[Utilization of remote psychosocial intervention with men: What is the state of knowledge?] / L'utilisation de l'intervention psychosociale à distance auprès des hommes : quel est l'état des connaissances ?

Background Remote psychosocial intervention has been used by most health care organizations since the beginning of COVID-19 pandemic. However, the rapid introduction of this type of practice generates new methods of intervention that raise many questions, particularly about men who, in general, use face-to-face psychosocial intervention less than women. This documentary research aims to report on current knowledge on remote psychosocial intervention with men. Methods PICO technique was used to find relevant documents to achieve the objective of this research. In accord with our criteria, 62 documents were selected in several databases and search engines. The selected texts were subject to an analysis process consisting of two stages: the creation of reading sheets followed by a content analysis. Results The results underline the lack of scientific data on the men's experience when they initiate a request for help, the commitment process, and the effectiveness of the remote intervention. Several elements seem potentially promising, including patients' perceptions of having more power and freedom which could favorize engagement of men who have a traditional vision of masculinity. Conclusions It appears that gender-related variables are not commonly used when it comes to analyze the effects of distance psychosocial intervention. Other studies will be needed to have a holistic vision of the realities experienced by men towards the offer of remote psychosocial intervention.

Masculinities and Men’s Health in the Caribbean

This document presents an analysis of masculinities and men’s health in the Caribbean, based on literature review, analysis of epidemiological data, and stakeholder interviews. The literature review elaborates on historical and sociological developments in the Caribbean, including slavery, colonialism, and multicultural population dynamics, which influenced the shaping of Caribbean masculinities. The data analysis highlights the excess mortality and morbidity of Caribbean males across the life course in comparison with their female counterparts, in particular due to external causes such as violence and injuries and other preventable causes such as cancers and noncommunicable diseases. The limited engagement of males with health promotion and care, and the lack of holistic men’s health approaches and programs contributes to the burden of male mortality, morbidity and risk factors. The analysis presented in this report underlines the need for increased investment in effective approaches to foster positive masculinities and address the health needs of males of all ages in the Caribbean.

Contribuições do psicodrama bipessoal sobre as masculinidades / Contributions of bipersonal psychodrama on masculinities / Aportes del psicodrama bipersonal sobre las masculinidades

INTRODUÇÃO: O papel de homem perpassa muitas construções sociais e é atravessado por conservas culturais diversas, inclusive de uma masculinidade hegemônica. OBJETIVO: Este artigo objetivou compreender as contribuições do psicodrama bipessoal nas conservas culturais relacionadas à masculinidade. MÉTODO: Por meio de uma pesquisa-ação, foram analisados os registros profissionais de recortes de sessões de dois homens adultos com demandas psicológicas relacionadas às masculinidades, sendo uma pesquisa descritiva, qualitativa e psicodramática. RESULTADOS E DISCUSSÃO: Através do psicodrama bipessoal, foi possível conhecer algumas conservas culturais associadas ao papel de homem e como estas influenciavam em uma masculinidade dividida entre estereótipos e demonstração ou não de vulnerabilidades. CONSIDERAÇÕES FINAIS: Nesse sentido, o psicodrama bipessoal contribuiu como forma de acesso a respostas espontâneas na busca por uma masculinidade com menor sofrimento psicológico.

INTRODUCTION: The role of man permeates many social constructions and is crossed by different cultural preserves, including hegemonic masculinity. OBJECTIVE: This article aimed to understand the contributions of bipersonal psychodrama in cultural preservations related to masculinity. METHOD: Through action research, professional records of session excerpts from two adult men with psychological demands related to masculinities were analyzed, using a descriptive, qualitative, and psychodramatic approach. RESULTS AND DISCUSSION: Through bipersonal psychodrama, it was possible to understand the cultural preservations associated with the role of men and how they influenced a masculinity divided between stereotypes and the expression or non-expression of vulnerabilities. CONCLUSIONS: In this sense, bipersonal psychodrama contributed as a means of accessing spontaneous responses in the pursuit of a masculinity with less psychological suffering.

INTRODUCCIÓN: El papel del hombre permea muchas construcciones sociales y está atravesado por diferentes conservaciones culturales, incluida la masculinidad hegemónica. OBJETIVO: Este artículo tiene como objetivo comprender las contribuciones del psicodrama bipersonal en la conservación cultural relacionada con la masculinidad. MÉTODO: A través de una investigación-acción, se analizaron los registros profesionales de fragmentos de sesiones de dos hombres adultos con demandas psicológicas relacionadas con la masculinidad, utilizando un enfoque descriptivo, cualitativo y psicodramático. RESULTADOS Y DISCUSIÓN: Mediante el psicodrama bipersonal, fue posible conocer las conservaciones culturales asociadas al rol del hombre y cómo estas influían en una masculinidad dividida entre estereotipos y la manifestación o no de vulnerabilidades. CONCLUSIONES: En este sentido, el psicodrama bipersonal contribuyó como una forma de acceso a respuestas espontáneas en la búsqueda de una masculinidad con menor sufrimiento psicológico.

For Exercise, Relaxation, or Spirituality: Exploring Participation Motives and Conformity to Masculine Norms among Male and Female Yoga Participants.

