Social Predictors of Continued and Indoor Smoking Among Partners of Non-smoking Pregnant Women: The TMM BirThree Cohort Study

BackgroundSecondhand smoke (SHS) from partners is a major source of exposure for non-smoking women. However, epidemiological studies have rarely examined social factors associated with continued and indoor smoking among pregnant women’s partners.MethodsWe analyzed data on 6,091 partners of non-smoking pregnant women in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Partners’ age, education, income, workplace SHS exposure (almost never or sometimes, almost every day), and pregnant women’s smoking history (never, quit before pregnancy awareness, quit after pregnancy awareness) were used as social factors. Multiple logistic regression analyses were conducted to examine the associations of social factors with partners’ continued smoking and indoor smoking.ResultsAmong 2,432 smoking partners, 2,237 continued to smoke after pregnancy awareness. Workplace SHS exposure was associated with increased risk of partners’ continued smoking: the odds ratio of workplace SHS exposure almost every day compared with almost never or sometimes was 2.08 (95% confidence interval, 1.52–2.83). Women’s quitting smoking after—but not before—pregnancy awareness was associated with decreased risk of partners’ continued smoking: the odds ratio of women’s quitting after pregnancy awareness compared with never smoking was 0.57 (95% confidence interval, 0.40–0.80). About one-third of partners who continued to smoke did so indoors. Older age, lower education, workplace SHS exposure, and women’s quitting smoking after pregnancy awareness were associated with increased risk of partners’ indoor smoking.ConclusionsWorkplace SHS exposure and pregnant women’s smoking history were associated with continued smoking and indoor smoking among partners of non-smoking pregnant women.Key words: continued smoking, indoor smoking, Japan, partners, pregnant women     

Surviving head injury: a social worker's account

Recovery from a head injury calls on all the resources of the patient and unflagging skill and sensitivity from those attempting to help. In recounting his own experience, a social worker who suffered a head injury details the patient's sources of distress and suggests methods to help those who have been injured succeed in their struggle to reclaim life.     

“They’re always in a hurry” – Older people´s perceptions of access and recognition in health and social care services

The article examines older people's perceptions of quality of life from the perspective of access and use of health and social care services. The data include focus group discussions with older people living alone. The data were analysed using thematic analysis focusing on the older people's collective views on health and social care services as supportive or restrictive factors for their quality of life. Two central themes were present in all the focus group discussions: the importance of accessing services and information regarding the services, and need for recognition within the services/by the professionals. Both themes were connected to the older people's desire to maintain autonomy in their everyday life despite increasing functional disabilities, which was seen as an important factor of quality of life. The older people felt that accessing and finding information about the services was difficult, and dependent on the professional's good will and the older person's own financial resources. Within the services, older people experienced a lack of recognition of their own personhood and individual needs. The participants felt that they were easily bypassed and left out of negotiations regarding their own care. The article highlights the importance of developing health and social care services and practices towards a more holistic approach recognising older people's individual needs.     

Four aspects of self-image close to death at home

Living close to death means an inevitable confrontation with one''s own existential limitation. In this article, we argue that everyday life close to death embodies an identity work in progress. We used a narrative approach and a holistic-content reading to analyze 12 interviews conducted with three persons close to death. By illuminating the unique stories and identifying patterns among the participants’ narratives, we found four themes exemplifying important aspects of the identity work related to everyday life close to death. Two of the themes, named “Inside and outside of me” and “Searching for togetherness,” represented the core of the self-image and were framed by the other themes, “My place in space” and “My death and my time.” Our findings elucidate the way the individual stories moved between the past, the present, and the future. This study challenges the idea that everyday life close to impending death primarily means limitations. The findings show that the search for meaning, new knowledge, and community can form a part of a conscious and ongoing identity work close to death.     

