Health Behavior Patterns and Associated Risk of Memory-Related Disorders Among Middle-Aged and Older Chinese Couples.

Objectives: Studies on the interdependence of couples' health behaviors and subsequent cognitive outcomes remain limited. Methods: Longitudinal data from the China Health and Retirement Longitudinal Study (2011-2018) were used (N = 1869 heterosexual couples). Latent class analysis identified the dyadic pattern of health behaviors in 2011 (i.e., alcohol consumption, smoking, and physical inactivity). Stratified Cox models examined the association of latent classes with risk of developing memory-related disorders in 2013-2018. Results: Three classes were identified: class 1 (21.25%, only husband smoke, and both active), class 2 (47.55%, both inactive, neither drink nor smoke), and class 3 (31.20%, both drink and smoke, and both active). Couples' sedentary lifestyle was associated with an increased risk of memory-related disorders among both husbands and wives. Conclusion: Couples were moderately concordant in their physical activity but weakly in smoking and drinking. Couple-based interventions, especially promoting physical activity, may reduce cognitive aging among middle-aged and older Chinese couples.

"It is what I tell her that she will do": a mixed methods study of married men's knowledge and attitude towards supporting their wives' cervical cancer screening in rural South-East Nigeria.

INTRODUCTION: cervical cancer is a leading cause of death among Nigerian women. Women often require spousal support before attending cervical cancer screening services. This study assessed married men´s knowledge and attitude towards male involvement in cervical cancer screening of their wives. METHODS: a cross-sectional study using a mixed methods approach was conducted among 245 married men in Izzi, Local Government Area of Ebonyi State, South-East Nigeria. Quantitative data collected using structured, interviewer-administered questionnaires and qualitative data from focus group discussions were triangulated. Data analysis was done using IBM SPSS version 20. Qualitative findings were analysed using thematic analysis. RESULTS: the mean knowledge of cervical cancer was 2.06±0.55. Only 2.9% of the respondents had adequate knowledge of risk factors for cervical cancer. Up to 89.8% were willing to approve screening for their spouses. Majority (76.3%) considered screening important in cervical cancer prevention, while 91.4% were willing to pay for the screening test. Most of them exhibited patriarchal tendencies and insisted that their wives must obtain their consent before screening as depicted by the statement "It is what I tell her that she will do". Previous spousal screening was a predictor of good knowledge (OR = 10.94, 95% CI = 2.44-48.93; P=0.002). CONCLUSION: married men in this study had poor knowledge of cervical cancer. However, they were willing to support cervical cancer screening conditional on their pre-information and consent. Awareness creation activities on cervical cancer screening should incorporate active engagement of husbands in order to promote screening uptake by their wives.

"Man in the driving seat": A grounded theory study of the psychosocial experiences of Black African and Black Caribbean men treated for prostate cancer and their partners.

OBJECTIVE: Evidence suggests that treatment side-effects of prostate cancer (CaP) substantially affect the psychosocial well-being of affected men and their partners. However, this phenomenon is poorly understood among high risk (1 in 4) Black African (BA)/Black Caribbean (BC) men and their partners, as they are currently under-represented in global research on CaP survivorship. This study explored the psychosocial experiences of BA/BC men with CaP and their partners in the United Kingdom as they lived through the side effects of CaP treatment within their own sociocultural and marital contexts. METHODS: Using constructivist grounded theory methodology, interviews and focus groups were conducted with eligible men (n = 25), partners (n = 11), and health care professionals (HCPs) (n = 11) recruited in England. Data were iteratively analysed using constant comparison following the key stages of initial, focused, and theoretical coding until saturation was achieved. RESULTS: Data analysis culminated in the development of a substantive theory "man in the driving seat," which describes the experiences of BA/BC men with CaP and their partners within their context. Culturally informed gender roles and identities influenced how men and partners responded and coped with the side effects of CaP treatment. There was a hierarchy of power within the BA/BC relationship, in which men were dominantly positioned as leaders, whilst partners mostly operated from a supportive but "accepting" position. CONCLUSION: Inclusive and culturally sensitive individual and couple-focused psychosocial support, which is devoid of stereotyping and recognises the experiences of both BA/BC men and their partners is recommended.

Reproductive choices: a qualitative study of Dutch Moroccan and Turkish consanguineously married women's perspectives on preconception carrier screening.