Yoga is a traditional practice from India with the potential to promote physical activity and health. Participation worldwide remains low, particularly among men. To better understand yoga participation parameters, with a special focus on what influences male participation, this study examined gender differences in participation motives and conformity to masculine norms. It also explored these factors across three participant subgroups who differed in their engagement with the physical and the more psycho-spiritual aspects of yoga. A total of 546 yoga participants (138 males, 399 females, 9 others), 18-73 years old, completed an online survey that included an adapted version of the Exercise Motivation Inventory-2 and three subscales from the Conformity to Masculine Norms Inventory-46. Results showed significant gender differences in participation motives and conformity to masculine norms. Females were more motivated by positive affect, health/fitness, nimbleness, mind-body integration, and coping/stress management, whereas males were more motivated by supplementary activity and competition/social recognition. These differences should be considered in tailoring messages to promote uptake and continued participation. Furthermore, males were more likely than females to conform to emotional control and heterosexual self-presentation masculine norms. Future research may examine how differences in masculine norm adherence influences uptake, particularly among men.

Implicações para homens do afastamento do(a) filho(a) devido medida protetiva de urgência / Impacto en los hombres del distanciamiento del(la) hijo(a) debido a medida protectora de urgencia / Implications for men of separation from their children due to emergency protective measure

Resumo Objetivo Desvelar as implicações para os homens do afastamento pai-filho(a) em decorrência de medida protetiva por violência conjugal. Métodos Estudo descritivo exploratório, abordagem qualitativa, desenvolvido com nove homens que respondiam a processo judicial por violência conjugal junto às 1ª e 2ª Varas de Justiça pela Paz em Casa de Salvador, Bahia, Brasil. A pesquisa ocorreu por meio da entrevista semiestruturada, tendo seu conteúdo gravado, transcrito e, em seguida, submetido à validação pelos homens. Os dados foram sistematizados com base nos passos preconizados pela análise de conteúdo temática categorial. Resultados O estudo revela que o afastamento pai-filho em decorrência da medida protetiva de urgência suscita no rompimento do vínculo paterno, fomentando o desenvolvimento de problemas psicoemocionais, como ansiedade, depressão e ideação suicida, muitas vezes somatizados e expressos desde cefaleia até condições que necessitam de cuidados hospitalares. Conclusão O comprometimento do exercício da paternidade viola também o direito de crianças e adolescentes ao convívio com a figura paterna. Deste modo, há grande necessidade de que a Política Nacional de Atenção Integral à Saúde dos Homens contemple uma gestão que priorize ações preventivas para a violência, assim como desempenhe acompanhamento psicossocial aos homens.

Resumen Objetivo Revelar el impacto en los hombres del distanciamiento padre-hijo(a) como consecuencia de medidas protectoras por violencia conyugal. Métodos Estudio descriptivo exploratorio, enfoque cualitativo, llevado a cabo con nueve hombres que respondían a juicio por violencia conyugal en el 1º y 2º Juzgado de Justicia por la Paz en Casa de Salvador, estado de Bahia, Brasil. La investigación se realizó a través de encuesta semiestructurada, con grabación y transcripción del contenido, y luego sometido a su validación por los hombres. Los datos fueron sistematizados con base en los pasos preconizados por el análisis de contenido temático de la categoría. Resultados El estudio revela que el distanciamiento padre-hijo como consecuencia de medidas protectoras de urgencia provoca la ruptura del vínculo paterno y fomenta el desarrollo de problemas psicoemocionales, como ansiedad, depresión e ideación suicida, muchas veces somatizados y expresados desde una cefalea hasta condiciones que necesitan cuidados hospitalarios. Conclusión El comprometimiento del ejercicio de la paternidad también viola el derecho de niños y adolescentes a convivir con la figura paterna. De este modo, hay una gran necesidad de que la Política Nacional de Atención Integral a la Salud de los Hombres contemple una gestión que establezca prioridades en acciones preventivas contra la violencia, así como también realice un seguimiento psicosocial de los hombres.

Abstract Objective To unveil the implications for men of father-son estrangement as a result of a protective measure for conjugal violence. Methods This is an exploratory descriptive study, with a qualitative approach, developed with nine men who were responding to a lawsuit for conjugal violence at the 1st and 2nd Courts of Justice of the Peace in Casa de Salvador, Bahia, Brazil. The research took place through a semi-structured interview, with its content recorded, transcribed and then submitted for validation by the men. Data were systematized based on the steps recommended by the categorical thematic content analysis. Results The study reveals that the father-son estrangement as a result of an emergency protective measure causes paternal bond rupture, promoting the development of psycho-emotional problems, such as anxiety, depression and suicidal ideation, often somatized and expressed from headache to conditions that require hospital care. Conclusion The commitment to the exercise of paternity also violates the right of children and adolescents to live with their father figure. Thus, there is a great need for the Brazilian National Policy for Comprehensive Care for Men's Health to include a management that prioritizes preventive actions against violence as well as providing psychosocial support to men.

"Lift Big-Get Big": The Impact of Images of Hyper-Muscular Bodies and Training Information.

Purpose: It has been suggested that the media influence beliefs regarding ideal body appearance and drive for muscularity whilst also offering recommendations for achieving this; most commonly heavy load free weight resistance training (RT). However, evidence for media effects are inconsistent in the literature. This study investigated this "lift big-get big" culture and effects of imagery on males' beliefs regarding RT. Method: An online survey was conducted with male participants (N = 110) randomized to different images (hyper-muscular/lean/control) and RT information ("lift big-get big"/"evidence based RT"/control). Results: Descriptive data suggested belief in necessity of heavy loads and free weights was pervasive. There was a small significant effect of condition for multivariate analysis of beliefs regarding RT. Univariate analyses showed significant effects of condition regarding the importance of free weights and heavy loads for strength, and free weights for hypertrophy. Small to moderate effects were found comparing "evidence-based RT" with a hyper-muscular physique to "lift big-get big" conditions with both hyper-muscular and lean physiques, the latter more likely to agree free weights and heavy loads are necessary for strength. A small effect was found comparing "lift big-get big" conditions with both hyper-muscular and lean physiques and the control condition, the former more likely to agree free weights are necessary for hypertrophy. Conclusions: Although hyper-muscular bodies alone did not influence RT beliefs, new information, i.e., "evidence-based RT" combined with a hyper-muscular physique had a small effect. The "lift big-get big" culture is perhaps pervasive enough that most conditions merely reinforced existing beliefs.

