A intimidade do casal como fator de proteção para cuidados em saúde: uma revisão sistemática / Couple intimacy as a protective factor for health care: a systematic review / Intimidad de la pareja como factor protector para el cuidado de la salud: una revisión sistemática

A intimidade na relação conjugal é um aspecto pertencente ao ciclo da vida humana que compreende a união e troca de afetos entre duas pessoas, sendo que a presença da mesma na díade permite que haja confiança, partilha, revelação de vulnerabilidades e reciprocidade. O objetivo deste artigo foi identificar na literatura se a intimidade em casais é compreendida enquanto um fator de proteção para cuidados em saúde de pacientes portadores de doenças crônicas. Desta forma, foi realizado a pesquisa dos artigos através do recurso de base de dados relacionadas com a temática e incluídos estudos com amostras compostas de casais em que um dos parceiros possuía diagnóstico de doença crônica. A partir dos resultados encontrados foi possível verificar que a presença da intimidade na díade, apesar dos prejuízos ocasionados pela doença e os respectivos tratamentos, acaba por se tornar um espaço onde o paciente obtêm a vivência de conforto, amparo e segurança.

Intimacy in marital relationships is an aspect belonging to the human life cycle that comprises union and exchange of affection between two people, and its presence in this dyad allows for trust, sharing, revelation of vulnerabilities and reciprocity. The objective of this article was to identify in the literature whether intimacy in couples is understood as a protective factor for health care in patients with chronic diseases. Thus, articles related to the theme were searched in databases, and the studies with samples composed of couples in which one of the partners had a diagnosis of chronic disease were included. From the results, the investigation verified that the presence of intimacy in the dyad, despite the damage caused by the disease and the respective treatments, turns into a space where the patient obtains the experience of comfort, support and security.

La intimidad en la relación conyugal es un aspecto perteneciente al ciclo vital humano que comprende la unión y el intercambio de afectos entre dos personas, su presencia en la díada permite que haya la confianza, el compartir, la revelación de vulnerabilidades y la reciprocidad. El objetivo de este artículo fue identificar en la literatura si la intimidad en las parejas es comprendida como un factor de protección para el cuidado de la salud de los pacientes con enfermedades crónicas. De esta manera, fue realizada la búsqueda de artículos a través del recurso de bases de datos relacionadas con el tema y se incluyeron estudios con muestras compuestas por parejas en las que uno de los miembros de la pareja tenía un diagnóstico de enfermedad crónica. A partir de los resultados fue posible verificar que la presencia de la intimidad en la díada, a pesar de los perjuicios causados por la enfermedad y los respectivos tratamientos, se convierte en un espacio donde el paciente obtiene confort, apoyo y seguridad.

Perdão e satisfação conjugal: uma revisão sistemática / Forgiveness and marital satisfaction: a systematic review / Perdón y satisfacción conyugal: una revisión sistemática

O objetivo deste estudo foi realizar uma revisão sistemática da literatura sobre o perdão, quando estudado, com a satisfação conjugal, possibilitando uma melhor integração empírica da investigação sobre os dois construtos. Apesar da interdisciplinaridade emergente, a investigação face a esses dois construtos têm permanecido inconsistente, existindo várias dúvidas quanto à relação entre ambos. Foi realizada uma pesquisa em diferentes bases de dados internacionais (Academic Search Complete, PsycArticles, PsycInfo, PsycCritiques, Psychology and Behavioral Sciences Collection), consultadas até 1990, retrospectivamente, permitindo uma identificação inicial de 516 estudos. Com base em critérios de inclusão e exclusão rigorosa e previamente definidos, 25 estudos, publicados entre 2002 e 2016, foram selecionados para uma análise crítica. Os resultados indicam que a maioria dos estudos aposta numa conceptualização multidimensional do perdão, emergindo a presença de uma dimensão motivacional positiva (benevolência) e a renúncia a um estado motivacional negativo (vingança, evitamento, retaliação). Os dados sugerem relações positivas entre perdão e satisfação conjugal: o perdão promove níveis superiores de satisfação conjugal; níveis superiores de satisfação conjugal promovem um maior perdão; a relação entre os construtos pode ser bidirecional. Contudo, a maioria dos estudos incluídos revela um design metodológico transversal, limitando a exploração e a retirada de conclusões acerca da direção das relações causais entre os dois construtos. Revela-se fundamental o desenvolvimento de estudos futuros com designs metodológicos mais complexos, permitindo uma compreensão mais rigorosa e o alargamento do campo de estudos.(AU)