Exploring the experiences of partners who live with a chronic low back pain sufferer

Chronic low back pain (CLBP) is a condition that causes individuals considerable distress. It also presents a significant challenge to the health service and is often viewed by clinicians as frustrating to manage. The purpose of the present paper is to explore the experiences of individuals in the immediate social sphere of those suffering from CLBP and their role in care-giving for their partner. An approach was taken using two qualitative research methods to gather data: journals and focus groups. Findings from the journals and the focus groups revealed issues for partners of CLBP sufferers in relation to living with their partners' pain, perceptions of healthcare and the dominance of illness over social contacts. Key themes revealed the complex emotions experienced by respondents, and underlined the need for their role as care givers and partners to be acknowledged by healthcare professionals. The data also highlighted respondents' desire to have greater involvement in their partners' healthcare, which includes provision of relevant information and involvement with therapeutic interventions. The findings emphasise the need for healthcare professionals to include and acknowledge partners and others in the immediate social sphere of patients in the management of chronic conditions.     

What you don’t know can hurt you: Perceptions of sex-partner concurrency and partner-reported behavior

BackgroundThe objectives of this study were as follows: (1) to determine the extent of agreement between adolescents’ perceptions of sex-partner concurrency (having a partner who has other overlapping sexual partnerships) and their partners’ self-reported concurrency, and (2) to identify the relationship-level factors associated with agreement.MethodsAdolescents ages 14 to 19 years, along with their main sex partners, were recruited from a primary care clinic and a public sexually transmitted disease clinic and interviewed separately about their own concurrency status and their perception of their partner’s concurrency status. Information from both participants and their partners were included in this analysis (N = 90 couples).ResultsThis sample consisted of African-American, sexually experienced heterosexual couples. For males and females who perceived their partner not to have other partners, 16% and 37% of their sex partners reported having other partners, respectively. Of males and females who perceived their partner to have other partners, 80% and 39% of their sex partners reported not having other partners, respectively. Multivariate logistic regression revealed that adolescents who had been with their partners for more than 6 months and considered themselves more emotionally close were nearly twice as likely to agree on concurrency.ConclusionsAmong adolescent couples, agreement between perceptions of sex-partner concurrency and partner-reported behavior was low. To the extent that partner self-reports are accurate, individuals who presume that they are in a mutually monogamous relationship often underestimate their own sexually transmitted disease risk. To appropriately tailor risk reduction messages, prevention efforts need to consider adolescents’ perceptions of concurrent sex partners.     

Spousal and Alcohol-Related Predictors of Smoking Cessation: A Longitudinal Study in a Community Sample of Married Couples

We investigated the longitudinal influence of spousal and individual heavy drinking and heavy smoking on smoking cessation among married couples. Couples'' (N = 634) past-year smoking, alcohol problems, and heavy drinking were assessed. We used an event history analysis and found that spousal and one''s own heavy smoking and one''s own heavy drinking decreased the likelihood of smoking cessation. Heavy drinking and spousal behavior should be considered when developing public health interventions and policies for smoking cessation.Spouses play a significant role in shaping each other''s health behaviors,¹ including tobacco use and alcohol consumption.^2,3 Previous published findings from a longitudinal community sample of married couples indicated that nonsmoking wives who had previously been smokers were more likely to resume smoking if their husbands smoked.³ Smokers are more likely to achieve cessation if their partners are nonsmokers.⁴ However, these studies often fail to examine simultaneously other factors related to changes in smoking, and many spousal studies use information from only 1 member of the couple.Researchers also have found a longitudinal influence of partners on each other''s drinking.^5,6 In a prospective study of partner influence and alcohol use, husbands’ premarital drinking predicted wives’ drinking during the first year of marriage, and wives’ drinking in the first year of marriage predicted husbands’ drinking in the second year of marriage.⁷ Taken together, significant evidence suggests that couples’ health behaviors affect each partner in complex ways. To date, researchers have not integrated individual and partner risk factors as they relate to smoking cessation.At the individual level, tobacco use and alcohol consumption are highly correlated, and alcohol consumption is a known risk factor for smoking cessation failure, especially among heavy drinkers.⁸ Researchers have proposed a cue reactivity model of polysubstance use,^9,10 in which individual smoking cues elicit urges to drink and alcohol cues elicit urges to smoke. However, this model has not been extended to consider an intimate partner specifically. Given the significant influence intimate partners have on each other''s behaviors, it is important to determine whether the drinking patterns of 1 spouse serve as cues to influence the tobacco use by the other, thereby hindering cessation.Our study uniquely addressed how married partners influence each other''s behaviors. Unlike other studies of couples that rely on partner reports, we independently assessed both husbands’ and wives’ behaviors over time. Participants enrolled at the beginning of their marriage, allowing assessment of life transitions. Our purpose was to investigate the longitudinal influence of spousal and individual heavy drinking, alcohol problems, and heavy smoking on smoking cessation within the first 7 years of marriage.     

