nous aider à réaliser cette étude, les données provenant de l’Enquête sur la santé des collectivités canadiennes (ESCC) volet 2.1 par Statistique Canada ont été utilisées. Les analyses multivariées réalisées ont révélé que l’horaire irrégulier de travail était significativement associé au risque de vivre de la détresse psychologique. Par rapport à la situation familiale, nous observons que l’état civil soit le fait d’être en couple agit en tant que facteur de protection contre la détresse psychologique tandis que la suffisance du revenu augmente le risque de rapporter de la détresse psychologique. De plus, les résultats obtenus soutiennent partiellement un effet modérateur de la situation familiale, car seul le statut économique du ménage modifie la relation entre l’autorité décisionnelle et les demandes physiques au travail dans l’explication de la détresse psychologique. Ainsi, ces deux facteurs du travail augmenteraient le risque de développer de la détresse psychologique lorsque le statut économique est pris en compte. Par conséquent, l’effet de certaines conditions de l’organisation du travail tend à influer différemment la détresse psychologique selon la situation économique du ménage.

Family Anomie and Juvenile Deliquency in Post-Communist Romania

The sensitivity of crime rates to social, economic and political influences has long aroused the interest of sociologists who have attempted to explain what kind of relationships might be associated with variations in crime rates between different social groups at different times. The earliest views were put forward by Emil Durkheim, and while later writers have developed (R.K. Merton, L. Srole, A, K. Cohen, etc.) have developed some aspects of his ideas further, his basic ideas of the divorce of the individual from normative standards and the lack of social integration are still valid. Ms. Voicu-Minea looked at the theoretical background in detail but then limited it to a specific social group, the family, asking first why certain individual within vulnerable families and/or negative social influences commit offences while others do not. In modern times the family has undergone massive structural and functional changes. Its former economic function, which once endowed it with a great capacity for social inclusion, has generally vanished, while its formerly crucial role in children's education has been massively reduced. These changes, which are still not complete, can lead to dysfunction and in certain social contexts such as that in post-communist Romanian society, this risk of dysfunction is still greater as unfavourably social circumstances more easily affect such families. The number of cases of juvenile delinquency in Romania has increased sharply ever since the end of the communist system and in 1996 reached the level of 18,317 cases. The sample examined included 1012 juvenile delinquents aged between 14 and 18, taken from all areas of Bucharest. Over 80% of charges related to theft, with more serious offences being relatively rare. The children underwent a series of psychological tests, accompanied by a questionnaire relating to family situation. The results showed that juvenile delinquency in Romania is overwhelmingly male, with 91.8% of offences being committed by boys. Two thirds of the research group were under the age of 16 and only just over one third attended school, with over half having left school before the legal age. While the majority of subjects had a lower than average level of education, they did not always recognise this, with two thirds seeing their level of education as being as good as or better than average. Nearly half the children (43%) did not live with both natural parents and majority came from families with three or more children. This applied both to their original families and to the families in which they were living at the time of the survey. The overwhelming majority of families were living in or around Bucharest, but under one third originated from there. Almost 25% of parents were under-schooled and around one third were unqualified workers. At least 30% of families lived in inadequate accommodation and family incomes were generally low. Ms. Voicu-Minea does however point out that over half the minors from the sample saw their family income as satisfactory or even more than satisfactory. When factors such as bad relationships between parents, corporal punishment, alcohol consumption and criminal records of family members were taken into account, the picture was bleak, making it understandable why over 36% of subjects had run away from home at least once, and in many cases repeatedly and for longer periods. The overwhelming majority of offences (80.8%) were committed in groups of between 2 and 11 persons, usually "friends" but in about 10% of cases member's of the family. IQ tests put about 75% of the sample at slightly under average, the difference being too slight to account for the behaviour problems of the majority. Personality tests, however, showed a different picture. Over 70% of those tested manifested an acute need of tenderness and a similar number a high level of potential aggressiveness. Almost half of the minors expressed such feelings as intolerance or a desire for revenge, and Ms. Voicu-Minea found a clear weakness of the Self. Around half the sample expressed sentiments of abandonment, renunciation and solitude.