Scale-Up and Scale-Out of a Gender-Sensitized Weight Management and Healthy Living Program Delivered to Overweight Men via Professional Sports Clubs: The Wider Implementation of Football Fans in Training (FFIT).

Increasing prevalence of obesity poses challenges for public health. Men have been under-served by weight management programs, highlighting a need for gender-sensitized programs that can be embedded into routine practice or adapted for new settings/populations, to accelerate the process of implementing programs that are successful and cost-effective under research conditions. To address gaps in examples of how to bridge the research to practice gap, we describe the scale-up and scale-out of Football Fans in Training (FFIT), a weight management and healthy living program in relation to two implementation frameworks. The paper presents: the development, evaluation and scale-up of FFIT, mapped onto the PRACTIS guide; outcomes in scale-up deliveries; and the scale-out of FFIT through programs delivered in other contexts (other countries, professional sports, target groups, public health focus). FFIT has been scaled-up through a single-license franchise model in over 40 UK professional football clubs to 2019 (and 30 more from 2020) and scaled-out into football and other sporting contexts in Australia, Canada, New Zealand, England and other European countries. The successful scale-up and scale-out of FFIT demonstrates that, with attention to cultural constructions of masculinity, public health interventions can appeal to men and support them in sustainable lifestyle change.

Seven A's of Active Aging: Older Men's Suggestions for Physical Activity Programs.

In an attempt to offset the widespread anticipated impact of aging populations, active aging programs have become nearly ubiquitous in Western society. Nonetheless, older adults tend to remain relatively inactive. The perspectives of older adults constitute a key resource to help guide active aging efforts. Moreover, gender-sensitized and ecological approaches to physical activity programming may contribute markedly to the efficacy and inclusiveness of such initiatives. Considering the paucity of research regarding older men's suggestions for physical activity programs, this study involved semistructured interviews to ascertain the perceptions among 19 older men (aged 75-90 years). Through a thematic analysis, seven key attributes emerged that participants believed physical activity programs should possess: affordable, available, accessible, adapted, alternative, accompanied, and awareness. The complexities and implications pertaining to these attributes are discussed in the context of ecological theory and ideals of masculinity.

Meat and masculinities. Can differences in masculinity predict meat consumption, intentions to reduce meat and attitudes towards vegetarians?

"Real men eat meat." While this idea is on the one hand widespread throughout time and cultures, it has also been criticized as being too stereotypical, not applicable to all men alike, and being dependent on group level cultural beliefs about gender norms. Increasingly some men question male norms and male privileges, and value authenticity, domesticity and holistic self-awareness. They identify themselves with 'new' forms of masculinity. This study investigates on an individual level if attachment to these newer forms of masculinity can predict differences in meat consumption, willingness to reduce meat, and attitudes towards vegetarians among men. A total of N = 309 male meat-eating participants were surveyed about their self-identification with new forms of masculinity, their attachment to meat, willingness to reduce their meat intake, and attitudes towards vegetarians. Results show that, as was predicted, men who identify more strongly with new forms of masculinity consume less meat, have a weaker attachment to meat, have a greater tendency to reduce their meat intake, and have more positive attitudes towards vegetarians. In sum this study carefully suggests to not only take biological sex differences, but socially and culturally determined gender differences into account when studying or promoting the (non-)consumption of meat.

Trabajadores sexuales masculinos: entre el sexo seguro y el riesgo. Etnografía en una sauna gay de Barcelona, España / Male sex workers: between safe sex and risk. Ethnography in a gay sauna in Barcelona, Spain

Resumen Esta etnografía se realizó en Barcelona, ciudad que ofrece diferentes recursos de ocio homosexual, como las saunas gay. El objetivo fue analizar desde los estudios sobre género y masculinidades, cómo se articula la sexualidad, la percepción sobre la infección por VIH y otras infecciones de transmisión sexual (ITS), y las medidas preventivas en trabajadores sexuales masculinos (TSM) usuarios de saunas gay. Se realizaron 10 entrevistas en profundidad y observación entre 2012 y 2016. Las prácticas de sexo seguro son más frecuentes con clientes, mientras que las de riesgo se realizan más con parejas no comerciales. La orientación sexual juega un rol relevante, los homosexuales asumen más prácticas de riesgo en el trabajo sexual que los heterosexuales. Consumo de drogas o la escasez de redes de apoyo se relacionaron con mayor vulnerabilidad social y conductas de riesgo. Contraer el VIH aún genera miedo, mientras que tener otras ITS se percibe como parte de la vida sexual de un hombre. El TSM afianza una masculinidad con múltiples parejas sexuales, breadwinner y por otra parte, cuestiona un modelo heteronormativo. Las intervenciones para la prevención del VIH e ITS en este colectivo, deberían considerar los determinantes sociales como las precarias alternativas laborales y el ofrecer mayor soporte social.