This study aimed to conduct a systematic review on forgiveness associated with marital satisfaction, enabling a better empirical integration of the literature on them. Despite the emergent interdisciplinarity, the true association between these constructs still raise many doubts, indicating the inconsistency in studies on this topic. Thus, this study conducted a retrospective search for articles published up from 1900 in the Academic Search Complete, PsycArticles, PsycInfo, PsycCritiques, Psychology, and Behavioral Sciences Collection databases, identifying 516 studies. After applying strict predefined inclusion and exclusion criteria, 25 studies published between 2002 and 2016 were selected for a critical analysis. The results indicate that most studies rely on a multidimensional conceptualization of forgiveness, resulting in a positive motivational dimension (benevolence) and the renouncement to a negative motivational state (revenge, avoidance or retaliation). Forgiveness and marital satisfaction were also positively and bidirectionally associated, with forgiveness promoting higher levels of marital satisfaction and higher levels of marital satisfaction promoting greater forgiveness. However, most of the studies adopted a cross-sectional design, limiting exploration and conclusions regarding the direction of causal relationships between the two constructs. Further studies on the theme, with more complex methodological designs, are essential for a more rigorous understanding and the broadening of the field of studies.(AU)

El objetivo de este estudio fue realizar una revisión sistemática de la literatura acerca del perdón asociado con la satisfacción conyugal, posibilitando una mejor integración empírica de la investigación sobre los dos constructos. A pesar de la emergente interdisciplinaridad, es inconsistente la investigación con estos dos constructos, lo que plantea dudas sobre la relación entre ambos. Se realizó una búsqueda en diferentes bases de datos internacionales (Academic Search Complete, PsycArticles, PsycInfo, PsycCritiques, Psychology and Behavioral Sciences Collection), consultadas hasta 1990 (retrospectivamente), y se obtuvo inicialmente 516 estudios. Con base en criterios de inclusión y exclusión rigurosos y previamente definidos, se seleccionaron 25 estudios, publicados entre 2002 y 2016, para el análisis crítico. Los resultados indican que la mayoría de los estudios presentan una conceptualización multidimensional del perdón, emergiendo la presencia de una dimensión motivacional positiva (benevolencia) y la renuncia a un estado motivacional negativo (venganza, evitación, represalia). Los datos evidencian relaciones positivas entre perdón y satisfacción conyugal: el perdón promueve niveles superiores de satisfacción conyugal; los altos niveles de satisfacción conyugal favorecen más el perdón; la relación entre los constructos puede ser bidireccional. Sin embargo, la mayoría de los estudios incluidos revelan un diseño metodológico transversal, limitando la exploración y la retirada de conclusiones acerca de la dirección de las relaciones causales entre los dos constructos. Es fundamental desarrollar estudios futuros con diseños metodológicos más complejos para obtener una comprensión más rigurosa y la ampliación del campo de estudios.(AU)

Factors facilitating implementation of school-based sexuality education in Portugal.