BACKGROUND: Cousin marriages, in the Netherlands most frequently between Turkish or Moroccan couples, are at higher risk of having offspring with recessive disorders. Often, these couples not perceive or accept this risk, and it is hardly considered a reason to refrain from family marriages. Preconception carrier screening (PCS) is offered to Jewish groups, and more recently in the Netherlands, to genetically isolated communities. In this study, Dutch Moroccan and Turkish women's perspectives on preconception carrier screening (PCS) and reproductive choices were explored. METHODS: Individual interviews were held with Dutch Turkish and Moroccan consanguineously married women (n = 10) and seven group discussions with Turkish and Moroccan women (n = 86). Transcripts and notes were analyzed thematically. RESULTS: All women welcomed PCS particularly for premarital genetic screening; regardless of possible reproductive choices, they prefer information about their future child's health. Their perspectives on reproductive choices on the basis of screening results are diverse: refraining from having children is not an option, in vitro fertilization (IVF) combined with pre-implantation genetic diagnosis (PGD) was welcomed, while prenatal genetic diagnosis (PND), termination of pregnancy (TOP), in vitro fertilization with a donor egg cell, artificial insemination with donor sperm (AID), and adoption, were generally found to be unacceptable. Besides, not taking any special measures and preparing for the possibility of having a disabled child are also becoming optional now rather than being the default option. CONCLUSIONS: The women's preference for PCS for premarital screening as well as their outspokenness about not marrying or even divorcing when both partners appear to be carriers is striking. Raising awareness (of consanguinity, PCS and the choice for reproductive options), and providing information, screening and counseling sensitive to this target group and their preferences are essential in the provision of effective health care.

The Effects of a Couples-Based Health Behavior Intervention During Pregnancy on Latino Couples' Dyadic Satisfaction Postpartum.

Many couples tend to report steadily decreasing relationship quality following the birth of a child. However, little is known about the postpartum period for Latino couples, a rapidly growing ethnic group who are notably underserved by mental and physical health caregivers in the United States. Thus, this study investigated whether a brief couples' intervention focused on helping couples support each other while increasing healthy behaviors might improve dyadic functioning postpartum. This study presents secondary analyses of data regarding couple functioning from a larger randomized controlled trial with 348 Latino couples to promote smoking cessation. Portions of the intervention taught the couple communication and problem-solving skills to increase healthy behavior. Couples participated in four face-to-face assessments across 1 year starting at the end of the first trimester. Latent growth curve analyses revealed that the treatment group reported an increase in relationship satisfaction and constructive communication after the intervention, which diminished by 1-year follow-up, returning couples to their baseline levels of satisfaction. Results suggest that incorporating a brief couple intervention as part of a larger health intervention for Latinos may prevent postpartum decreases in relationship satisfaction.

African American Women's Involvement in Promoting Informed Decision-Making for Prostate Cancer Screening Among Their Partners/Spouses.

Routine prostate cancer screening is not recommended but African American men who are at higher risk for the disease should be offered the opportunity for shared decision-making with their health-care providers. This qualitative study sought to better understand the potential role of women in educating their male spouses/partners about prostate cancer screening. Nine focus groups were conducted ( n = 52). Women were recruited from a variety of community venues. Those eligible were African American and married to or in a partnership with an African American male age ≥ 45. Women provide numerous types of support to their male partners in an effort to facilitate participation in preventive health care. While women agreed that they would like to educate their partners about prostate cancer screening, they had little information about screening guidelines or the potential harms and limitations. The current findings suggest that women are eager information-seekers and can disseminate information to men and facilitate their efforts to make more informed decisions about prostate cancer screening. Women should be included in educational interventions for to promote informed decision-making for prostate cancer screening.

A Survey of the Knowledge of African-American Women About Prostate Cancer Screening.

Prostate cancer is the second most common cancer diagnosed in men. Its incident and mortality rates are generally higher in populations of African descent. The scientific community recommends that men should be informed of the benefits, risks, and limitations of screening in order to make an informed decision regarding participation in prostate cancer screening. Women are known to act as the healthcare gatekeeper for the family. As such, African-American (AA) women could facilitate the informed decision-making process by providing prostate cancer and screening information to AA men. However, little is known about AA women's knowledge regarding prostate cancer and screening. This report describes the findings of a non-experimental cross-sectional study conducted using a convenience sample of 200 AA women. Data was collected using the knowledge subscale of the Eastland prostate cancer survey. Data was analyzed using JMP 13 statistical software developed by Statistical Analysis Systems (SAS) Institute. The overall mean knowledge score was 6.59 (47.1%). Knowledge was significantly associated with personal or family history of cancer (p = .02), family history of prostate cancer (p = .002), and the age of the respondents (p = .004) with those of older age (51 years and above) scoring higher on the knowledge scale. The results indicated that the AA women had a low knowledge of prostate cancer and screening. The findings indicate the need to develop and implement prostate cancer educational programs that include AA women.