Abstract This ethnography was conducted in Barcelona, a city that provides different gay leisure resources, such as gay saunas. We aimed to analyze from studies on gender and masculinities, how sexuality, perception of HIV infection and other sexually transmitted infections (STIs), and preventive measures are articulated in gay sauna male sex workers (MSW). Ten in-depth interviews and observation were conducted between 2012 and 2016. Safe sex practices are more frequent with clients, while risk practices are carried out more with non-commercial partners. Sexual orientation plays an important role. Homosexuals assume riskier practices in sex work than heterosexuals. Drug use or lack of support networks were associated with higher social vulnerability and risk behaviors. Contracting HIV still creates fear, while having other STIs is perceived as part of a man's sexual life. The MSW affirms masculinity with concurrent sexual partners, breadwinner, and on the other hand, questions a heteronormative model. Interventions for the prevention of HIV and STIs in this group should consider social determinants such as inferior work alternatives and the provision of more significant social support.

Male sex workers: between safe sex and risk. Ethnography in a gay sauna in Barcelona, Spain. / Trabajadores sexuales masculinos: entre el sexo seguro y el riesgo. Etnografía en una sauna gay de Barcelona, España.

This ethnography was conducted in Barcelona, a city that provides different gay leisure resources, such as gay saunas. We aimed to analyze from studies on gender and masculinities, how sexuality, perception of HIV infection and other sexually transmitted infections (STIs), and preventive measures are articulated in gay sauna male sex workers (MSW). Ten in-depth interviews and observation were conducted between 2012 and 2016. Safe sex practices are more frequent with clients, while risk practices are carried out more with non-commercial partners. Sexual orientation plays an important role. Homosexuals assume riskier practices in sex work than heterosexuals. Drug use or lack of support networks were associated with higher social vulnerability and risk behaviors. Contracting HIV still creates fear, while having other STIs is perceived as part of a man's sexual life. The MSW affirms masculinity with concurrent sexual partners, breadwinner, and on the other hand, questions a heteronormative model. Interventions for the prevention of HIV and STIs in this group should consider social determinants such as inferior work alternatives and the provision of more significant social support.

Esta etnografía se realizó en Barcelona, ciudad que ofrece diferentes recursos de ocio homosexual, como las saunas gay. El objetivo fue analizar desde los estudios sobre género y masculinidades, cómo se articula la sexualidad, la percepción sobre la infección por VIH y otras infecciones de transmisión sexual (ITS), y las medidas preventivas en trabajadores sexuales masculinos (TSM) usuarios de saunas gay. Se realizaron 10 entrevistas en profundidad y observación entre 2012 y 2016. Las prácticas de sexo seguro son más frecuentes con clientes, mientras que las de riesgo se realizan más con parejas no comerciales. La orientación sexual juega un rol relevante, los homosexuales asumen más prácticas de riesgo en el trabajo sexual que los heterosexuales. Consumo de drogas o la escasez de redes de apoyo se relacionaron con mayor vulnerabilidad social y conductas de riesgo. Contraer el VIH aún genera miedo, mientras que tener otras ITS se percibe como parte de la vida sexual de un hombre. El TSM afianza una masculinidad con múltiples parejas sexuales, breadwinner y por otra parte, cuestiona un modelo heteronormativo. Las intervenciones para la prevención del VIH e ITS en este colectivo, deberían considerar los determinantes sociales como las precarias alternativas laborales y el ofrecer mayor soporte social.

As relações das meninas com os saberes das lutas nas aulas de Educação Física / Relations of girls students to martial arts knowledge in Physical Education lessons / Las relaciones de las ninãs con los saberes de las luchas en las clases de Educación Física

Com base na teoria da "relação com o saber" de Bernard Charlot, esta investigação teve como objetivo analisar as relações de sentido e a mobilização das meninas com os saberes das lutas. Para tanto, este estudo utilizou: (i) observação de aulas do conteúdo judô em uma turma do 7º ano do Ensino Fundamental; e (ii) entrevistas semiestruturadas com 17 alunos da turma. Os resultados indicaram menor mobilização das meninas em comparação aos meninos. Os elementos desfavoráveis à mobilização feminina foram separados em três categorias: (i) a masculinização e o machismo na luta; (ii) o medo de se machucar; (iii) vergonha de se expor. Ressaltar as dificuldades do tema gênero e lutas não significa descartá-las do processo pedagógico, por isso, concluímos o artigo apontando a criação de experiências que subvertam e transgridam tais barreiras.

Based on "relation to knowledge" theory of Bernard Charlot, the question of this investigation is: what are the relations of meaning and mobilization of girls with martial arts knowledge? This a qualitative study with the following procedures: lessons observation of judo content in a seventh grade class of Midle School; and semi-estructured interviews with 17 class students. The results indicated less mobilization of girls in comparison to boys. The elements unfavorable to female mobilziation were separated into three categories: (i) masculinization and machismo in martial arts; (ii) the fear of being hurt; (iii) embarrassment to expose yourself. To conclude, is important to emphasize that difficulties of gender and martial arts does not mean discarding them from the pedagogical process, but rather encourages the creation of experiences that subvert and trangress such barries.

