This thesis presents a literature review and data from individual interviews conducted with a total of 20 men in Southern Ontario and the Lower Mainland of British Columbia. The objective of this qualitative study was to identify what these men consider to be their main health problems, and what they consider to be the main health problems of Canadian men in general. In addition, this study explored the ways in which the men understand health and the particular health problems they experienced. Several general trends emerged in the data. Respondents described health in both physical and mental terms. They associated physical health predominantly with lifestyle in the form of adequate activity/exercise, diet, and balance of activities. Mental health was associated with state of mind. Insofar as respondents worried about their health, they were concerned about developing physical health problems such as prostate and testicular cancer. However, the day-to-day problems that they actually experienced were low level mental health problems such as stress and tiredness. Data analysis revealed a broader underlying theme of control. In particular, respondents' explanations of health reflected their ability to control the onset of many health problems by living a healthy lifestyle. Yet, social structural influences, specifically work and gender roles, did not always afford these men control over health-related problems such as stress. Respondents explained the health of Canadian men in terms of lifestyle (reflecting control over health), and by unknown etiology (reflecting lack of control over diseases such as cancer). Review of the research findings identifies gaps in research and offers suggestions for further studies. / Thesis / Master of Arts (MA)

This study explores the defining moments in six men’s lives. The empirical dimension of the research is built around the personal narratives these men tell of their lives across a series of four interviews. The central research theme is the notion of the defining moment as a key element in the processes of establishing how men understand and interpret the events and incidents that have shaped their lives. In the context of this study, the defining moment is seen as the moment or period in time when an individual gives definition to a specific event or experience, as a transition point with (potentially) life-altering consequences. Some of the thematic structures presented include relationships with significant adults (parents, teachers), masculinity, self-harm, schooling, mental illness, isolation, loneliness, stress and relationships with peers. In my pursuit of a methodology that could accommodate the aims of this study, I explored the process of meaning through the qualitative paradigm. Drawing on the principles of qualitative research, as applied through narrative inquiry, I deployed a semi-structured interview format to collect the lived experiences of participants. By privileging the stories that individuals tell of their experiences, the narrative method recognises that data are inexorably located in the contextual and contingent. The experiences and narratives that are presented in this thesis are built around the authentic voices of participants. The study presents a warrant for working with men’s defining moments to disrupt, alter and redefine their attitudes and behaviours in order to improve their lives. Based on the insights gleaned through this study, I argue that there are defining times/points in people’s lives where their experiences can be life altering. When these experiences involve uncertainty, anxiety, stress and other pernicious effects, their longer-term consequences can be devastating. The study confirms existing research, that men are reluctant to seek help or reveal their insecurities during such times, therefore making them particularly vulnerable to defining moments. The conclusion of this thesis establishes some broad recommendations pertaining to working effectively with men and their defining moments. I focus particular attention on the place of schooling and education in helping individuals recognise and respond to the early symptoms of what is potentially a life-altering experience. Schools and, by association, teachers need to be actively and strategically involved in this process. To this end, I argue the need for targeted interventions that are both sensitive and timely. In their engagements with young males, parents, teachers, coaches and mentors need to be particularly attuned to their silent screams for help.

Hegemonic Masculinity informs every aspect of a man’s life regardless of whether they conform to the standards or reject them. Although masculinity informs occupational roles, it can also be seen as an occupation in its own right. Illnesses and injuries can challenge masculine status and result in loss of identity, as well as changing men’s abilities, transforming their occupational roles and providing a challenge to their self-perception of masculinity. There are significant gaps in the literature; particularly regarding the impact health status has on masculine perceptions within a New Zealand context and the idea of masculinity as an occupation. This study goes someway to address these gaps. A qualitative descriptive methodology was employed to understand and describe the stories of 12 men living with the ongoing effects of illness or injury. A general inductive approach to content analysis was undertaken to identify the key themes. The study’s findings show illness and injury and the subsequent changes in occupational roles had a significant impact on participants’ masculine perceptions. Study participants experienced loss in many areas of their lives and described being occupied in recreating and renegotiating their masculinity in varying areas such as work, personal relationships and social activities. Further research, conducted within a New Zealand context, will be invaluable in validating the current findings in this area. The application of this knowledge is an area requiring extensive exploration and research. There is significant scope for healthcare professionals to gain understanding of men’s relationship to, and their self-perceptions of, masculinity and to utilise and incorporate these findings into therapeutic settings, therefore gaining more valuable outcomes for their clients.