Motivations, challenges and coping strategies for smoking cessation: Based on multi-ethnic pregnant couples in far western China.

The present study aimed to clarify the smoking cessation motivations, challenges and coping strategies among pregnant couples. A qualitative design using a grounded theory approach was applied. Data were collected by individual semi-structured interviews with 39 married individuals (21 non-smoking pregnant women and 18 smoking or ever-smoking men with a pregnant wife) and 3 imams in an ethnically diverse region of far western China. The most common theme for smoking cessation motivation was "embryo quality" (i.e., a healthier baby), followed by family's health. Most interviewees reported that husband's withdrawal symptoms were the greatest challenge to smoking cessation, followed by the Chinese tobacco culture. Coping strategies given by the pregnant women typically involved combining emotional, behavioral and social interventions. Social interventions showed advantages in helping to quit smoking. Pregnancy appears to be a positive stimulus for pregnant couples' smoking cessation. Our results suggest that pregnancy, a highly important life event, may help to reduce barriers to smoking cessation at the social level (e.g., limiting access to cigarettes, avoiding temptation to smoke), but does little to help with the withdrawal symptoms. Professional guidance for smoking cessation is still necessary.

Spousal concordance in the use of alternative tobacco products: A multi-country investigation.

BACKGROUND: Married couples often share similar health-related characteristics and behaviors, including cigarette smoking status. Despite their rising popularity in the U.S., little research has examined the patterns of spousal concordance (SC) for alternative tobacco products (ATPs), such as e-cigarettes, cigars, and hookah. METHODS: The purpose of this project was to examine the roles of age, gender, and culture in the strength of SC for these ATPs. Analyses focused on a diverse community sample of married individuals in Ohio, U.S. (N=278), but also examined patterns in Austria, Greece, Israel, the Netherlands, and Slovakia. All participants completed a survey in which they indicated both their own, and their spouse's ever-use of various tobacco products. RESULTS: For the U.S. sample, SC was highest for e-cigarettes, flavored e-cigarettes, flavored cigarettes, and hookah (ϕs=0.48- 0.61); SC appeared to be stronger among younger couples, and when there was only a small female vs. male differences in use. Similar patterns were found in the other countries, with a few key exceptions. In particular, there was low SC for e-cigarettes and flavored e-cigarettes in the other countries, where e-cigarettes had been federally regulated by the time of data collection. CONCLUSION: Overall, these findings have implications for the continued spreading popularity of these tobacco use behaviors.

The Influence of Antenatal Partner Support on Pregnancy Outcomes.

BACKGROUND: While there has been considerable attention given to the multitude of maternal factors that contribute to perinatal conditions and poor birth outcomes, few studies have aimed to understand the impact of fathers or partners. We examined associations of antenatal partner support with psychological variables, smoking behavior, and pregnancy outcomes in two socioeconomically distinct prebirth cohorts. MATERIALS AND METHODS: Data were from 1764 women recruited from an urban-suburban group practice (Project Viva) and 877 women from urban community health centers (Project ACCESS), both in the Boston area. Antenatal partner support was assessed by the Turner Support Scale. Multivariable linear and logistic regression analyses determined the impact of low antenatal partner support on the outcomes of interest. RESULTS: In early pregnancy, 6.4% of Viva and 23.0% of ACCESS participants reported low partner support. After adjustment, low partner support was cross-sectionally associated with high pregnancy-related anxiety in both cohorts (Viva AOR 1.8; 95% CI: 1.0-3.4 and ACCESS AOR 1.9; 95% CI: 1.1-3.3) and with depression in ACCESS (AOR 1.9; 95% CI: 1.1-3.3). In Viva, low partner support was also related to depression mid-pregnancy (AOR 3.1; 95% CI: 1.7-5.7) and to smoking (AOR 2.2; 95% CI: 1.3-3.8). Birth weight, gestational age, and fetal growth were not associated with partner support. CONCLUSIONS: This study of two economically and ethnically distinct cohorts in the Boston area highlights higher levels of antenatal anxiety, depression, and smoking among pregnant women who report low partner support. Partner support may be an important and potentially modifiable target for interventions to improve pregnancy outcomes.