Con base en la teoria de la "relación con el saber" de Bernard Charlot, esta investigación parte de la cuestión: ¿cuáles son las relaciones de sentido y movilización de las niñas con los saberes de las luchas? Se trata de un estudio cualitativo que utilizó: la observación de clases del contenido judo en una clase del 7º año de enseñanza primaria; y entrevistas semiestructuradas con 17 alumnos de la clase. Los resultados indicaron menor movilizacíon de las niñas en comparación a los niños. Los elementos desfavorables a la movilización femenina se separaron en tres categorías: (i) la masculinización y el machismo en la lucha; (ii) el miedo de herirse; (iii) vergüenza de exponerse. Se concluye que resaltar las dificultades del tema género y luchas, no significa descartarlas del proceso pedagógico, sino de incentivar la creación de experiencias que subvierten y transgreden tales barreras.

Los Procesos de Comunicación Educativos sobre el Cáncer de Próstata / The Educational Communication Processes on Prostate Cancer

Introducción: El cáncer de próstata es una neoplasia en la cual la comunicación y el conocimiento de la población puede ayudar al diagnóstico temprano y tratamiento temprano. El objetivo de este estudio fue investigar que conocen los pacientes y acompañantes sobre los procesos de comunicación educativa para la salud en cáncer de próstata. Métodos: El presente estudio descriptivo, fue realizado en el Instituto Oncológico Nacional "Dr Juan Tanca Marengo" Solca-Guayaquil. Se utilizó una encuesta de salud sobre el conocimiento de la entidad nosológica, el conocimiento de los métodos diagnósticos y la predisposición a acudir a charlas educativas. La muestra fue calculada en 80 encuestas a familiares, acompañantes y pacientes del Instituto. Resultados: Se registraron 80 encuestas. Sobre el cáncer de próstata el 52.5 % de los encuestados declara no tener conocimiento alguno sobre el mismo, un 31.25 % asegura tener poco conocimiento sobre el cáncer de próstata, y el 16.25 % declara tener un conocimiento apropiado sobre el cáncer de próstata. Sobre el diagnóstico de Cáncer de Próstata el 58.75 % de los encuestados no sabe cómo se diagnostica, un 22.5% % está informado someramente y un 18.75 % tiene conocimiento del diagnóstico. Conclusión: En este reporte se evidencia el desconocimiento sobre cáncer de próstata que tienen los encuestados sobre su concepto y diagnóstico

Introduction: Prostate cancer is a neoplasm in which communication and knowledge of the population can help early diagnosis and early treatment. The objective of this study was to investigate what patients and companions know about the processes of educational communication for health in prostate cancer. Methods: The present descriptive study was carried out in the National Drugs Institute "Dr Juan Tanca Marengo" Solca-Guayaquil. A health survey was used on the knowledge of the nosological entity, the knowledge of the diagnostic methods and the predisposition to attend educational talks. The sample was calculated in 80 surveys to relatives, companions and patients of the Institute. Results: 80 surveys were registered. Regarding prostate cancer, 52.5% of the respondents declare to have no knowledge about it, 31.25% claim to have little knowledge about prostate cancer, and 16.25% declare to have an appropriate knowledge about prostate cancer. About the diagnosis of Prostate Cancer, 58.75% of respondents do not know how it is diagnosed, 22.5%% is briefly informed and 18.75% have knowledge of the diagnosis. Conclusion: This report shows the lack of knowledge about prostate cancer that respondents have about their concept and diagnosis.

Gender Perception After Raising Vowel Fundamental and Formant Frequencies: Considerations for Oral Resonance Research.

OBJECTIVES: Voice feminization therapy for male-to-female transgender women typically targets increasing fundamental frequency (F0). Increasing vowel formant frequencies (FFs) has also been proposed. To better understand formant conditions that shift listeners' perception of gender from male to "not-male," individual and combined vowel FFs were incrementally raised, whereas F0 was held constant at a gender-ambiguous level. METHODS: The study used a prospective, experimental group design. Using a customized MATLAB program, vowels (/i/, /æ/, /ɑ/, and /u/) spoken by an adult were manipulated by isolating and increasing FF1-3 until they matched those of a woman. Listeners heard randomized samples and perceptually categorized each as male, female, or gender neutral. The latter two choices were combined and labeled not-male. RESULTS: Chi-square analyses revealed that listeners rated samples as not-male for /ɑ/ and /æ/ with all three formants shifted or individual formants shifted at >60%. Individual analysis of vowels, formants, and shifted FF using Kruskal-Wallis revealed a statistical significance for vowels only. CONCLUSIONS: Results suggest that voice was convincingly perceived as not-male, for vowels characterized by a high F1 frequency, and that raising FFs for all four vowels increased (in varying amounts) the perception of voice femininity beyond that of raising F0 alone.

Cuidado clínico ao homem em cirurgia oncológica do trato aerodigestivo superior com necessidade de saúde e qualidade de vida / Clinical care to the man in oncological surgery of the upper aerodigestive tract with need of health and quality of life

