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Men have different strategies from women when they are patients, attaching less importance to their treatment and the disease than what might happen subsequently. The author suggests ways in which healthcare professionals can take these different strategies into account when communicating with men.

Background: In 2011 the European Commission launched the report ‘The State of Men's Health in Europe’ covering the health of 290 million men across 34 European countries. This is the first official statement on the health of men in Europe. The work was carried out by a team of writers from across Europe aided by a management advisory group, a reviewing group and a broader reference group. Methods: Data from major international databases were used to compile a detailed analysis based on population data, lifestyle and preventable risk factors, use of health services and morbidity and mortality data based on the ICD-10, with the results focused on the “European shortlist” of 65 causes of death. Results: Changes in male demographics are creating a reversal in the age distribution ratio, with a decreasing younger population but increasing numbers of elderly men. The data on morbidity and mortality are most striking in relation to the high levels of premature death in men across the disease spectrum with marked differences between countries. Conclusions: The very large variations seen in the health of men across Europe demonstrates that much of men's higher risk of premature death is caused by socio-cultural factors and therefore avoidable. No country should be complacent about the health of its male population.

Dans une sous-étude du programme de recherche « Relations des pères avec leurs nourrissons » (Fathers' relation to their infants), une enquête a été menée sur les pères et l'accouchement au Danemark. Les pères étaient présents dans 88,1 % de tous les accouchements (N=698). Les raisons invoquées pour la non-participation de 11,9 % d'entre eux étaient liées aux convictions religieuses (islamiques) (6 %), aux circonstances particulières de l'accouchement, ou au fait que la mère était célibataire. Dans les réponses à un questionnaire avant l'accouchement (N=165), les pères ont affirmé qu'ils désiraient être présents non seulement pour soutenir leurs partenaires mais pour eux-mêmes ; et à un deuxième questionnaire, après l'accouchement (N=116), ils ont répondu être heureux d'y avoir assisté (98 %). Quatre-vingt sept pour cent des pères ont participé à des consultations prophylactiques. La majorité d'entre eux ont estimé que l'expérience leur a été bénéfique. Les deux tiers des répondants se sentaient personnellement impliqués mais 54 % ne se sont pas sentis directement invités ; 40 % n'ont pas estimé qu'ils avaient été directement interpellés par les sage-femmes au cours des consultations. Les résultats indiquent la nécessité d'apporter des changements dans les façons de faire des hôpitaux afin de les ajuster aux désirs actuels des familles., Fathers' presence at deliveries in Denmark In a sub-study under the research program Fathers' Relation to Their Infants, an investigation was conducted on fathers and delivery in Denmark. The fathers were present in 88.1% of all deliveries (N=698). For the most of the remaining 11.9% the reasons for not participating seem related to either an Islamic background (6%), special circumstances at the delivery, or the woman being single. The fathers stated in answers to a questionnaire before delivery (N=165) that they wanted to be present for their own sake and not only to support their partners, and to another questionnaire after delivery (N=116) that they were happy to have been there (98%). 87.5% of the fathers participated in prophylactic consultations. Almost all of them found it beneficial. Two-thirds felt personally welcome but 54% did not feel directly invited and 40% did not experience that they were directly addressed to by the midwives during the consultations. The results point to the need for changes in routines in hospitals in accordance with the actual wishes in families of today., Un estudio en Dinamarca. La presencia de los padres al parto En un subestudio del programa de investigción "Relaciones de los padres con sus niños lactantes" una investigación fue realisada sobre los padres y el parto en Dinamarca. Los padres estaban presentes en 88,1% de todos los partos (N=698). Razones invocadas por la falta de participación de 11,9% dentre ellos estaban ligadas a convicciones religiosas (islamicas) (6%), a las circunstancias particulares del parto o al hecho de que la madre era soltera. En un cuestonario antes del parto (N=165), los padres afirmaron que querian estar presente no solamente para sostener sus partenarios pero para ellos mismos. En un secondo cuestionario, después del parto, (N=116) respondieron estar felices haber asistido (98%). Ochenta por ciento de los padres participaron en consultas profilácticas. Dentre ellos la mayoridad estimaron la experiencia benífica. Dos terceros de los respondientes se sentian personalmente implicados pero 54% no se sentiron directamente invitados; 40% no estimaron haber sido directamente interpelados por las parteras durante las consultas. Los resultados indican la necesidad de aportar cambios en la manera de proceder de los hospitales para ajustarlos a los deseos actuales de las familias.