Thesis (Ed. D.)--Teachers College, Columbia University. / Typescript; issued also on microfilm. Sponsor: Paul Byers. Dissertation Committee: William C. Sayres. Bibliography: leaves 97-103.

BACKGROUND: Maladaptive patterns of alcohol consumption can lead to clinically significant impairment or distress and have been established as a partial cause of a wide variety of health conditions, including neuropsychiatric disorders, cardiovascular diseases, hepatic inflammations, certain cancers, and infectious diseases. In the United States, Hispanic and non-Hispanic white (NHW) men have comparable rates of moderate alcohol consumption, however, Hispanic men are more likely to consume higher volumes of alcohol and with more frequency and experience disproportionate levels of adverse health and social consequences of alcohol abuse when compared to NHW men. Further, Hispanic men face greater barriers than NHW men in accessing, engaging, and completing alcohol abuse treatment services despite the contrasting burden of alcohol-related consequences they face. OBJECTIVES: This dissertation is composed from three studies addressing the following aims to: 1) synthesize the culturally- and gender-responsive components of alcohol and substance abuse and dependence treatment programs designed for Hispanic males in the United States; 2) explore Hispanic male perspectives and opinions regarding alcohol use and abuse patterns that may lead to disparate rates of alcohol abuse in Hispanic males in the United States; and 3) examine U.S. Hispanic male perspectives regarding the barriers to alcohol abuse treatment-seeking related behaviors that lead to disparate treatment engagement and completion rates. METHODS: A systematic literature search was conducted for Aim 1 in which articles reporting on culturally- and/or gender-adapted alcohol and/or substance abuse interventions designed exclusively for Hispanic males were identified. Aim 2 and Aim 3 used semi-structured interviews to elicit Hispanic male perspectives of alcohol abuse and alcohol abuse treatment seeking behaviors. Separate thematic analyses were conducted as per the objectives of Aims 2 and 3. Data analysis was based on a deductive process including a preliminary codebook that was supplemented with inductive codes that surfaced during iterative thematic analyses. RESULTS: Regarding Aim 1, literature searches yielded 2685 titles, resulting in 12 articles that fit the parameters of the review. The most scientifically rigorous findings suggest that cultural adaptations may outperform standard treatment for Hispanic men (n=6). Nevertheless, a fraction of the included interventions (n=4) did not improve outcomes compared to standard treatment. Considering the scarce number of publications, it is difficult to discern how much findings reflect ineffective interventions or methodological limitations. Findings for Aim 2 indicate that there are intersected effects of machismo, a culture of normalized overconsumption, social context stressors, and poor coping strategies that may influence maladaptive relationships with alcohol use. Findings for Aim 3 suggest that treatment seeking behaviors are highly influenced by; a) structural factors related to treatment accessibility, and linguistic and cultural-responsiveness of available treatment, b) sociocultural factors related to difficulties problematizing alcohol abuse due to lack of knowledge and cultural normalization of consumption, and societal stigmatization of alcohol abuse treatment, and c) individual factors related to machismo-bound pride as well as lack of knowledge. CONCLUSIONS: Given the rapid expansion of the Hispanic population in the United States, and the parallel growth of alcohol abuse implications in this population, it is imperative that we learn where these problems may be rooted to better understand how to diminish the existing gaps. Collectively, these findings point to the need for treatment providers to disseminate accurate information about treatment availability and eligibility, and the treatment process. This work also illustrates the need to for consciousness building efforts targeting the Hispanic male community regarding the detrimental effects of alcohol-related problems and treatment, in order to diminish the stigma. Increased or redistributed funding for linguistically and culturally responsive programs is also needed in communities with large Hispanic populations in order to meet the growing demand, particularly for the uninsured. Further research is needed to identify other potential barriers and recovery resources for this population and other Hispanic subgroups in other parts of the United States.