Esta tese tem como objeto identificar a necessidade de cuidado e qualidade de vida de homens em tratamento cirúrgico oncológico do trato aerodigestivo superior. Trata-se da identificação das necessidades de cuidado e qualidade de vida relacionada à saúde dos homens antes e após o tratamento cirúrgico e da avaliação dos domínios que afetaram a qualidade de vida, utilizando o questionário da Universidade de Washington (UW-QOL) para construção de uma cartilha de cuidado para as necessidades de saúde e qualidade de vida. Com bases na fundamentação teórico-conceitual de Masculinidades de Connell, de Cuidado de Coelho e de Cotidiano de Michel Certeau, utilizou-se o método misto, com 58 homens em tratamento cirúrgico. A coleta de dados aconteceu entre fevereiro e dezembro de 2016, no Hospital do Câncer I, Rio de Janeiro, Brasil, respeitando as questões éticas com CAAE n° CEP-INCA 52647116430015274. Foi realizada entrevista semiestruturada com aplicação do questionário da (UW-QOL - 4° versão, 2006) para coleta de dados. Os resultados quantificáveis foram analisados pela estatística descritiva com auxílio do software R, e os qualificáveis, pela técnica de Análise de Conteúdo Temático de Bardin. Emergiram três categorias temáticas. A primeira ­ qualidade de vida relacionada à saúde do homem antes da cirurgia ­, caracterizou-se por atitudes positivas e negativas, já que qualidade de vida significava: poder trabalhar; ganhar dinheiro para sustentar a família; satisfação, como alimentar-se pela boca; comer churrasco e mastigar. Por outro lado, as atitudes que levaram o homem ao adoecimento e a genética das neoplasias do trato aerodigestivo superior estão associadas ao fumo, álcool e trabalho em excesso. A segunda categoria ­ qualidade de vida relacionada à saúde do homem após a cirurgia ­ aborda o contexto da cirurgia com aspectos positivos, renascimento por saberem que não tinham mais o câncer e sentir-se curados e não sentir mais dor, não ter ficado com limitações físicas e estéticas, além da qualidade de vida. Todavia, houve alterações funcionais orgânicas na fala, mastigação e deglutição associadas à cirurgia, que mudaram o cotidiano do homem. Logo, o construto de qualidade de vida antes e após a cirurgia foi caracterizado como subjetivo/objetivo e mulifatorial, por envolver dimensão de aspecto positivo e negativo à medida que o homem percebia a satisfação, ou não, das necessidades de saúde e as alterações de atividades laborais de vida diária. Na terceira categoria ­ necessidade de cuidado da saúde do homem em tratamento cirúrgico ­, os aspectos mais afetados foram os psicobiológicos e as necessidades de cuidado com alimentação via sonda gástrica e de informação sobre vida íntima, com demanda de cuidado integrado com a equipe de saúde. Nos resultados quantificaveis com aplicação do questionário UW-QOL, evidenciou-se que as médias mais altas foram os domínios "recreação" e "dor", e as mais baixas, "mastigação" e "fala". O pior resultado da melhor resposta possível do escore cem foram os domínios: "fala", "aparência" e "deglutição", com alterações funcionais e estéticas causando interferência na qualidade de vida. Logo, os homens lutaram pela vida com coragem, criatividade, com enfrentamento para o cuidado a saúde ou não. Mesmo com diminuição das atividades formais, buscaram o trabalho informal, persistindo na produção laboral como dimensão de masculinidade hegemônica.

This thesis intends to identify the needs of care and quality of life of men undergoing oncological surgical treatment of upper aerodigestive tract. It approaches the need for care and health-related quality of life of men before and after surgical treatment and the assessment of fields that affect the quality of life, using the University of Washington questionnaire (UW-QOL) for producing a primer of care for the needs of health and quality of life. Based on theoretical-conceptual grounds of Masculinities by Connell, Care by Coelho and Daily Life by Michel Certeau, the mixed method was used, with 58 men in surgical treatment. Data collection took place between February and December 2016, at Cancer Hospital I, Rio de Janeiro, Brazil, in compliance with the ethical issues of CAAE n° CEP- INCA 52647116430015274. Semi-structured interview was carried out with application of UW-QOL questionnaire, 4th version, 2006) for data collection. The quantifiable results were analyzed using descriptive statistics with R software assistance, and qualifiable results were analyzed using Badin ́s Thematic Content Analysis. Three themes emerged. The first, health- related quality of life of man before surgery, was characterized by positive and negative attitudes, since quality of life meant: capable to work, earn money to support the family, satisfaction with feeding by mouth, eat barbecue and chew. On the other hand, the attitudes that led to illness and genetics of upper aerodigestive tract neoplasms are associated to smoking, alcohol and excess work. The second category, health-related quality of life of man after surgery, approaches the context of surgery with positive aspects and the revival because they know that no longer had cancer and feel healed and feel no more pain, with no aesthetic and physical limitations, and a quality of life. However, there have been changes in the organic functional speech, chewing and swallowing associated with surgery, which changed the daily life of the men. Therefore, the construct of quality of life before and after surgery was characterized as subjective/objective and multifatorial, involving positive and negative aspect dimension, as the man realized the satisfaction, or not, of health needs and the changes of labour activities of daily life. In the third category, need for health care in surgical treatment, the most affected aspects were the psychobiological care needs with gastric tube feeding and information about private life, demanding integrated care from the health team. In the quantifiable results with application of UW-QOL questionnaire, it was shown that the higher means were the domains "amusement" and "pain", and the lowest were "chewing" and "talk". The worst result of the best possible answer of 100 score were the fields "speak", "appearance" and "swallowing" with functional and aesthetic changes causing interference on quality of life. Therefore, the men fought for life with courage, creativity, coping for health care or not. Even with reduction of formal activities, the men sought the informal work, persisting in the work production as the hegemonic masculinity dimension.