Importance of Women’s Relative Socioeconomic Status within Sexual Relationships in Communication about Safer Sex and HIV/STI Prevention

The socioeconomic status (SES) of women is increasingly considered an important factor for HIV/STI risk. The HIV/STI literature has largely focused on women’s absolute levels of SES, and therefore, the importance of their SES relative to their male sexual partners remains understudied. This paper examines the association between women’s relative SES and frequency of safer sex communication among heterosexual couples. A convenience sample of 342 couples (N = 684) recruited in New York City was asked about frequency of discussions with their partner about the need to use male condoms, about HIV prevention, and about STI prevention in the previous 90 days. Differences between partners in education, income, employment, housing, and incarceration history were combined using principal component analysis to form an index of women’s relative SES. Negative binomial regression models assessed associations between woman’s relative SES and communication frequency controlling for age, sex, race, ethnicity, education, and relationship type using a generalized estimating equation framework. On average, participants had 2.5, 4.2, and 4.8 discussions regarding the need to use male condoms, about HIV prevention, and about STI prevention, respectively. A one standard deviation increase in a woman’s relative SES score was associated with increased frequency of discussions about male condom use (adjusted rate ratio [aRR], 1.15; 95 % confidence interval [CI], 1.03–1.29), about HIV prevention (aRR, 1.25; CI, 1.14–1.37), and about STI prevention (aRR, 1.29; CI, 1.18–1.41). Women’s relative SES may be an important factor for sexual communication, and further research on its role in HIV/STI risk may uncover avenues for intervention.

Electronic supplementary material

The online version of this article (doi:10.1007/s11524-014-9935-y) contains supplementary material, which is available to authorized users.     

Suffering from meticillin-resistant Staphylococcus aureus: experiences and understandings of colonisation

The objective was to explore individuals' experiences and understandings of meticillin-resistant Staphylococcus aureus (MRSA) colonisation. Thirteen interviews were performed and processed using content analysis, resulting in the theme ‘Invaded, insecure and alone’. The participants experienced fears and limitations in everyday life and expressed a need to protect others from contagion. Moreover, they experienced encounters with, and information from, healthcare workers differently: some were content, whereas others were discontent. The described fears, limitations and inadequate professional–patient relationship generated unacceptable distress for MRSA-colonised persons. Thus, the healthcare sector should assume responsibility for managing MRSA, and healthcare workers must improve their professionalism and information skills, so as to better meet MRSA-colonised persons' needs.     

Quality of life in partners of patients with localised prostate cancer

Purpose

The diagnosis of prostate cancer and the following treatment does not only affect the patient, but also his partner. Partners often suffer even more severely from psychological distress than the patients themselves. This analysis aims to describe the quality of life (QoL) after the cancer diagnosis over time and to identify the effects of possible predictors of partners’ quality of life in a German study population.

Data and methods

Patients with localised prostate cancer and their partners were recruited from a prospective multicenter study in Germany, the Prostate Cancer, Sexuality, and Partnership (ProCaSP) Study. At five observation times during the follow-up period of 2 years after diagnosis, QoL (EORTC QLQ-C30) and personal, social, and cancer-related health factors as well as adaptation and coping factors of 293 couples were observed and analysed with mixed effects analysis.

Results

The men’s prostate cancer diagnosis had a small, but significant impact on their partner’s QoL. However, QoL of partners was most affected by the partners’ own physical health and psychological condition, time, and their relationship quality.