The primary purpose of this research is to examine the effectiveness of male infertility treatment methods. The secondary purpose is to analyze the psychological consequences of failed male infertility treatments. A literature review will be performed regarding male infertility and the relationship to factors that decrease spermatic production, testicular disease, and testicular dysfunction. The focus will relate to decreasing fertility in men and treatments aimed at the improvement of sperm production and maintenance. Preliminary results show artificial reproductive techniques yield higher rates of success compared to alternative methods such as lifestyle changes in the preservation of spermatic function in men. Furthermore, the results are expected to show an increase in anxiety and depression following failed male infertility treatment methods. The increase in global male infertility rates is concerning and can lead to decreasing population stagnation and decreased birth rates. The research can be of value through synthesis of treatment methods to combat male infertility.

Os valores da cultura masculina envolvem comportamentos de risco à saúde, sendo que a forma como os homens constroem e vivenciam a sua masculinidade torna-se uma das matrizes masculinas dos modos de adoecer e morrer. Objetivos: Considerando-se a relevância para o planejamento de políticas de saúde, este estudo abarcou, enquanto objetivo geral: Descrever e analisar os fatores associados à procura dos serviços de saúde por pessoas do sexo masculino e sexo feminino. Os objetivos específicos visaram: Descrever o perfil sócio-demográfico e clínico-epidemiológico de homens e mulheres que procuram os serviços de saúde nos níveis de complexidade primário e secundário; Descrever variáveis relacionadas à procura e aderência aos serviços de saúde entre homens e mulheres e entre os níveis de complexidade primário e secundário; Comparar a procura e aderência aos serviços de saúde entre homens e mulheres considerando-se os níveis de complexidade primário e secundário; Caracterizar os serviços de saúde que apresentam aspectos considerados adequados relacionados à procura e aderência entre o sexo masculino e o feminino. Métodos: Trata-se de um estudo transversal, no qual se utilizou roteiro estruturado de entrevista, aplicado mediante seleção aleatória de homens e mulheres que se encontravam, no momento da coleta de dados, nos seguintes serviços de saúde do município de Ribeirão Preto: Núcleos de Saúde da Família I e IV da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, além de ambulatórios e enfermarias clínicas e cirúrgicas do Hospital Estadual de Ribeirão Preto. As variáveis dependentes deste estudo foram: o sexo do usuário (considerado como indicador cultural) e a procura pelo serviço de saúde (considerada como indicador do uso de serviços de saúde). As variáveis independentes do estudo incluíram: características sócio-demográficas e clínico-epidemiológicas. A amostra do estudo foi composta por 320 pessoas. Para a análise de associação entre variáveis empregou-se a Razão de Prevalência e seu Intervalo de Confiança a 95%. Resultados: Os resultados sugerem como fatores de risco para a não procura: ser do sexo masculino, o horário de funcionamento das unidades de saúde versus o horário de trabalho do usuário e a referência de não possuir nenhuma doença. Em contrapartida, os fatores de proteção contra a não procura, ou seja, de favorecimento da procura foram: ser usuário de Unidades com Equipe de Saúde da Família, ser do sexo feminino e do lar, estar situado na faixa etária de 50 a 65 anos, possuir domicílio próprio, juntamente, com uma renda individual e familiar maior que quatro salários míninos, ser aposentado/pensionista, comparecer aos retornos e ser acompanhante de algum familiar ou outros aos serviços de saúde. Conclusão: É relevante a efetiva consolidação de um modelo de atenção à saúde que questione a contradição existente entre os dados epidemiológicos quanto à saúde masculina e a posição dos serviços de saúde de permanecerem no senso comum da invulnerabilidade dos homens ao adoecimento. / The values of the masculine culture involving health risk behaviors, and how men construct their masculinity and experience becomes one of the matrices of the male modes of illness and death. Objectives: Considering the relevance for the planning of health policies, this study encompassed, while overall goal: To describe and analyze the factors associated with seeking health services for males and females. The specific objectives aimed at: Describe the socio-demographic, clinical and epidemiological study of men and women seeking health services at the levels of primary and secondary complexity; describe variables related to demand and adherence to health services for men and women and between levels of complexity primary and secondary; Compare and demand adherence to health services for men and women considering the levels of primary and secondary complexity; characterize health services that have considered aspects related to demand and adequate adhesion between sex male and female. Methods: This is a transversal study in which we used structured interviews applied by random selection of men and women who were at the time of data collection, the following health services in Ribeirão Preto: Family Health Unit I and IV of the Faculty of Medicine of Ribeirao Preto, University of São Paulo, as well as ambulatories and clinical and surgical wards from the State Hospital of Ribeirão Preto. The dependent variables in this study were: the user gender (regarded as cultural marker) and demand for health services (considered as an indicator of the use of health services).The independent variables of the study included: socio-demographic, clinical and epidemiological characteristics. The study sample consisted of 320 people. For the analysis of association between variables it was used the prevalence ratio and its confidence interval at 95%. Results: The results suggested as risk factors for non-seeking: being male, the opening hours of health facilities versus user\'s working hours and not reporting any disease. In contrast, protective factors against non-demand, that is, facilitation of search, were: to be anuser of the Family Health Unit, being female and work at home, being situated at the age of 50 to 65 years, owning their own home, along with an individual and family incomes greater than four times the minimum wage, retired / pensioner, from returns appear to be a companion of a family member or other health services. Conclusion: It is relevant to the effective consolidation of a model of health care to question the contradiction between the epidemiological data regarding the position of men\'s health and health services which remain in the common sense of invulnerability to the disease of men.