El objeto de esta tesis es identificar la necesidad de atención y calidad de vida de los hombres en tratamiento quirúrgico oncológico del tracto aerodigestivo superior. Trata la identificación de la necesidad de atención y calidad de vida relativa a la salud de hombres antes y después del tratamiento quirúrgico y evaluación de los campos que afectan la calidad de vida. Adopta el cuestionario de la Universidad de Washington (UW-QOL) para la construcción de una cartilla para satisfacer las necesidades de salud y calidad de vida. Basándose en la fundamentación teórico-conceptual de la masculinidad de Connell, de la atención de Coelho y de la vida cotidiana de Michel Certeau, se utilizó el método mixto, con 58 hombres en tratamiento quirúrgico. La recolección de datos ocurrió entre febrero y diciembre de 2016, en el Hospital del cáncer I, Río de Janeiro, Brasil, en cumplimiento de los aspectos éticos CAAE n° CEP-INCA 52647116430015274. La entrevista semiestructurada se realizó con la aplicación del cuestionario (UW-QOL- versión 4, 2006) para la recolección de datos. Los resultados cuantificables fueron analizados por medio de la estadística descriptiva con la ayuda de software R y los resultados cuantificables, por medio de la técnica de análisis de contenidos temáticos de Bardin. Tres categorías temáticas surgieron. La primera categoría - calidad de vida relacionada con la salud del hombre antes de la cirugía ­ se caracterizó por actitudes positivas y negativas, porque la calidad de vida significa: se puede trabajar; ganar dinero para mantener a su familia; satisfacción, como la alimentación por vía oral; comer barbacoa y masticar. Por otra parte, las actitudes que condujeron al hombre a la enfermedad y genética de neoplasias del tracto aerodigestivo superior se asocian a fumar, el alcohol y el exceso de trabajo. La segunda categoría ­ calidad de vida relacionada con la salud del hombre después de la cirugía ­ analiza el contexto de la cirugía con aspectos positivos, un renacimiento porque saben que ya no tienen cáncer y se sienten curados y no sienten más dolor, no quedam con limitaciones estética y física y tienen calidad de vida. Sin embargo, ha habido cambios en el discurso funcional orgánico, masticación y deglución asociados con la cirugía, que cambió la vida cotidiana del hombre. Por consiguiente, el constructo de calidad de vida antes y después de la cirugía fue caracterizado como subjetivo/objetivo y mulifatorial, con dimensión de los aspectos positivos y negativos en la medida que el hombre entendía la satisfacción, o no, de las necesidades de salud y los cambios de las actividades laborales de la vida cotidiana. En la tercera categoría ­ necesidad de atención de salud en el tratamiento quirúrgico, los más afectados fueron los aspectos psicobiológicos y el cuidado de las necesidades con alimentación por sonda gástrica e información sobre la vida privada, con demanda de atención integrada con el equipo de salud. En los resultados cuantificables con aplicación del cuestionario UW-QOL, se evidenció que la media más alta fueran los dominios de "recreación" y "dolor" y la más baja, "masticar" y "hablar". El peor resultado de la mejor respuesta posible de la puntuación 100 fueron los campos: "hablar", "apariencia" y "deglución", con cambios funcionales y estéticos que causan interferencia en la calidad de vida. Por consiguiente, los hombres lucharon por la vida con valentía, creatividad, sobrellevando la atención de la salud o no. A pesar de la reducción de las actividades formales, los hombres buscaran el trabajo informal, que persiste en la producción laboral como dimensión de la masculinidad hegemónica.

Masculinidades emergentes a través de la trayectoria del padecimiento: implicaciones para el cuidado de la salud de varones que viven con VIH / Emerging masculinities across the pathway of the disease: Implications for the health care of men living with HIV

Resumen Se realizaron entrevistas a profundidad a doce varones para comprender el sentido que atribuyen a su vivencia con el VIH y la forma en que construyen su masculinidad, en relación con los ideales hegemónicos presentes en su contexto sociocultural. Los resultados indican que durante el transcurso del padecimiento existe una transformación de su masculinidad, pues, al reconocer la vulnerabilidad física, social y emocional que conlleva el diagnóstico de VIH, construyen una masculinidad emergente que permite mantener el autocuidado y normalizar la vida con el padecimiento. Los elementos de esta masculinidad emergente deben ser comprendidos por los servicios de salud y considerados durante el tratamiento para facilitar su atención integral.

Abstract Twelve in-depth interviews with men were conducted in order to understand the meaning they attribute to their experience with HIV and how they construct their masculinity in relation to the hegemonic ideals present in their sociocultural context. The results indicate that during the course of illness there is a transformation of their masculinity, thus recognizing the physical, social and emotional vulnerability that involves the diagnosis of HIV, allows them to build an emergent masculinity that keeps the self-care and the normalization of life with illness. The elements of this emerging masculinity must be understood by health services and considered during treatment to facilitate comprehensive care.

From the "Technician Thing" to the "Mental Game": Masculinity and U.S. Homebirth.

Previous research on pregnancy and birth from the perspective of men has found that men approach them from the perspective of hegemonic masculinity, though many find that hospital birth is a time of potential failure at masculinity. In this qualitative study of 11 men who had children born at home, I find that, like their hospital-birth counterparts, they find roles in their partners' pregnancies and early labors that are congruent with hegemonic masculinity. In ways that converge and diverge with the experience of hospital-birth fathers, they find their masculinity disrupted as the birth approaches, becoming nurturers and servers rather than technicians and protectors. These acts shift them from the masculinity of a young man to that of a father. This is consonant with Connell's (1995) theory that masculinity is not singular, but shifts situationally and across the life course, and Butler's (2003) theory that gender is constructed through acts.

Does on-site chaplaincy enhance the health and well being of fly-in, fly-out (FIFO) personnel?