Conclusion

The finding that average QoL increased again 3 months after diagnosis and later should give partners faith and hope for the future. The identified most important predictors of partners’ QoL are potentially susceptible to intervention, and further research on target groups in special need of support and on adequate interventions is needed.     

Gender Role Conflict Among African American Men Who Have Sex With Men and Women: Associations With Mental Health and Sexual Risk and Disclosure Behaviors

Objectives. We investigated whether high gender role conflict (GRC; internal conflict with traditional gender-role stereotypes and an individual’s perceived need to comply with these roles) is associated with psychological distress and HIV-related risk behaviors in a sample of African American men who have sex with men and women (MSMW).Methods. We analyzed baseline data collected from questionnaires completed by 400 MSMW participating in the Men of African American Legacy Empowering Self project in Los Angeles, California, in 2007 to 2010 for associations between participants’ GRC and experiences of poor mental health and HIV risk outcomes.Results. MSMW who reported higher levels of GRC than other participants also reported more psychological distress, lower self-esteem, greater internalized homophobia, less HIV knowledge, lower risk reduction skills, less disclosure of same-sex behaviors to others, and more unprotected vaginal or anal intercourse with female partners.Conclusions. Future research should consider how high GRC affects African American MSMW’s lives and identify specific approaches to help alleviate the psychological distress and other negative behavioral outcomes associated with internal conflict caused by rigid gender role socialization.Despite the heavy toll the HIV/AIDS epidemic has exerted on the lives of African American men who have sex with men (MSM), conspicuously few behavioral interventions have been developed to reduce HIV transmission in this population.1,2 Behavioral HIV prevention interventions designed specifically for men of any race/ethnicity who have sex with both men and women (MSMW) are practically nonexistent. In response to a 2005 report of HIV prevalence as high as 46% among African American MSM,3 the Centers for Disease Control and Prevention and other funding agencies began making resources available to adapt existing HIV prevention interventions, developed originally for gay White men, and to design and evaluate theory-driven HIV interventions to address the specific prevention needs of gay-, bisexual-, and heterosexual-identified African American MSM.The Men of African American Legacy Empowering Self (MAALES) project, conducted in Los Angeles, California, is an example of a collaborative academic–community effort to develop and rigorously test a culturally appropriate behavioral HIV intervention for African American MSMW.4 The critical thinking and cultural affirmation model, one of the behavioral theories underlying the MAALES small-group intervention, posits that a healthy integration of racial/ethnic pride, gender role, and sexual identity will allow African American MSMW to operate from a culturally rooted foundation to make healthier choices in their lives and relationships with sexual partners. This model recognizes that concerns regarding the preservation of African American masculinity underlie much of the conflict and discourse regarding male homosexuality and bisexuality in African American communities. A unique component of the MAALES intervention—aimed at reducing HIV acquisition and transmission risk behaviors—is its reliance on a culturally congruent framework that bolsters racial and cultural pride while reducing HIV stigma and gender role conflict (GRC).4GRC refers to negative consequences that can result from individuals'' socialization regarding the roles ascribed to their gender and the need to comply with these roles. According to O’Neil, such consequences for men can stem from “negative critiques of self or others when conforming to, deviating from, or violating stereotypic gender role norms of masculinity ideology.”5^(p363) Previous research on how males are socialized into traditional gender roles and the negative impacts of high GRC on mental health and other issues was conducted in samples primarily comprising heterosexual men.6–9 With the exception of a recent investigation of the impact of high GRC on condom use in a sample of African American MSM,10 most investigations of the impact of GRC on the lives of MSM have enrolled samples largely consisting of White gay-identified men.11–13In recent work to develop more effective HIV prevention programs for African American MSMW, Operario et al. conducted qualitative interviews with heterosexual-identified, behaviorally bisexual African American men to better understand the context of MSMW’s sexual behaviors with both male and female partners and the need for secrecy and confidentiality regarding same-sex behaviors.14 The study findings revealed a high level of internal conflict among participants stemming from their desire for male partners in the context of community norms that valued rigid male gender roles, namely, an explicit expectation that “real” men will only partner with women. The investigators also found that participants emphasized the need to conceal their same-sex behaviors from female partners and members of their broader social network because of their perceptions that the African American community viewed homosexuality as a weakness. Previous quantitative research in samples of heterosexual men also found higher levels of GRC to be associated with greater psychological distress.15,16 Similarly, among predominantly gay-identified White MSM, high GRC has been associated with higher levels of depression and anxiety and lower self-esteem.12,17We expanded on previous work by quantitatively investigating whether high GRC is associated with psychological distress as well as HIV-related risk behaviors in a sample of behaviorally bisexual African American men. Our theoretical rationale was that GRC may be related to African American men’s engagement in HIV risks through 2 mechanisms: indirectly, by influencing poor mental health outcomes such as psychological distress and lower self-esteem, which may reduce protective, safer-sex practices, and directly, because men with greater GRC may view vulnerability (either physical or emotional) as contrary to society’s expectation of masculinity. In other words, men may try to avoid the appearance of physical vulnerability by electing not to use condoms, an act that may be perceived as showing fear about health threats such as HIV. Men with greater GRC may also avoid the appearance of emotional vulnerability demonstrated by their use of condoms to protect their sexual partners’ health. Similarly, men struggling with GRC may see a need to have multiple female partners or to have more insertive anal intercourse with men to reinforce their masculinity.Consistent with observations in other populations, we hypothesized that high GRC contributes to increased psychological distress and reduced self-esteem in African American MSMW. In addition, we hypothesized that high GRC contributes to increased homophobia by heightening concerns over the implications of intercourse with other men for masculine status. These factors, in turn, may influence HIV risk by reducing African American MSMW’s motivation to acquire HIV knowledge and skills and to practice HIV preventive behaviors, thus increasing the likelihood that they will engage in risky behaviors such as drug use prior to intercourse with other men. We used baseline data collected from MAALES project participants to examine whether African American MSMW with higher levels of GRC than other participants also reported (1) higher levels of psychological distress and poorer self-concept, (2) greater secrecy regarding MSM behaviors, and (3) higher frequencies of engagement in HIV risk behaviors.     