A protecção constitucional da família por via dos impostos: um estudo comparado entre o ordenamento jurídico Angolano e o ordenamento jurídico Português

Dissertação de mestrado em Direito Tributário e Fiscal

Utentes da Consulta Externa de Ginecologia/Obstetrícia da Maternidade Júlio Dinis

Com o objectivo de fazer a caracterização da situação social e demográfica e das condições de saúde médica e psicológica das utentes da Consulta Externa de Ginecologia/Obstretícia da Maternidade Júlio Dinis e de seus companheiros, duzentas mulheres e cento e setenta e cinco homens (N=375) foram entrevistados com base num questionário desenhado para o efeito, durante o primeiro trimestre de gestação. Observamos o desfavorecimento social e económico da amostra, particularmente no grupo das mulheres. Constatamos que a situação matrimonial e familiar é estável; no entanto, muitos agregados familiares são recentes, incluem outros familiares e este é um primeiro filho do casal. A rede de apoio social e emocional da amostra é geralmente constituída por familiares, estando mais presente para as mulheres do que para os homens e muitas vezes o companheiro não é referido como confidente, sobretudo pelas mulheres. A gestação não é geralmente de risco; não obstante, a presença frequente de problemas psicológicos uma pior aceitação inicial da gravidez no caso das mulheres. Os hábitos de vida tornam-se mais saudáveis com a gestação; no entanto, é ainda elevado o consumo de substâncias, como o tabaco, pela grávida. Problemas ginecológicos e obstétricos foram referidos, assim como a presença de adversidades na história psicológica e desenvolvimental dos participantes. Concluímos que as utentes da Consulta Externa de Ginecologia/Obstetrícia da Maternidade Júlio Dinis e seus companheiros apresentam indicadores relevantes de risco médico, psicológico e social que devem ser considerados na prestação de melhores cuidados de saúde.

Gender and the professional career of primary care physicians in Andalusia (Spain).

Background: Although the proportion of women in medicine is growing, female physicians continue to be disadvantaged in professional activities. The purpose of the study was to determine and compare the professional activities of female and male primary care physicians in Andalusia and to assess the effect of the health center on the performance of these activities. Methods: Descriptive, cross-sectional, and multicenter study. Setting: Spain. Participants: Population: urban health centers and their physicians. Sample: 88 health centers and 500 physicians. Independent variable: gender. Measurements: Control variables: age, postgraduate family medicine specialty (FMS), patient quota, patients/day, hours/day housework from Monday to Friday, idem weekend, people at home with special care, and family situation. Dependent variables: 24 professional activities in management, teaching, research, and the scientific community. Self-administered questionnaire. Descriptive, bivariate, and multilevel logistic regression analyses. Results: Response: 73.6%. Female physicians: 50.8%. Age: female physicians, 49.1 ± 4.3 yrs; male physicians, 51.3 ± 4.9 yrs (p < 0.001). Female physicians with FMS: 44.2%, male physicians with FMS: 33.3% (p < 0.001). Female physicians dedicated more hours to housework and more frequently lived alone versus male physicians. There were no differences in healthcare variables. Thirteen of the studied activities were less frequently performed by female physicians, indicating their lesser visibility in the production and diffusion of scientific knowledge. Performance of the majority of professional activities was independent of the health center in which the physician worked. Conclusions: There are gender inequities in the development of professional activities in urban health centers in Andalusia, even after controlling for family responsibilities, work load, and the effect of the health center, which was important in only a few of the activities under study.

Características de la familia de origen y de la familia formada por las médicas y los médicos de familia de Andalucía.