Issue addressed The fly-in, fly-out (FIFO) work style has been linked to mental-health and interpersonal issues and a need for strategies that maintain a healthy workforce. This study investigated whether 24/7 on-site chaplains deliver a service that promotes the health and well being of FIFO personnel. Methods A phenomenological approach was used to explore the perceptions of FIFO personnel working in different roles and organisational sections on a remote mine site in Western Australia. Multi-pronged strategies recruited 29 participants who represented management, supervisors, workers and support staff. Participants took part in semistructured interviews conducted either one-on-one or in pairs. Results Chaplains were described as making a valuable contribution to the physical and mental health of FIFO personnel. Specific aspects of the service such as active outreach, effective trust building and the on-site availability were identified as central to the service being accessed and overcoming barriers embedded in mining culture and masculinity. Conclusions On-site chaplaincy appears to be effective in promoting the physical and mental health of FIFO personnel working at a remote mine site. So what? This promising model of active on-site outreach offered by chaplains is set apart from existing FIFO support structures. We recommend further exploration of its potential to become part of an integrated health-support system in the mining sector and other industries.

Men, masculinity, and engagement with treatment as prevention in KwaZulu-Natal, South Africa.

Men's poorer engagement with healthcare generally and HIV care specifically, compared to women, is well-described. Within the HIV public health domain, interest is growing in universal test and treat (UTT) strategies. UTT strategies refer to the expansion of antiretroviral therapy (ART) in order to reduce onward transmission and incidence of HIV in a population, through a "treatment as prevention" (TasP). This paper focuses on how masculinity influences engagement with HIV care in the context of an on-going TasP trial. Data were collected in January-November 2013 using 20 in-depth interviews, 10 of them repeated thrice, and 4 focus group discussions, each repeated four times. Analysis combined inductive and deductive approaches for coding and the review and consolidation of emerging themes. The accounts detailed men's unwillingness to engage with HIV testing and care, seemingly tied to their pursuit of valued masculinity constructs such as having strength and control, being sexually competent, and earning income. Articulated through fears regarding getting an HIV-positive diagnosis, observations that men preferred traditional medicine and that primary health centres were not welcoming to men, descriptions that men used lay measures to ascertain HIV status, and insinuations by men that they were removed from HIV risk, the indisposition to HIV care contrasted markedly with an apparent readiness to test among women. Gendered tensions thus emerged which were amplified in the context where valued masculinity representations were constantly threatened. Amid the tensions, men struggled with disclosing their HIV status, and used various strategies to avoid or postpone disclosing, or disclose indirectly, while women's ability to access care readily, use condoms, or communicate about HIV appeared similarly curtailed. UTT and TasP promotion should heed and incorporate into policy and health service delivery models the intrapersonal tensions, and the conflict, and poor and indirect communication at the micro-relational levels of couples and families.

Violência e vida familiar: abordagens psicanalíticas e de gênero / Violence and family life: psychoanalytic and gender approaches

Busca-se examinar as possibilidades de diálogo interdisciplinar entre a psicanálise e a teoria de gênero, tal como tem sido usada em estudos acerca da violência na Saúde Coletiva, para abordar ocorrências de agressão e abuso na vida familiar e seus possíveis impactos na saúde, com especial atenção às repercussões psíquicas nas crianças e mulheres, bem como no grupo familiar como um todo. Com base em autores clássicos para ambos os aportes disciplinares, examina-se um caso concreto extraído de situação de atendimento à família. Esse exame é composto de três dimensões interpretativas: primeiro, considerações sobre o caso individual em seu contexto familiar; segundo, o caso visto da perspectiva das questões culturais; por fim, a relação entre a cultura e sua expressão individualizada no caso. Aponta-se para a possibilidade de se realizar uma abordagem que integre a dimensão intrapsíquica, que diz respeito ao funcionamento do mundo interno dos sujeitos envolvidos, à realidade sociocultural e histórica que constitui o seu contexto de vida. E com vistas a uma atenção mais integral dos casos, aponta-se a importância prática de combinar a reflexão e intervenção de natureza psicodinâmica, fruto do exame dos impactos intrapsíquicos da violência a partir de conceitos como trauma e terror, com reconhecimentos das expressões culturais no plano individual e familiar, que reforçam aceitações normativas de agressões, vitimizações, silenciamentos e banalizações das violências. O diálogo interdisciplinar permite compreender o desenvolvimento de sentimentos e comportamentos, reforçados culturalmente, tais como medos e vergonhas nas vítimas e reiteração das violências nos agressores.

We aim to examine the possibilities for an interdisciplinary dialogue between Psychoanalysis and gender theory, as expressed in studies about violence on Collective Health, to approach occurrences of aggression and abuse in family life and their possible impacts on health, with particular attention to the psychological impacts on children and women, as well as in the family group as a whole. Based on classical authors for both disciplinary contributions, we examine a concrete case taken from a family care situation. This examination consists of three interpretative dimensions: first, considerations on the individual case in its family context; second, the case seen from the perspective of cultural issues; and third, the relation between culture and its individualized expression in the case. We show the possibility of conducting an approach that integrates the intrapsychic dimension, which concerns the functioning of the inner world of the individuals involved, with the sociocultural and historical realities that constitute their context of life. With the aim of a comprehensive care of the cases, we highlight the practical importance of combining reflection and action of psychodynamic nature, a result of the examination of the intrapsychic impacts of violence from concepts such as trauma and terror, with recognition of cultural expressions in the individual and family realms, which strengthen normative acceptances of aggressions, victimizations, silencing, and trivialization of violence. The interdisciplinary dialogue makes possible to understand the development of culturally reinforced feelings and behaviors, such as fear and shame in the victims and repetition of violence in the aggressors.