OBJECTIVES: The aims of the study were to examine in Portuguese schools the facilitating factors at micro- and exosystem levels generally associated with more effective implementation of sexuality education (SE). METHODS: A representative sample of principals/lead teachers from 296 Portuguese schools completed a questionnaire about SE at school that included items related to factors at micro- and exosystem levels. Bivariate and multivariate logistic regression analyses were performed to examine factors associated with the development of an SE project. RESULTS: The majority of schools (96%) implemented some form of SE. Specifically, 79% of schools had developed an SE project. The odds that a school had designed an SE project increased significantly when the school did not implement extracurricular activities only (odds ratio [OR] 7.9), when it had an SE team (OR 7.2) and when it had established partnerships (OR 4.5). Bivariate and multivariate logistic regression models for each factor and each level revealed that other variables were associated with the development of a project, such as the perceived support offered by the regional education department. CONCLUSIONS: The results highlight the importance of variables at micro- and exosystem levels as facilitating factors, and reinforce the ecological approach as being well suited for SE/health education in schools. The findings have implications for policy-makers as well as for practice.

Sexuality education in a representative sample of Portuguese schools: examining the impact of legislation.

OBJECTIVES: To share Portugal's experience with school-based sexuality education, and to describe its implementation at a local level, following an ecological model and using a mixed methodology approach. The study also examines the impact of the latest policies put into effect, identifying potential weaknesses and strengths affecting the effectiveness of sexuality education enforcement. METHODS: A representative sample of 296 schools in Portugal was analysed. Teachers representing the school completed a questionnaire and were asked to share any kind of official document from their sexuality education project (such as curriculum content). A subsample of these documents was analysed by two coders. Quantitative analysis was carried out using descriptive statistics. RESULTS: The majority of Portuguese schools delivered sexuality education, in line with Portuguese technical guidelines and international recommendations. There were common procedures in planning, implementation and evaluation of sexuality education. Some strengths and weaknesses were identified. Results highlighted the impact of the various systems on the planning, enforcement and evaluation of sexuality education in school. CONCLUSIONS: The latest policies introduced valuable changes in school-based sexuality education. A way of assessing effectiveness of sexuality education is still needed.

Do Namoro ao Casamento: Significados, Expectativas, Conflito e Amor / From Dating to Marriage: Meanings, Expectations, Conflict and Love

O presente estudo, de cariz exploratório, analisa i) os significados de casamento e amor, ii) as expectativas para o casamento, o cônjuge e o próprio, e iii) a emergência e resolução do conflito, em duas fases: namoro e casamento. Com base numa entrevista semiestruturada, entrevistaram-se cinco casais heterossexuais (cada cônjuge separadamente) casados há pelo menos dois anos, sendo que o namoro foi explorado retrospetivamente. Para o tratamento dos dados, recorreu-se à análise de conteúdo. Concluiu-se que as díades, no namoro, não exploram intencionalmente os significados e expectativas para o casamento; que este assume diferentes significados; que as expectativas, quando casados, veem-se correspondidas ou superadas; e, no casamento, surgem novas fontes de conflito bem como pequenas mudanças nas estratégias de resolução.

The present, exploratory, study analyses i) the meanings of marriage and love, ii) the expectations for marriage, for the partner and for oneself, and iii) the rising and resolution of conflict, in two stages: dating and marriage. Using a semi-structured interview, five heterosexual couples, married for at least two years, were interviewed (each member separately), and dating was explored in retrospective. Content analysis was used as the data analysis strategy. It was concluded that couples, while dating, do not explore the meanings and expectations for marriage intentionally; that marriage assumes different meanings; that expectations are matched or surpassed; and that there are new sources of conflict in marriage as well as small changes in coping strategies.