Ethnic differences in types of social support from multiple sources after breast cancer surgery.

OBJECTIVES: Diagnosis of and treatment for breast cancer (BCa) may require psychological adaptation and often involve heightened distress. Several types of social support positively relate to psychological adaptation to BCa, and negative support is associated with poorer adaptation. Although Hispanic women report greater distress than non-Hispanic White (NHW) women after diagnosis of BCa, no studies have examined ethnic differences in types of social support received from varying sources after surgery for BCa. DESIGN: Hispanic (N = 61) and NHW (N = 150) women diagnosed with early-stage BCa self-reported emotional, informational, instrumental, and negative support from five sources. Ethnic differences in levels of social support were compared using multiple regression analysis. RESULTS: When controlling for age, income, days since surgery, and stage of disease in multivariable models there were no ethnic differences in levels of emotional support from any source. Hispanic women reported greater informational support from adult women family members and children and male adult family members than did NHW women. Instrumental support from adult women family members was also greater among Hispanic than NHW women. Hispanic women reported higher negative support from husbands/partners and from children and male adult family members. When the number of years in the USA was controlled, Hispanic women showed greater informational support from adult women family members, children and male adult family members, and friends. Instrumental support from adult women family members remained greater in Hispanic women, but negative support no longer differed. CONCLUSION: Family is a greater source of informational and instrumental support for Hispanic than NHW women. Hispanic women reported higher negative support from male sources than did NHW women. Level of support from different sources may also depend on time spent in the USA. Longitudinal studies are needed to determine whether patterns and sources of social support shift over the course of BCa treatment.

Israeli and Chinese partners of women with breast cancer: a cross-cultural view of marital issues.

OBJECTIVE: Cultural nuances may influence the interface between the cancer experience and marital issues, specifically for the partner. Most of the literature has focused on the woman's narrative or couple's adjustment to cancer in general. The purpose of this study was to describe and compare the marital relationship, sexuality, and marital adjustment of Israeli and Chinese husbands of women with breast cancer and the discussion of the health-care team concerning these issues. METHODS: A convenience sample of 50 Chinese and 50 Israeli men, ages of 28-79 years, completed components of the Psychological Adjustment to Illness Scale, the Locke Wallace Adjustment Scale, and a background questionnaire. RESULTS: The majority of husbands were in their first marriage. The average time since diagnosis was 16.7 months. No significant difference was found between the two groups on issues of marital relationship. Significant differences were found between Israeli and Chinese husbands on sexual interest, pleasure, and performance (p<0.05). Israeli husbands reported a significantly higher level of marital adjustment as opposed to the Chinese husbands (p = 0.006). Marital adjustment for both groups was significantly related only to perceived quality of the relationship (p<0.03). CONCLUSIONS: Significant cultural differences were found in sexuality variables with no differences discerned on marital relationship variables. Couple-based interventions for marital issues are a critical component of support for both partners. Culturally sensitive assessment and care of the spouse as well as the woman with breast cancer should be part of a holistic, comprehensive family care plan.

The factors associated with the quality of life of the spouse caregivers of patients with cancer: a cross-sectional study.

BACKGROUND: It is well known that cancer greatly affects not only patients but also their families. However, few studies on caregivers' quality of life have been conducted within the Asian population. METHODS: We carried out a survey using well-constructed, self-administered questionnaires that were answered by pairs of patients with cancer and their spouse-caregivers (n=100 pairs) who were visiting the cancer daycare center at Seoul National University Hospital. The caregiver's quality of life (QOL) was assessed by the Korean version of the Caregiver Quality Of Life Index-Cancer (CQOLC), which contains four domains along with other items. Possible determinants of caregiver QOL were categorized according to sociodemographic factors, caregiver burden, health risk factors, spirituality, and family function. Multiple linear regression analysis was used to identify the factors associated with spouse-caregivers' QOL. RESULTS: Having a reason or purpose for living was associated with the total CQOLC score (ß=3.408, p=0.025) and positive adaptation (ß=1.035, p=0.009). Family function was associated with total CQOLC and all the domains except burden, and caregivers' religion was associated with total CQOLC. Monthly household income and cigarette smoking status were associated with financial concern. CONCLUSIONS: Having a reason and purpose for living, which is an aspect of spirituality, was a relevant factor in the spousal caregivers' QOL. Future research is needed to confirm the association between spirituality and caregivers' QOL and whether interventions supporting spirituality could improve their QOL.