BACKGROUND The origin and formed family characteristics are related to physician's professional career. The purpose of this study was to know and compare by sex the characteristics of the origin family and formed family of women and men family physician in Andalusia. METHODS Cross sectional and multicenter study. SETTING Urban primary health care centres from Andalusian province capitals. PARTICIPANTS Physician of primary health care centres. INCLUSION CRITERIA at least one year using computerized medical history with the same quota patients. Multistage random sample, 88 primary health care centres and 500 physicians, 50% of both sexes (alpha=5%, power=90%, precision=15%). Postal auto administrated questionnaire. VARIABLES sex, age, tutor of resident in family medicine, last father's activity, last mother's activity, number of brothers or sisters, family situation, last couple's activity (if any), to have or not children. RESULTS 73.6 % responses. In no responses there weren't differences of sex neither tutor of resident in family medicine. Mean age: women physicians 49.5 +/- 4.3 and men physician 51.3 +/- 4.9 (p= or < 0.005). Postgraduate formation in family medicine: 42.2% of women and 33.3% of men (p=0.016). Live alone: 6.1% of women physician and 2.7% men physician (p=0.005). Live alone with children 9.9% of women and 2.2% of men (p=0.005). 16.5% of women and 10.2% of men don t have children (p=0.077). 21.1% of men physician s couples work only at home vs. 0.1% of women physician s couples (p= or < 0.005). 46% of women physician s couples is also physician vs. 22% of men physician s couples (p= or < 0.005). No significant differences registered in parent s activities neither in the number of brother or sisters. CONCLUSION There are no significant differences in physician s origin family. However important differences in the characteristics of formed family are observed in both sexes.

Patrons d'incorporació sociolaboral immigració llatinoamericana en dos contestos urbans, Barcelona i Manchester

La present memòria de treball presenta les principals conclusions del projecte titulat “Patrons d'incorporació sociolaboral immigració llatinoamericana en dos contestos urbans, Barcelona i Manchester" finançat per la convocatòria Projectes Batista i Roca PBR 2009 i executat pels grups de recerca GEDIME (Grup d’estudis de migracions i minories ètniques) de la UAB, i el Global Urban Research Centre (GURC-University of Manchester). El projecte s’aproxima, des d’un pla estructural i des d’una anàlisi comparativa, al context de recepció d’ambdós territoris (context institucional, social i econòmic), que determina l’estructura d’oportunitats dels immigrants i condiciona les seves estratègies com agents socials, en interacció amb les diferents situacions de cada immigrant (nivell educatiu, situació familiar, cicle vital, classe social, etc.). A través dels seminaris i workshops realitzats en ambdues universitats participants, s'ha establert vincles de col•laboració estable entre els dos grups de recerca implicats en el projecte. Aquest marc de cooperació es valora com una iniciativa que ha de transcendir el temps de desenvolupament d’aquest estudi i que ha de donar lloc a la presentació de nous projectes competitius, publicacions conjuntes, etc. Aquesta opció, valorada com a fonamental pels dos centres de recerca, ha servit per generar un flux d’informació científica permanent entre ambdós centres de recerca.

Descripció de la tipologia d'usuaris derivats al servei de Teràpia Ocupacional Domiciliària a la comarca d'Osona: estudi descriptiu preliminar

Introducció Aquest treball, aborda l'atenció domiciliaria a les persones amb dependència des de la perspectiva de la teràpia ocupacional a la comarca d’Osona. Conèixer aquesta tipologia de persones i la seva problemàtica, ha de servir per adaptar les infraestructures d’aquests serveis a fi de donar millor resposta a les seves necessitats. Objectiu Descriure la tipologia d'usuaris que es deriven al servei de Teràpia Ocupacional Domiciliària a la comarca d'Osona Metodologia S'ha realitzat un estudi descriptiu preliminar d'una mostra (n=65) de usuaris de la base de dades del Banc D'ajudes Tècniques (BAT Osona) del Consell Comarcal d'Osona. En aquest estudi s'han analitzat les variables de sexe, edat, nivell funcional, diagnòstic, situació familiar, agents derivadors, motius de derivació i problemàtica principal detectada. Resultats S'indica un perfil femení de la mostra (72,09%), amb una mitjana d'edat de 74,41 anys. A nivell funcional, la mitjana de puntuació ha estat de 65 punts en l'Ìndex de Barthel, en persones amb patologia osteoarticular en el 18,60% dels casos. La situació familiar situa un perfil compartit de persones que viuen en família (41,86%) o soles (39,53%). En les derivacions al servei, el 58,13% dels casos es fa des dels Ajuntaments i per dificultats en el quarto de bany (46,51%). La problemàtica més detectada en aquests domicilis és la dificultat per l'accés a la banyera (67,40%). Conclusió Aquests resultats ens indiquen una clara tipologia de persones que s’han d’atendre i unes problemàtiques en la seva vivenda que provoquen serioses dificultats de desenvolupament funciona. Es precís, en futures investigacions acotar encara més aquets perfils i problemàtiques a fi de precisar les estratègies d’intervenció i optimitzar millor aquest tipus de recursos.