Women's perceptions of how pregnancy influences the context of intimate partner violence in Germany

Intimate partner violence during pregnancy is receiving increased attention because of its high prevalence and health effects. Still, little is known about women's perceptions on how their pregnancy influences the context in which intimate partner violence occurs. We conducted 19 in-depth interviews with women who had experienced intimate partner violence around the time of pregnancy. Women clearly perceived pregnancy as a turning point, because it created new expectations and a feeling of being overwhelmed. This led to violence by reducing women's acceptance of their partner's unemployment, alcohol abuse and lack of relationship commitment, or by increasing women's vulnerability because they felt too young to raise a child alone. Pregnancy also led to violence by bringing back childhood memories or by taking attention away from their partners. Understanding how pregnancy influences the context in which intimate partner violence occurs is important to provide abused, pregnant women with the services they need.     

When Self-Worth Is Tied to One’s Sexual and Romantic Relationship: Associations with Well-Being in Couples Coping with Genito-Pelvic Pain

Contingent self-worth (CSW; the pursuit of self-esteem via a particular domain in one’s life) impacts well-being based on one’s perceived success or failure in the contingent domain. In a community sample, individuals with sexual problems reported greater sexual CSW—self-worth dependent on maintaining a sexual relationship—than those without problems. Couples coping with provoked vestibulodynia (PVD), a genito-pelvic pain condition, perceive failures in their sexual relationship, which could be associated with more pain and poorer well-being. In contrast, relationship CSW—self-worth dependent on the overall romantic relationship—may act as a buffer against adverse outcomes. Eighty-two women with PVD and their partners completed online standardized measures of sexual and relationship CSW, sexual distress and satisfaction, relationship satisfaction, and depressive symptoms, and women reported their pain intensity. Analyses were based on the actor–partner interdependence model. Women with PVD who reported greater sexual CSW experienced more sexual distress and pain. Additionally, when partners reported greater sexual CSW, they were less sexually and relationally satisfied and more sexually distressed, and women had greater depressive symptoms and lower relationship satisfaction. In contrast, when partners reported higher relationship CSW, they were more sexually and relationally satisfied and less sexually distressed, and women reported lower depressive symptoms and greater relationship satisfaction. Results suggest that couples’ (particularly partners’) greater sexual CSW is linked to poorer sexual, relational, and psychological well-being in couples affected by PVD, whereas partners’ greater relationship CSW is associated with better well-being. Thus, sexual and relationship CSW may be important treatment targets for interventions aimed at improving how couples adjust to PVD.     