Background During cancer treatment children have reduced contact with their social network of friends, and have limited participation in education, sports, and leisure activities. During and following cancer treatment, children describe school related problems, reduced physical fitness, and problems related to interaction with peers. Methods/design The RESPECT study is a nationwide population-based prospective, controlled, mixed-methods intervention study looking at children aged 6-18 years newly diagnosed with cancer in eastern Denmark (n = 120) and a matched control group in western Denmark (n = 120). RESPECT includes Danish-speaking children diagnosed with cancer and treated at pediatric oncology units in Denmark. Primary endpoints are the level of educational achievement one year after the cessation of first-line cancer therapy, and the value of VO2max one year after the cessation of first-line cancer therapy. Secondary endpoints are quality of life measured by validated questionnaires and interviews, and physical performance. RESPECT includes a multimodal intervention program, including ambassador-facilitated educational, physical, and social interventions. The educational intervention includes an educational program aimed at the child with cancer, the child’s schoolteachers and classmates, and the child’s parents. Children with cancer will each have two ambassadors assigned from their class. The ambassadors visit the child with cancer at the hospital at alternating 2-week intervals and participate in the intervention program. The physical and social intervention examines the effect of early, structured, individualized, and continuous physical activity from diagnosis throughout the treatment period. The patients are tested at diagnosis, at 3 and 6 months after diagnosis, and one year after the cessation of treatment. The study is powered to quantify the impact of the combined educational, physical, and social intervention programs. Discussion RESPECT is the first population-based study to examine the effect of early rehabilitation for children with cancer, and to use healthy classmates as ambassadors to facilitate the normalization of social life in the hospital. For children with cancer, RESPECT contributes to expanding knowledge on rehabilitation that can also facilitate rehabilitation of other children undergoing hospitalization for long-term illness. Trial registration Clinical Trials.gov: file. NCT01772849 and NCT01772862

BACKGROUND A feature of the health of men across Europe is their higher rates of premature mortality and shorter life expectancy at birth than women. Following the publication of the first State of Men's Health in Europe report, we sought to explore possible reasons. METHOD We analyzed trends in life expectancy at birth in 19 European Union member states (EU19) between 1999 and 2008 using mortality data obtained from Eurostat. We then used Pollard's decomposition method to identify the contribution of deaths from different causes and at different age groups to differences in life expectancy. RESULTS Between 1999 and 2008, life expectancy at birth in the EU19 increased by 2.74 years for men and by 2.09 years for women. Most of these improvements were due to reductions in mortality at ages >60, with cardiovascular disease accounting for approximately half these improvements for men. In 2008, life expectancy of men in the EU19 was 5.92 years lower than that of women. Deaths from all major groups of causes, and at all ages, contributed to this gap, with external causes contributing 0.96 years, cardiovascular disease 1.80 years and neoplasms 1.61 years. CONCLUSION Improvements in the life expectancy at birth of men and women have mostly occurred at older ages. There has been little improvement in the high rate of premature death in younger men, suggesting a need for interventions to tackle their high death rate.

Ten years ago the BMJ published a special issue on men’s health. It noted how, although men fare better than women in most conventional measures such as top jobs and earnings, this advantage is not reflected in their health. A report we produced this summer, The State of Men’s Health in Europe, shows that little has changed. At any given age, men are still more likely than women to die from most of the leading causes, and in the European Union men have more than twice as many deaths a year as women throughout the working ages (15-64 years). This high level of premature mortality in men has psychological, social, and economic consequences for relatives, households, communities, and the workplace. Yet, in both national and European health policy, men and “masculinity” are largely taken for granted. This has limited the development of evidence based programmes that meet their health needs.

Med fædres øgede deltagelse i omsorg og kontakt med spædbarnet lige fra fødslen får professionelle også øjnene op for spædbarns-faderskabets psykiske dynamik. I denne dynamik ser vi både særtræk og ligheder i forhold til moderskabets psykologi. Herunder finder vi fødselsdepressioner som en af de mulige vildveje også i mænds forældredannelsesproces. Mænds depressionstilstande og reaktionsmønstre kan på visse områder adskille sig fra kvinders, og der kan også ses sådanne forskelle i spædbarnsmødres og -fædres fødselsdepressioner. Disse og andre kønsspecifikke karakteristika ved mange mænds forældredannelsesproces og psykologiske reaktionsmønstre peger på behov for psykoterapeutiske metoder til fædre med fødselsdepression, der også inddrager en kønsspecifik indfaldsvinkel. Herunder må der bl.a. fokuseres på de udadreagerende træk, der hyppigere ses i mænds depression, og på mandens ambivalens imellem tilknytning og autonomi. Terapien må arbejde med dobbelt fokus skiftende mellem relationerne til barnet og mandens egne erfaringer med tilknytning.

Siden tilknytningsforskningens start har fokus været på mor-barn-relationer. I de seneste tiår er der gennemført flere og flere undersøgelser af far-barn-relationer. Disse viser, på trods af mange påstande om det modsatte, at tilknytningsteorien er en kønsneutral teori. Forskningsresultater har vist, at børn kan have forskellige tilknytningsmønstre med henholdsvis deres far og mor. De viser desuden, at fædre i et repræsentativt udsnit af befolkningen i lige så stort omfang som mødre har potentialer for at udgøre en tryg base for deres børn; ca. 60 procent af alle mænd og kvinder undersøgt med Adult Attachment Interview tilhører gruppen ‘Secure/Autonemous’. I en dansk undersøgelse af fædres tilknytning til spædbørn er det vist, at mænds modeller for omsorg for spædbørn udspringer af deres relation til deres egne mødre.