Os valores da cultura masculina envolvem comportamentos de risco à saúde, sendo que a forma como os homens constroem e vivenciam a sua masculinidade torna-se uma das matrizes masculinas dos modos de adoecer e morrer. Objetivos: Considerando-se a relevância para o planejamento de políticas de saúde, este estudo abarcou, enquanto objetivo geral: Descrever e analisar os fatores associados à procura dos serviços de saúde por pessoas do sexo masculino e sexo feminino. Os objetivos específicos visaram: Descrever o perfil sócio-demográfico e clínico-epidemiológico de homens e mulheres que procuram os serviços de saúde nos níveis de complexidade primário e secundário; Descrever variáveis relacionadas à procura e aderência aos serviços de saúde entre homens e mulheres e entre os níveis de complexidade primário e secundário; Comparar a procura e aderência aos serviços de saúde entre homens e mulheres considerando-se os níveis de complexidade primário e secundário; Caracterizar os serviços de saúde que apresentam aspectos considerados adequados relacionados à procura e aderência entre o sexo masculino e o feminino. Métodos: Trata-se de um estudo transversal, no qual se utilizou roteiro estruturado de entrevista, aplicado mediante seleção aleatória de homens e mulheres que se encontravam, no momento da coleta de dados, nos seguintes serviços de saúde do município de Ribeirão Preto: Núcleos de Saúde da Família I e IV da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, além de ambulatórios e enfermarias clínicas e cirúrgicas do Hospital Estadual de Ribeirão Preto. As variáveis dependentes deste estudo foram: o sexo do usuário (considerado como indicador cultural) e a procura pelo serviço de saúde (considerada como indicador do uso de serviços de saúde). As variáveis independentes do estudo incluíram: características sócio-demográficas e clínico-epidemiológicas. A amostra do estudo foi composta por 320 pessoas. Para a análise de associação entre variáveis empregou-se a Razão de Prevalência e seu Intervalo de Confiança a 95%. Resultados: Os resultados sugerem como fatores de risco para a não procura: ser do sexo masculino, o horário de funcionamento das unidades de saúde versus o horário de trabalho do usuário e a referência de não possuir nenhuma doença. Em contrapartida, os fatores de proteção contra a não procura, ou seja, de favorecimento da procura foram: ser usuário de Unidades com Equipe de Saúde da Família, ser do sexo feminino e do lar, estar situado na faixa etária de 50 a 65 anos, possuir domicílio próprio, juntamente, com uma renda individual e familiar maior que quatro salários míninos, ser aposentado/pensionista, comparecer aos retornos e ser acompanhante de algum familiar ou outros aos serviços de saúde. Conclusão: É relevante a efetiva consolidação de um modelo de atenção à saúde que questione a contradição existente entre os dados epidemiológicos quanto à saúde masculina e a posição dos serviços de saúde de permanecerem no senso comum da invulnerabilidade dos homens ao adoecimento. / The values of the masculine culture involving health risk behaviors, and how men construct their masculinity and experience becomes one of the matrices of the male modes of illness and death. Objectives: Considering the relevance for the planning of health policies, this study encompassed, while overall goal: To describe and analyze the factors associated with seeking health services for males and females. The specific objectives aimed at: Describe the socio-demographic, clinical and epidemiological study of men and women seeking health services at the levels of primary and secondary complexity; describe variables related to demand and adherence to health services for men and women and between levels of complexity primary and secondary; Compare and demand adherence to health services for men and women considering the levels of primary and secondary complexity; characterize health services that have considered aspects related to demand and adequate adhesion between sex male and female. Methods: This is a transversal study in which we used structured interviews applied by random selection of men and women who were at the time of data collection, the following health services in Ribeirão Preto: Family Health Unit I and IV of the Faculty of Medicine of Ribeirao Preto, University of São Paulo, as well as ambulatories and clinical and surgical wards from the State Hospital of Ribeirão Preto. The dependent variables in this study were: the user gender (regarded as cultural marker) and demand for health services (considered as an indicator of the use of health services).The independent variables of the study included: socio-demographic, clinical and epidemiological characteristics. The study sample consisted of 320 people. For the analysis of association between