Sífilis e pré-natal na rede pública de saúde e na área indígena de Amambai, MS: conhecimento e prática de profissionais / Syphilis and prenatal care in public health and in the area of indigenous Amambai, MS: knowledge and practice of professional

A qualidade da assistência durante a gestação é um importante determinante da redução de transmissão vertical da sífilis. A sífilis congênita (SC) é uma das grandes causas de morbidade na vida intrauterina, levando a resultados negativos na gestação em mais de 50 ٪ dos casos. É importante ressaltar que a SC pode ser considerado um claro indicador da qualidade da assistência à saúde no pré-natal, pois se é feito o diagnóstico da sífilis e o tratamento adequado da gestante e do parceiro durante o pré-natal, consegue-se assim reduzir a incidência desse agravo. O objetivo geral deste estudo transversal foi descrever os conhecimentos e práticas dos profissionais que realizam a assistência pré-natal na rede pública de saúde e na área indígena do município de Amambai, MS, referentes à detecção, tratamento e acompanhamento da gestante com sífilis. Foram entrevistados 24 profissionais pré-natalistas, através de questionário contendo perguntas abertas e fechadas, autorrespondido pelo entrevistado em seu ambiente de trabalho.Os resultados mostraram que 66,7 por cento dos profissionais pré-natalistas possuem especialização, 41,7 por cento são formados há mais de 10 anos e 33,3 por cento atuam como pré-natalistas há mais de 10 anos.O primeiro atendimento à gestante é realizado pelo enfermeiro (91,7 por cento), com 100 por cento dos profissionais solicitando a coleta da triagem pré-natal. Observou-se que 41,7 por cento dos profissionais realizaram algum treinamento sobre sífilis na gestação e 87,5 por cento conhecem o manual do Ministério da Saúde. Com relação à situação da sífilis congênita em Amambai, 50 por cento dos profissionais desconhecem a realidade do município.

Em relação às condutas preconizadas pelo Ministério da Saúde, 75 por cento dos profissionais informaram solicitar o exame do VDRL no primeiro e terceiro trimestres. Quanto aos parceiros, 54,2 por cento dos profissionais relataram convocá-los a vir à unidade e somente 20,8 por cento realizam visita domiciliar. As dificuldades alegadas pelos profissionais para o manejo adequado da sífilis na gestação incluíram: o início tardio do pré-natal (83,3 por cento) e o não comparecimento do parceiro (54,1 por cento). As dificuldades relatadas na abordagem da gestante com sífilis foram: conversar sobre e com o parceiro (54,2 por cento) e conversar sobre a forma de transmissão da sífilis (20,9 por cento). As estratégias propostas pelos profissionais para a melhoria da situação foram: capacitações curtas em serviço (54,2 por cento), mudanças nas unidades para facilitar o tratamento dos parceiros (79,2 por cento) e acesso à informação sobre os casos ocorridos na cidade (41,7 por cento). Este estudo ficou limitado no número de participantes, porém de acordo com a distribuição populacional. Conclui-se que as dificuldades encontradas pelos profissionais pré-natalistas em Amambai não diferem de outras realidades, como o início tardio do pré-natal, o não comparecimento do parceiro como acompanhante da gestante, a dificuldade em tratar de maneira adequada a gestante e seu parceiro. As informações obtidas no estudo apontam para uma necessidade de capacitação frequente e em serviço, assim como algumas mudanças estruturais nos serviços existentes, de modo a garantir o tratamento adequado da gestante e de seu parceiro, visando à eliminação da SC.

Occupational, social, and relationship hazards and psychological distress among low-income workers: implications of the 'inverse hazard law'.

