Pela grande produção de equinos no Brasil, perdas econômicas causadas por mortalidade ou perdas reprodutivas neste plantel simbolizam grandes prejuízos, tanto na produção para o mercado interno quanto para a exportação. Necessário se faz o acompanhamento de enfermidades que afetam o sistema nervoso desta espécie. Agentes virais e bacterianos causando problemas neurológicos e reprodutivos, nesta espécie, são amplamente estudados no Brasil. Pouco se conhece sobre o papel dos protozoários da família Sarcocystidae em determinar sinais clínicos neurológicos e reprodutivos. O objetivo deste estudo é identificar protozoários formadores de cistos, com potencial para causar doença neurológica e reprodutiva, em amostras de tecido encefálico de equinos com diagnóstico clínico de encefalopatias e de fetos abortados. Foram analisadas 165 amostras de SNC e 21 amostras de feto abortado de equinos, enviados ao Instituto Biológico para realização de exames laboratoriais. As amostras foram submetidas à nested PCR-ITS1 com primers direcionados às regiões conservadas do lócus ribossômico de protozoários da família Sarcocystidae. Após confirmação do resultado, os produtos de amplificação foram sequenciados para a determinação das sequências ITS1, discriminatórias entre as diversas espécies de protozoários da família Sarcocystidae. Das 15 amostras positivas (duas de feto abortado e 13 de SNC de equino com sintomatologia neurológica) em 14 o protozoário envolvido foi Toxoplasma gondii e em uma delas Sarcocystis neurona. Para Neospora spp não foi encontrada nenhuma amostra positiva. Nas amostras de SNC também foi realizado o exame histopatológico para análise das alterações histopatológicas. Todos os materiais positivos para S. neurona ou T. gondii apresentaram algum tipo de alteração (infiltrado inflamatório meníngeo/neurópilo), congestão/edema, hemorragia, necrose, malácia, indicando a ação de patógeno neurotrópico. A frequência de amostras positivas pela nested PCR-ITS1, para a presença de protozoários foi 7,9% (13/165) e de abortamento por protozário (T. gondii) foi de 9,5% (2/21). Sarcocystis neurona foi encontrado em apenas uma amostra de SNC. Pelos resultados é possível inferir que a ocorrência de mieloencefalite e abortamentos causados pelos protozoários Sarcocistideos em equinos pode revelar-se maior do que se considera atualmente, caso o estudo do SNC nesta espécie seja executado rotineiramente para a conclusão de casos clínicos. / Regarding the importance of equine husbandry in Brazil, economic losses due to mortality or reproductive failures within these herds could mean significant problems for national and international trade market. Therefore, it is necessary to research for diseases affecting the central nervous system (CNS). In Brazil, a broad amount of studies has been made concerning viral and bacterial neurvous and/or reproductive diseases. Although, little is stablished about the rule of protozoan from Sarcocystidae family leading to that kind of symptomatology. This study aimed to identify cystic protozoa which are potentially pathogenic for reproductive and neural tracts using samples from equine encephalic tissue of animals diagnosed with clinical encephalopathy and aborted fetuses. 165 samples of equine CNS and 21 aborted fetuses of this same species were analyzed in the Instituto Biológico facilities. They were submitted to nested PCR-ITS1 using primer to conserved regions from ribosomal locus of Sarcocystidae family protozoa. After confirmatory results, amplified samples were submitted to sequencing for determination of ITS-1 sequences, which are discriminatory concerning the several species of protozoan from Sarcocystidae family. Among the 15 positive identified samples (2 from aborted fetuses and 13 from adult equine CNS), in 14 were detected Toxoplasma gondii as the protozoa involved with the symptoms and in one of them Sarcocystis neurona was detected. None was found positive for Neospora spp. All samples collected were examined using histopathological techniques looking for disease findings. Positive samples for S. neurona or T. gondii showed varied types of alteration (neutrophilic/meningeal inflammatory infiltrate), congestion/edema, hemorrhage, necrosis and malacia, indicating that they were affected by a neurotropic pathogen. The frequency of parasitic equine encephalitis using nested PCR-ITS1 was 7,9% (13/165) and abortion by protozoa (T. gondii was 9,5% (2/21). The incidence of these diseases may be higher than registered nowadays if equine CNS could be analyzed during clinical diagnosis routine for case conclusion.