Do Namoro ao Casamento: Significados, Expectativas, Conflito e Amor / From Dating to Marriage: Meanings, Expectations, Conflict and Love

O presente estudo, de cariz exploratório, analisa i) os significados de casamento e amor, ii) as expectativas para o casamento, o cônjuge e o próprio, e iii) a emergência e resolução do conflito, em duas fases: namoro e casamento. Com base numa entrevista semiestruturada, entrevistaram-se cinco casais heterossexuais (cada cônjuge separadamente) casados há pelo menos dois anos, sendo que o namoro foi explorado retrospetivamente. Para o tratamento dos dados, recorreu-se à análise de conteúdo. Concluiu-se que as díades, no namoro, não exploram intencionalmente os significados e expectativas para o casamento; que este assume diferentes significados; que as expectativas, quando casados, veem-se correspondidas ou superadas; e, no casamento, surgem novas fontes de conflito bem como pequenas mudanças nas estratégias de resolução.(AU)

The present, exploratory, study analyses i) the meanings of marriage and love, ii) the expectations for marriage, for the partner and for oneself, and iii) the rising and resolution of conflict, in two stages: dating and marriage. Using a semi-structured interview, five heterosexual couples, married for at least two years, were interviewed (each member separately), and dating was explored in retrospective. Content analysis was used as the data analysis strategy. It was concluded that couples, while dating, do not explore the meanings and expectations for marriage intentionally; that marriage assumes different meanings; that expectations are matched or surpassed; and that there are new sources of conflict in marriage as well as small changes in coping strategies.(AU)

Pego do Diabo (Loures, Portugal): dating the emergence of anatomical modernity in westernmost Eurasia.

BACKGROUND: Neandertals and the Middle Paleolithic persisted in the Iberian Peninsula south of the Ebro drainage system for several millennia beyond their assimilation/replacement elsewhere in Europe. As only modern humans are associated with the later stages of the Aurignacian, the duration of this persistence pattern can be assessed via the dating of diagnostic occurrences of such stages. METHODOLOGY/PRINCIPAL FINDINGS: Using AMS radiocarbon and advanced pretreatment techniques, we dated a set of stratigraphically associated faunal samples from an Aurignacian III-IV context excavated at the Portuguese cave site of Pego do Diabo. Our results establish a secure terminus ante quem of ca. 34,500 calendar years ago for the assimilation/replacement process in westernmost Eurasia. Combined with the chronology of the regional Late Mousterian and with less precise dating evidence for the Aurignacian II, they place the denouement of that process in the 37th millennium before present. CONCLUSIONS/SIGNIFICANCE: These findings have implications for the understanding of the emergence of anatomical modernity in the Old World as a whole, support explanations of the archaic features of the Lagar Velho child's anatomy that invoke evolutionarily significant Neandertal/modern admixture at the time of contact, and counter suggestions that Neandertals could have survived in southwest Iberia until as late as the Last Glacial Maximum.

Dental maturational sequence and dental tissue proportions in the early Upper Paleolithic child from Abrigo do Lagar Velho, Portugal.

Neandertals differ from recent and terminal Pleistocene human populations in their patterns of dental development, endostructural (internal structure) organization, and relative tissue proportions. Although significant changes in craniofacial and postcranial morphology have been found between the Middle Paleolithic and earlier Upper Paleolithic modern humans of western Eurasia and the terminal Pleistocene and Holocene inhabitants of the same region, most studies of dental maturation and structural morphology have compared Neandertals only to later Holocene humans. To assess whether earlier modern humans contrasted with later modern populations and possibly approached the Neandertal pattern, we used high-resolution microtomography to analyze the remarkably complete mixed dentition of the early Upper Paleolithic (Gravettian) child from Abrigo do Lagar Velho, Portugal, and compared it to a Neandertal sample, the late Upper Paleolithic (Magdalenian) child of La Madeleine, and a worldwide extant human sample. Some aspects of the dental maturational pattern and tooth endostructural organization of Lagar Velho 1 are absent from extant populations and the Magdalenian specimen and are currently documented only among Neandertals. Therefore, a simple Neandertal versus modern human dichotomy is inadequate to accommodate the morphostructural and developmental variation represented by Middle Paleolithic and earlier Upper Paleolithic populations. These data reinforce the complex nature of Neandertal-modern human similarities and differences, and document ongoing human evolution after the global establishment of modern human morphology.