Relationship Characteristics Differ Based on Use of Substances with Sex among an Urban Internet Sample of HIV-Discordant and HIV-Positive Male Couples

Previous research with men who have sex with men (MSM) has found that substance use with sex is strongly associated with HIV acquisition and poor adherence to HIV treatments. Although some studies have assessed male couples’ use of substances with unprotected anal sex, little is known on whether differences in their relationship dynamics are associated with their usage. Current HIV prevention initiatives underscore the importance of studying male couples’ relationship dynamics. Using dyadic data from 28 HIV-positive and 58 HIV-discordant male couples, this analysis sought to: (1) describe, by substance type, whether neither, one, or both partners in the couple used a particular substance with sex within their relationship or outside of the relationship, respectively, and (2) assess, by substance type, whether relationship characteristic differences existed between these three groups of couples with respect to substance use with sex within and outside the relationship. Data from 86 dyads came from a cross-sectional, Internet study. Multivariate multinomial regression models were employed to achieve the aims. Except for alcohol, most did not use substances with sex. Within the relationship, those who used with sex varied by substance type; outside the relationship, most couples had only one partner who used with sex regardless of substance type. Several relationship characteristic differences were noted between the groups of couples. Within the relationship, marijuana and erectile dysfunction medication (EDM) use with sex was associated with having less tangible resources; for outside the relationship, these were associated with perceiving to have greater quality of alternatives. In general, amyl nitrates and party drug use with sex were associated with viewing the main partner as being less dependable for trustworthiness. Marijuana and party drug use with sex within the relationship and EDM use with sex outside the relationship were negatively associated with being able to communicate constructively. Mixed results were noted for relationship satisfaction. Additional research is urgently needed for prevention and promotion of healthy relationships for male couples who use substances with sex.     

Survivors’ experiences from a train crash

Rarely described are people''s lived experiences from severe injury events such as train crashes. The number of train crashes named disasters with ≥10 killed and/or ≥100 nonfatally injured grows globally and the trend shows that more people survive these disasters today than did so in the past. This results in an increased number of survivors needing care. The aim of the study was to explore survivors’ experiences from a train crash. Narrative interviews were performed with 14 passengers 4 years after a train crash event. Qualitative content analysis was used to analyse the interviews. Experiences were captured in three main themes: (1) Living in the mode of existential threat describes how the survivors first lost control, then were thrown into a state of unimaginable chaos as they faced death. (2) Dealing with the unthinkable described how survivors restored control, the central role of others, and the importance of reconstructing the event to move forward in their processing. (3) Having cheated death shows how some became shackled by their history, whereas others overcame the haunting of unforgettable memories. Furthermore, the result shows how all experienced a second chance in life. Experiencing a train crash meant that the passengers experienced severe vulnerability and a threat to life and interdependence turned out to play a crucial role. Focusing on helping other passengers on site was one way to regain the loss of control and kept the chaos at bay. Family, friends, and fellow passengers turned out to be extremely important during the recovery process why such closeness should be promoted and facilitated.     