variables it was used the prevalence ratio and its confidence interval at 95%. Results: The results suggested as risk factors for non-seeking: being male, the opening hours of health facilities versus user\'s working hours and not reporting any disease. In contrast, protective factors against non-demand, that is, facilitation of search, were: to be anuser of the Family Health Unit, being female and work at home, being situated at the age of 50 to 65 years, owning their own home, along with an individual and family incomes greater than four times the minimum wage, retired / pensioner, from returns appear to be a companion of a family member or other health services. Conclusion: It is relevant to the effective consolidation of a model of health care to question the contradiction between the epidemiological data regarding the position of men\'s health and health services which remain in the common sense of invulnerability to the disease of men.

Submitted by Carvalho Dias João Paulo (joao.dias@famerp.br) on 2018-04-09T14:03:49Z No. of bitstreams: 1 franciscoppinheiro_dissert.pdf: 2652106 bytes, checksum: d8b41972ded49c36bd524b42677ff8a2 (MD5) / Made available in DSpace on 2018-04-09T14:03:49Z (GMT). No. of bitstreams: 1 franciscoppinheiro_dissert.pdf: 2652106 bytes, checksum: d8b41972ded49c36bd524b42677ff8a2 (MD5) Previous issue date: 2016-07-20 / Introduction: The comfort of modern life causes two important side effects: physical inactivity and obesity. The current lifestyle is strongly influenced by sedentary behavior with a possible effect on sexual activity. Objective: To investigate the relationship between sedentary lifestyle and erectile dysfunction (DE), considering: a) the clinical characterization of patients; b) an evaluation of the level of physical activity, and c) a possible correlation between ED and physical activity. Patients and Method: We prospectively studied 50 patients with ED treated between August 2014 and February 2015. The analysis of the association between the degree of ED (moderate and severe) and qualitative variables (diabetes, alcoholism, smoking and physical activity) was investigated using Pearson's chi-square test. Results: Of the patients studied, 21 (42%) had moderate (grade 2) and 29 (58%) of severe (grade 3). The most common age (38%) was the sixth decade of life. Most patients (86%) was overweight. Regarding the level of physical activity of the participants, 38 (76%) reported being active, 6 (12%) insufficiently active and 6 (12%) reported though sedentary. Results showed that 38 participants (76%) presented DE even being physically active, contrary to our initial expectations, since regular physical activity has not reduced the occurrence of ED. Conclusions: There was predominance of patients with ED in the sixty decade of life and overweight. The majority of patients with ED presented high level of physical activity. There was not a significant association between ED (moderate and severe) and level of physical activity (active, insufficiently active, and sedentary). / Introdução: O conforto que a vida moderna oferece traz dois importantes efeitos colaterais: sedentarismo e obesidade. O estilo de vida adotado atualmente tem sido fortemente influenciado pela adoção de comportamentos sedentários, os quais podem refletir-se na atividade sexual. Objetivo: Investigar a relação entre estilo de vida sedentário e disfunção erétil, considerando-se: a) caracterização clínica e demográfica dos pacientes; b) determinação do nível de atividade física e c) correlação entre DE e a prática de atividade física. Casuística e Método: Foram estudados prospectivamente 50 pacientes com DE atendidos entre agosto/2014 e fevereiro/2015. A análise de associação entre grau de DE (moderado e grave) e variáveis qualitativas (diabetes, etilismo, tabagismo e nível de atividade física) foi efetuada por meio do teste quiquadrado de Pearson. Resultados: Dos pacientes estudados, 21 (42%) tinham DE moderada (grau 2) e 29 (58%) DE grave (grau 3). A faixa etária mais frequente (38%) foi a sexta década de vida. A maioria dos pacientes (86%) apresentou excesso de peso corpóreo. Com relação ao nível de atividade física dos participantes, 38 (76%) declararam-se ativos, 6 (12%) insuficientemente ativos e 6 (12%) afirmaram ser sedentários. Os resultados mostraram que 38 participantes (76%) apresentaram DE mesmo sendo fisicamente ativos, contrariando nossas expectativas iniciais, pois a atividade física regular não minimizou a ocorrência de DE. Conclusões: Houve predomínio de pacientes com DE na sexta década de vida e com excesso de peso. O nível de atividade física da maioria dos participantes foi elevado. Não houve associação significativa entre DE (graus moderado e grave) e nível de atividade física (ativo, insuficientemente ativo e sedentário).