BACKGROUND: Few studies have simultaneously included exposure information on occupational hazards, relationship hazards (eg, intimate partner violence) and social hazards (eg, poverty and racial discrimination), especially among low-income multiracial/ethnic populations. METHODS: A cross-sectional study (2003-2004) of 1202 workers employed at 14 worksites in the greater Boston area of Massachusetts investigated the independent and joint association of occupational, social and relationship hazards with psychological distress (K6 scale). RESULTS: Among this low-income cohort (45% were below the US poverty line), exposure to occupational, social and relationship hazards, per the 'inverse hazard law,' was high: 82% exposed to at least one occupational hazard, 79% to at least one social hazard, and 32% of men and 34% of women, respectively, stated they had been the perpetrator or target of intimate partner violence (IPV). Fully 15.4% had clinically significant psychological distress scores (K6 score ≥ 13). All three types of hazards, and also poverty, were independently associated with increased risk of psychological distress. In models including all three hazards, however, significant associations with psychological distress occurred among men and women for workplace abuse and high exposure to racial discrimination only; among men, for IPV; and among women, for high exposure to occupational hazards, poverty and smoking. CONCLUSIONS: Reckoning with the joint and embodied reality of diverse types of hazards involving how people live and work is necessary for understanding determinants of health status.

Prevalence and determinants of intimate partner violence against women in Kazeroon, Islamic Republic of Iran.

The aim of this study was to screen for and estimate the prevalence of intimate partner violence (IPV) among women in Kazeroon, Iran. In November 2007, multistage cluster sampling was employed to recruit 702 women to participate in the study. A descriptive, cross-sectional design was employed. The prevalence of physical, psychological, and sexual abuse against women was 43.7%, 82.6%, and 30.9%, respectively, and there was a significant relationship between IPV and family income, education level, and level of religious commitment in both women and husbands. The study suggests that major strategies for prevention of IPV are empowering women and improving their status in the society by promoting of sexual equality in all rights, especially in employment and education.

Sífilis congênita: fatores associados ao tratamento das gestantes e seus parceiros / Congenital syphilis: factors associated with treatment of pregnant women and their partners

Das várias doenças que podem ser transmitidas durante o período de gestação e parto, a sífilis é a que tem maior taxa de transmissão vertical, resultando em desfechos negativos devido à sífilis congênita (SC). Em 2008, Mato Grosso do Sul apresentou incidência de SC de3,1/1.000 nascidos vivos e Campo Grande 2,3/1000. O não tratamento do parceiro implica em tratamento materno inadequado pelo risco constante de reinfecção da mãe, colocando em risco a vida fetal. Neste município o percentual de parceiros tratados para a doença tem sido menor que 30. Assim, o objetivo deste estudo transversal foi descrever os fatores relacionados ao tratamento da sífilis das gestantes e seus parceiros. A população do estudo foi composta por 110 mulheres que estiveram grávidas no período de outubro de 2008 a setembro de 2009, residentes no município de Campo Grande, com diagnóstico laboratorial de sífilis confirmado por critério laboratorial do IPED/APAE. Foi utilizado um instrumento para coleta de dados do tipo formulário semi-estruturado, desenvolvido a partir da revisão de literatura, sendo que as variáveis sociodemográficas foram categorizadas seguindo o exemplo dos questionários da PNAD e IBGE e, as variáveis relacionadas à sífilis espelharam-se no Projeto Nascer.Os resultados mostraram que 84 por cento das gestantes foram tratadas para a doença, porém apenas 63 por cento de maneira adequada. Dentre as gestantes que não receberam tratamento, a razão alegada por 61 por cento das entrevistadas foi a falta de prescrição médica. Para as variáveis relacionadas ao tratamento dos parceiros, 72 por cento (66) realizaram o tratamento, com 56 por cento tratados de maneira adequada e somente 18 por cento foi tratado junto com a gestante. Dentre os motivos da não realização do tratamento destacaram-se o fato do VDRL estar negativo (20,5 por cento) e ter medo de injeção (11,4 por cento)...

Interferencias entre la migración, la situación conyugal y la descendencia: Mujeres y varones peruanos en Buenos Aires entre siglos / Interference between migration, marital status and descendant: Peruvian women and men in Buenos Aires between centuries

El objetivo del artículo es mostrar algunas características de la interferencia entre el fenómeno migratorio, la situación conyugal y la descendencia. Se consideran las formas en que las parejas encararon su migración, así como el movimiento de los hijos y las experiencias de reunificación en el destino. En el caso de quienes al momento de su migración no estaban unidos, se analizan las características que adquiere su entrada a la vida conyugal en el destino. Se utiliza información cualitativa y cuantitativa especialmente recolectada para la investigación. El estudio muestra que las parejas optaron por la migración escalonada o de uno de sus miembros. En general, las esposas fueron las pioneras. La reunificación en el destino se produjo más rápido cuando la mujer migró antes que el varón. Por otra parte, más de dos tercios de quienes nunca habían estado en unión conyugal antes de moverse, una vez en la Argentina, han experimentado la vida en pareja. Los varones dejaron pasar un poco más de tiempo entre su movimiento y su primera unión, se unieron con una frecuencia algo menor y experimentaron más rupturas de sus primeras uniones. Finalmente, cabe destacar que poco más de un tercio de los encuestados había ejercido la paternidad o la maternidad antes de su migración. La gran mayoría de los hijos reside en la Argentina, lo cual indica que se trata de un flujo que ha fijado una nueva residencia base, es decir, que tiene cierto carácter irreversible.(AU)