Diabetes Distress and Depressive Symptoms: A Dyadic Investigation of Older Patients and Their Spouses

In this dyadic study, we examined diabetes distress experienced by male and female patients and their spouses (N = 185 couples), and its association with depressive symptoms using the Actor‐Partner Interdependence Model. Diabetes‐related distress reported by both patients and spouses was associated with each partner's own depressive symptoms (actor effects) but generally was not associated with the other's depressive symptoms (partner effects). Moreover, diabetes distress was associated with depressive symptoms more strongly for male than for female patients, but this association did not differ between female and male spouses. Findings underscore the dyadic nature of managing chronic illness in that disease‐related distress was experienced by patients and by their spouses and consistently was associated with poorer affective well‐being.     

The Couple Context of Pregnancy and its Effects on Prenatal Care and Birth Outcomes

The couple context of pregnancy and newborn health is gaining importance with the increase in births to unmarried couples, a disproportionate number of which were not intended. This study investigates the association of early prenatal care, preterm birth, and low birth weight with the couple relationship context, including partners’ joint intentions for the pregnancy, their marital status at conception, and the presence of relationship problems during pregnancy. Data are drawn from the first wave of the Early Childhood Longitudinal Study––Birth Cohort, a representative study of births in 2001. The sample is composed of parents residing together with their biological child at the time the child is 9 months old, where both the mother and father completed the self-report interview (N = 5,788). Couple-level multivariate logistic regression models, weighted to account for the complex sampling design, were used in the analysis. Risk of inadequate prenatal care and preterm birth was increased when partners did not share intentions or when neither partner intended the pregnancy. Couples were at additional risk of inadequate prenatal care when the pregnancy was conceived nonmaritally and when the mother did not tell the father about the pregnancy, particularly when neither partner intended the pregnancy. The risk of premature birth was particularly high when the partners were unmarried and either or both did not intend the pregnancy. The couple context of pregnancy is important for a healthy pregnancy and birth. When the partner is present, practitioners and programs should maintain a focus on the couple, and researchers should make every effort to include the father’s own perspective.     

Dutch Preadolescents’ Food Consumption at School: Influence of Autonomy,Competence and Parenting Practices

Eating habits appear to become less healthy once children move into adolescence. Adolescence is characterized by increasing independence and autonomy. Still, parents continue influencing adolescents’ eating habits. This cross-sectional study used a Self-Determination Theory perspective to examine how parents can support preadolescents’ food-related autonomy and competence and how these factors are associated with healthy eating motivation and food consumption at school. In addition, the effect of relative healthy food availability at home on preadolescents’ food consumption at school was explored. In total, 142 Dutch preadolescents (mean age 12.18) and 81 parents completed questionnaires. The results showed that preadolescents perceived themselves as having higher food-related autonomy and lower competence to eat healthily as compared to their parents’ perceptions. A path analysis was conducted to test the hypothesized model. Although parental support was positively associated with food-related autonomy, higher food-related autonomy was related to less healthy food intake at school. On the other hand, competence to eat healthily indirectly affected preadolescents’ healthy intake ratio through their healthy eating motivation. Finally, the relative availability of healthy options at home was positively associated with preadolescents’ healthy intake ratio outside the home. Findings from the study advance the understanding of individual and environmental factors that influence eating habits during the key life period of early adolescence. The results may inform interventions aiming to guide preadolescents to make healthy food choices on their own.     

Couples' happiness and its relationship to functioning in everyday life after brain injury

The objective of this survey was to identify couples' joint perception of their satisfaction with life as a whole when one of the persons in the couple had acquired brain injury between one and five years earlier. The focus was on the influence that functioning and disability in everyday life have on the couple's joint life satisfaction after brain injury. The sample consisted of 55 couples, and the mean age of the brain-injured persons was 51 years. Both persons in the couple answered a mailed questionnaire encompassing questions concerning perceived impairments, activity limitations, participation restrictions, and life satisfaction. The results showed that in 16 of the 55 couples both partners were satisfied with life as a whole. The joint experience of life satisfaction was significantly related to the couple's functioning in everyday life, and specifically to perceived participation in leisure time and in their social life, and in their ability to wash clothes. Important implications from this study, showing that only one-third of the couples were satisfied, are that the partners should be included to a greater extent in the rehabilitation process and the couple's perspective of what they find difficult to deal with should serve as a guide during rehabilitation.