Orientador: Batista de Oliveira Junior / Resumo: O câncer de próstata é o tipo de tumor de maior incidência nos homens, atrás somente do câncer de pele não melanoma, é o segundo em mortalidade no Brasil, sendo um grave problema de saúde pública, pois mesmo sendo um câncer de crescimento lento e de simples detecção, muitos pacientes descobrem tardiamente a doença, diminuindo as chances de cura e de sobrevida. Os objetivos da pesquisa foram: desvelar alguns dos motivos do diagnóstico e encaminhamento tardio para um serviço de referência; analisar quais regiões encaminharam pacientes mais tardiamente e entender o itinerário terapêutico desses pacientes. Trata-se de uma pesquisa quanti-qualitativa, desenvolvida em duas etapas. No 1º momento realizou-se um estudo retrospectivo, descritivo e quantitativo de dados levantados junto ao RHC, de 1531 pacientes com câncer de próstata recebidos no Hospital Amaral Carvalho em 2015 e 2016. Na segunda etapa foi realizado um estudo qualitativo, com realização de 100 entrevistas, com perguntas fechadas e abertas. Entre os resultados destaca-se que a maioria dos pacientes está acima de 50 anos (97,77%), com média de 66 anos. A faixa etária de 70 a 79 anos apresentou o maior número de óbitos (3,66%) do total de 141 (9,21%), sendo o maior índice de pacientes com estádio IV (4,25%). 28,15% (431) dos pacientes chegaram com estádio avançado, sendo 131 da DRS VI (Bauru), 85 da DRS IX (Marília), 84 da DRS XVI (Sorocaba), 52 da DRS III (Araraquara) e os demais casos em menores números das demais DRS.... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Prostate cancer is the second most common type of tumor in men, behind only non-melanoma skin cancer. It is the second most common type of cancer in Brazil, being a serious public health problem. simple detection, many patients belatedly discover the disease, decreasing the chances of cure and survival. The objectives of the research were: to unveil some of the reasons for the diagnosis and late referral for a referral service; to analyze which regions referred patients later and to understand the therapeutic itinerary of these patients. It is a quantitative qualitative research, developed in two stages. A retrospective, descriptive and quantitative study of 1531 prostate cancer patients received at the Amaral Carvalho Hospital in 2015 and 2016 was carried out in the 1st stage. A second qualitative study was carried out with 100 interviews, with closed and open questions. Among the results it is highlighted that the majority of patients are over 50 years (97.77%), with a mean of 66 years. The age group from 70 to 79 years old had the highest number of deaths (3.66%) out of 141 (9.21%), being the highest rate of patients with stage IV (4.25%). 28,15% (431) of the patients arrived at an advanced stage, 131 of the DRS VI (Bauru), 85 of the DRS IX (Marília), 84 of the DRS XVI (Sorocaba), 52 of the DRS III (Araraquara) and the other cases in smaller numbers of the other DRS. In the second stage of the research, it was verified that of the 100 patients interviewed: 78 are married, ... (Complete abstract click electronic access below) / Mestre