Este trabalho teve como objetivo compreender a atenção à saúde da mulher em situação de abortamento, à luz da proposta de humanização do atendimento preconizada pelo Ministério da Saúde Norma Técnica Atenção Humanizada ao Aborto (NTAHA), de 2005, em que o aborto é reconhecido como problema de saúde pública e que aponta orientações legais, éticas e práticas para a assistência às mulheres em processo de abortamento. Visando a apreender a realidade por meio da interpretação dos sujeitos que a vivenciam, o estudo baseou-se nos pressupostos da pesquisa qualitativa. Foram realizadas entrevistas semiestruturadas com nove mulheres atendidas no centro obstétrico de um hospital municipal da cidade de São Paulo, com diagnóstico de abortamento incompleto ou complicações decorrentes de abortamento, e oito profissionais de saúde envolvidos no atendimento. Os resultados indicaram que: 1. os profissionais participantes desconhecem a Norma Técnica de Atenção Humanizada ao Abortamento; 2. a condição de ilegalidade compromete o atendimento, à medida que impele profissionais ao julgamento velado de todas as mulheres que recorrem ao hospital, em decorrência de aborto, seja espontâneo ou provocado; 3. a assistência da equipe se limita a procedimentos técnicos, e não há atenção psicossocial; 4. pacientes mencionam a falta de informação e de diálogo com os profissionais como os principais problemas no atendimento; 5. no que tange à polêmica sobre a descriminalização e legalização do aborto, as opiniões das mulheres e dos profissionais entrevistados transcendem a polarização entre ser contra ou a favor do aborto, revelando-se uma diversidade de opiniões, por vezes, ambíguas e contraditórias. Em face dessa realidade, a humanização da assistência a mulheres em situação de abortamento configura-se como desafio para a saúde pública. É urgente a capacitação dos profissionais de saúde acerca da NTAHA, além da necessidade de mudança na lei que criminaliza o aborto, apontando para políticas públicas que respeitem a autonomia da mulher em decidir sobre o próprio corpo / This study had the purpose to understand the attention to the health of woman in abortion situation, from the perspective the service humanization proposal envisioned by the Health Department Technical Standard Humanized Attention to Abortion (NTAHA), 2005, in which the abortion is recognized as a public health matter, and points to legal, ethical and practical orientation to assist women in the abortion process. Aiming to comprehend the reality through the interpretation of individuals who experience it, the study was based on the assumption of qualitative research. Semi-structured interviews were carried out with nine women attended at the obstetric Center at a municipal hospital in the city of São Paulo, with the diagnosis of incomplete abortion or complications resultant from an abortion, and eight health professionals involved in the service. The results indicated: 1. the participant professionals are not familiar with the Technical Standard of Humanized Attention to Abortion (NTAHA); 2. The condition of illegality undermines the service, because it leads the professionals to the veiled judgment of all women who make use of the hospital, due to the abortion, spontaneous or not; 3. the assistance of the team is limited to technical procedures and there is no psychosocial attention; 4. patients mention the lack of information and dialogue with the professionals, as the main service problems; 5. concerning the controversy about the decriminalization and legalization of the abortion, the opinion of the interviewed women and professionals go beyond the polarization between being against or favorable, proving to be a diversity of opinions, at times, ambiguous and contradictory. In the face of this reality, the humanization of women assistance in abortion situation is considered a challenge to public health. It is urgent to train the health professionals regarding the NTAHA, besides the need to change the law that incriminates the abortion, pointing to public politics that respects women autonomy to decide about their own bodies