French Swiss physicians' attitude toward palliative sedation: Influence of prognosis and type of suffering.

OBJECTIVE: Palliative sedation is a last resort medical act aimed at relieving intolerable suffering induced by intractable symptoms in patients at the end-of-life. This act is generally accepted as being medically indicated under certain circumstances. A controversy remains in the literature as to its ethical validity. There is a certain vagueness in the literature regarding the legitimacy of palliative sedation in cases of non-physical refractory symptoms, especially "existential suffering." This pilot study aims to measure the influence of two independent variables (short/long prognosis and physical/existential suffering) on the physicians' attitudes toward palliative sedation (dependent variable). METHODS: We used a 2 × 2 experimental design as described by Blondeau et al. Four clinical vignettes were developed (vignette 1: short prognosis/existential suffering; vignette 2: long prognosis/existential suffering; vignette 3: short prognosis/physical suffering; vignette 4: long prognosis/physical suffering). Each vignette presented a terminally ill patient with a summary description of his physical and psychological condition, medication, and family situation. The respondents' attitude towards sedation was assessed with a six-point Likert scale. A total of 240 vignettes were sent to selected Swiss physicians. RESULTS: 74 vignettes were completed (36%). The means scores for attitudes were 2.62 ± 2.06 (v1), 1.88 ± 1.54 (v2), 4.54 ± 1.67 (v3), and 4.75 ± 1.71 (v4). General linear model analyses indicated that only the type of suffering had a significant impact on the attitude towards sedation (F = 33.92, df = 1, p = 0.000). Significance of the results: The French Swiss physicians' attitude toward palliative sedation is more favorable in case of physical suffering than in existential suffering. These results are in line with those found in the study of Blondeau et al. with Canadian physicians and will be discussed in light of the arguments given by physicians to explain their decisions.

Descripció de la tipologia d'usuaris derivats al servei de Teràpia Ocupacional Domiciliària a la comarca d'Osona: estudi descriptiu preliminar

Introducció Aquest treball, aborda l'atenció domiciliaria a les persones amb dependència des de la perspectiva de la teràpia ocupacional a la comarca d’Osona. Conèixer aquesta tipologia de persones i la seva problemàtica, ha de servir per adaptar les infraestructures d’aquests serveis a fi de donar millor resposta a les seves necessitats. Objectiu Descriure la tipologia d'usuaris que es deriven al servei de Teràpia Ocupacional Domiciliària a la comarca d'Osona Metodologia S'ha realitzat un estudi descriptiu preliminar d'una mostra (n=65) de usuaris de la base de dades del Banc D'ajudes Tècniques (BAT Osona) del Consell Comarcal d'Osona. En aquest estudi s'han analitzat les variables de sexe, edat, nivell funcional, diagnòstic, situació familiar, agents derivadors, motius de derivació i problemàtica principal detectada. Resultats S'indica un perfil femení de la mostra (72,09%), amb una mitjana d'edat de 74,41 anys. A nivell funcional, la mitjana de puntuació ha estat de 65 punts en l'Ìndex de Barthel, en persones amb patologia osteoarticular en el 18,60% dels casos. La situació familiar situa un perfil compartit de persones que viuen en família (41,86%) o soles (39,53%). En les derivacions al servei, el 58,13% dels casos es fa des dels Ajuntaments i per dificultats en el quarto de bany (46,51%). La problemàtica més detectada en aquests domicilis és la dificultat per l'accés a la banyera (67,40%). Conclusió Aquests resultats ens indiquen una clara tipologia de persones que s’han d’atendre i unes problemàtiques en la seva vivenda que provoquen serioses dificultats de desenvolupament funciona. Es precís, en futures investigacions acotar encara més aquets perfils i problemàtiques a fi de precisar les estratègies d’intervenció i optimitzar millor aquest tipus de recursos.