Women's marital adjustment and hopelessness levels after mastectomy.

AIM: This descriptive study aims to determine the marital adjustment and hopelessness level of breast cancer in women who had a mastectomy. MATERIALS AND METHODS: The study was carried out in Ondokuz Mayis University, Medical Faculty's chemotherapy, radiotherapy and surgical clinics. A sample of 59 subjects were included in the study. A descriptive questionnaire, the dyadic adjustment scale, and Beck's hopelessness scale were used to collect the data. RESULTS: 38.3% of women stated that, they believed the operation would not affect their marriages while 34% of them stated that, they believed the operation would affect negatively their marriages. The hopelessness score for these women was average at 5.02+/-4.82. Marital adjustment was also average, with a score of 102.79+/-24.68. No relationship was found between marital adjustment and hopelessness in the sample (r=-0.021, p=0.875). However, it was found that the status of hopelessness as perceived by women before the mastectomy affected marital adjustment (p<0.05) but this was not linked with hopelessness after the mastectomy (p>0.05). Age, education, place of living and marital relationship status were not linked with hopelessness and marital adjustment after the mastectomy. The marital adjustment of the women who did not feel hopeless was found to be higher than those who were feeling hopelessness. CONCLUSION: The results of the study suggest that hopelessness levels in women with a mastectomy are low and their marital adjustment level at a medium level. However, some women with mastectomy, particularly those who feel hopelessness and have weak family relationships may need more support to cope with this experience.

Esposas como principais provedoras de renda familiar / Wives as the main household earners

Este trabalho procura discutir um aspecto ainda pouco explorado do papel da mulher na formação dos rendimentos familiares, que é a situação na qual as esposas obtêm, no mercado de trabalho, rendimentos superiores aos de seus cônjuges. Além da descrição de características demográficas e socioocupacionais destas mulheres e de seus cônjuges, procura-se discutir as seguintes questões: como algumas das características observadas estão correlacionadas com a probabilidade de as famílias terem as esposas como principais provedoras; a não reversão dos padrões tradicionais de divisão do trabalho, já que a mulher mantém um número de horas muito maior do que seus cônjuges nas tarefas domésticas, mesmo quando é a principal provedora financeira do casal; e os diferenciais no rendimento médio de maridos e esposas provedores e a decomposição deste diferencial entre o que pode ser atribuído às características produtivas de ambos os grupos e o que é geralmente chamado de discriminação.

In this article three questions related to wives who outearn their husbands in Brazil are examined. First we discuss the demographic and socio-economic characteristics associated with the probability that the wife will be the main earner. Second, the patterns of the division of labor among couples where the women are the primary earners are examined, especially as to whether the women spend more time on domestic work than their husbands. Third, we quantify differentials in income between wife and husband earners and examine how these differentials are explained by differences in (1) professional characteristics between men and women and (2) discrimination.

Este trabajo procura discutir un aspecto aún poco explorado del papel de la mujer en la formación de los rendimientos familiares, que es la situación en la cual las esposas obtienen, en el mercado de trabajo, rendimientos superiores a los de sus cónyuges. Además de la descripción de características demográficas y socio-ocupacionales de estas mujeres y de sus cónyuges, se busca discutir los siguientes aspectos: como algunas de las características observadas están correlacionadas con la probabilidad de que las familias tengan a las esposas como principales proveedoras; la no reversión de los estándares tradicionales de división del trabajo, ya que la mujer dedica un número de horas mucho mayor que sus cónyuges a las tareas domésticas, aún cuando es la principal proveedora financiera de la pareja; los diferenciales en el rendimiento promedio de maridos y esposas proveedores y la descomposición de este diferencial entre lo que puede ser atribuido a las características productivas de ambos grupos y lo que es generalmente llamado discriminación.