La contribution de la famille sur la relation entre les conditions de l’organisation du travail et la consommation de médicaments psychotropes

RÉSUMÉ: L’objectif de ce mémoire de recherche était double, soit de mesurer l’effet des conditions de l’organisation du travail sur la consommation de médicaments psychotropes ainsi que de mesurer l’effet modérateur de la famille sur cette relation dans la population de travailleurs canadiens. Les données utilisées pour mener à terme cette recherche sont des données secondaires provenant de l’Enquête sur la Santé dans les Collectivités Canadiennes (ESCC cycle 2.1) de Statistique Canada. La consommation de médicaments psychotropes fut mesurée sur une période d’un mois. La prévalence de consommation chez les travailleurs canadiens s’élève à 8.8%, plus particulièrement 6.3% pour les hommes et 11.7% en ce qui concerne les femmes. À l’égard des conditions de l’organisation du travail, le nombre d’heures travaillées est associé de manière négative à la consommation de médicaments psychotropes. Ainsi, plus le nombre d’heures travaillées augmente, plus le risque de consommer des médicaments psychotropes est faible. Quant à la situation familiale, le fait de vivre seul, ainsi que le fait d’avoir un revenu économique élevé sont tous deux associés à la consommation de médicaments psychotropes. Les résultats de cette étude suggèrent une influence de la part des conditions de l’organisation du travail et de la famille sur la consommation de médicaments psychotropes. Toutefois, il nous est impossible à cette étape de montrer un effet modérateur de la famille sur la relation entre les conditions de l’organisation du travail et la consommation de médicaments psychotropes. MOTS CLÉS : Conditions de l’organisation du travail, médicaments psychotropes, famille, population active canadienne

Évolution de la qualité de l'emploi des femmes et des hommes au Québec entre 1997 et 2007 : l'ascenseur de la scolarisation et le fardeau des responsabilités familiales

Cette thèse de doctorat porte sur l’évolution de la qualité de l’emploi des travailleuses et des travailleurs québécois entre 1997 et 2007. À partir d’une nouvelle typologie, nous analysons les changements dans la qualité de l’emploi des femmes et des hommes et l’impact sur l’écart entre les genres. L’originalité de cette thèse est qu’elle permet de jeter un regard multidimensionnel sur la qualité de l’emploi en considérant quatre dimensions à la fois : la rémunération, la stabilité de l’emploi, la qualification et les heures de travail. Après avoir présenté notre problématique de recherche relative aux inégalités professionnelles entre les genres, l’étude fait une revue des écrits portant sur les principales théories en jeu et sur le concept de la qualité de l’emploi. Ensuite, le cadre conceptuel est présenté afin de situer notre contexte de recherche, les questions générales considérées, la pertinence d’une typologie et les principaux déterminants de la qualité de l’emploi. Le chapitre suivant est consacré à la démarche visant la création d’une nouvelle typologie de la qualité de l’emploi et celle relative au cadre d’analyse. Enfin, nous présentons une analyse des changements de la situation des hommes et des femmes dans les divers types d’emploi en tenant compte de la situation familiale, du niveau de scolarité des personnes et de certaines caractéristiques du marché du travail. Le constat global qui ressort de notre étude est qu’il y a eu une réduction appréciable de l’écart entre les genres au chapitre de la qualité de l’emploi (baisse générale de plus de 30 %). Notre recherche révèle que ce changement s’est surtout produit chez les personnes ayant une scolarité élevée, vivant en couple mais engagées dans des responsabilités familiales limitées. Une bonne partie des changements notés s’expliquent par l’amélioration notable de la qualité de l’emploi des femmes, plutôt que par une baisse de la qualité de l’emploi des hommes. Ces résultats montrent que la situation conjugale et la charge familiale de même que le niveau de scolarité sont des paramètres déterminants des changements observés.

Cancer et grossesse : une réflexion selon une approche par principes

Étude de cas / Case study