O trabalho se propõe a compreender como as mulheres em situação de abortamento reconhecem o cuidado de enfermagem que o vivencia. Para tanto, a autora recorre à metodologia qualitativa utilizando a análise de conteúdo. Foram coletados depoimentos de treze mulheres hospitalizadas, em situação de abortamento, mediante as questões: "Como você reconhece o cuidado de enfermagem que está recebendo? Você pode descrever para mim?" Os discursos foram analisados e possibilitaram a construção de algumas categorias temáticas, que sinalizaram para o reconhecimento do cuidado de enfermagem e podem se constituir de subsídios para nortear a assistência à mulher, para que a sua situacionalidade e individualidade seja contemplada. Os resultados possibilitaram o reconhecimento de questões importantes ligadas à mulher que recebe o cuidado de enfermagem nessa situação, como um cuidado que deve levar em consideração o contexto de vida dessas mulheres, que envolve perspectivas e tabus, criando expectativas do cuidado que irão receber, envolto por preconceito, um cuidado no qual o biológico é priorizado o que pelas falas é insuficiente necessitando de um envolvimento genuíno dos profissionais e busca da integridade. Mostrouse também como um cuidado no qual há dificuldade na identificação dos profissionais e no qual o anonimato da equipe se faz presente. O reconhecimento desses aspectos abre novos caminhos para a assistência de enfermagem a essas mulheres no sentido de contemplá-las em sua totalidade. / This work aims at understanding how the women in the situation of abortion recognize the care of nursing which they have experienced it. For this purpose, the author used the qualitative methodology of using the analysis of the content. Thirteen women interviews were applied, while in abortion situation. The interviews were focused on the questions: "How do you recognize the nursing care that been assisting? Could you describe it to me?" The talks were analyzed and they enabled the creation of thematics categories that indicated the recognition from the care of nursing and may also provide guidelines for the development of assistance that would meet their specific needs. The results make possible the recognition of the important questions links of women who receive this care, which are considered their life contexts, which involves perspectives ands taboos, bringing up expectations about the care that they will receive, joined to prejudice. As the talks aren't enough for a biological care, there was a need for genuine involvement and search of entirety. It also showed that there's difficult to identify professionals and also that staff should be anonymous. The recognition of these aspects open up new ways completely to the nursing assistance.

Faculty of health sciences School of Public Health 0204521g dgresie@yahoo.co.uk;dgresie@hotmail.com / Ethylene oxide is used widely in hospitals as a gaseous sterilant for heat-sensitive medical items, surgical instruments and other objects and fluids that come into contact with biological tissues. Although ethylene oxide is recognised as a reproductive toxicant in humans, so far few studies have been carried out to investigate the association between exposure to ethylene oxide and the occurrence of adverse reproductive outcomes (Hemminki et al 1982 and 1983; Rowland et al, 1996; Yakubova et al, 1976). The results of these studies suggested that ethylene oxide is capable of causing reproductive dysfunction and that further research is needed in order to understand its effects on reproductive health. This study investigated the association between exposure to ethylene oxide during pregnancy and adverse reproductive outcome in women sterilising staff working in sterilising units using ethylene oxide in Gauteng province, South Africa. The study had the following objectives: 1) to describe the extent and nature of ethylene oxide use in sterilising units operational in medical facilities in Gauteng; 2) to assess the current exposure to ethylene oxide in sterilising units in Gauteng; 3) to collect information on the last recognised pregnancy using a questionnaire; 4) to assess the validity of the information on the evolution and outcome of the last recognised pregnancy collected by the means of the questionnaire; 5) to assess the association between occupational exposure to ethylene oxide during pregnancy and adverse reproductive outcome. The study population was represented by singleton pregnancies that: 1) occurred in women currently working in sterilising units using ethylene oxide in Gauteng province, South Africa; 2) were the last recognised pregnancy occurring in these women after the 1st January 1992; 3) occurred while the mother was employed. The adverse reproductive outcome was defined as the occurrence of any the following: spontaneous abortion, still birth, pregnancy loss (spontaneous abortion or still birth), low birth weight and combined adverse reproductive outcome (spontaneous abortion, still birth or low birth weight). The study enrolled 68.8% of the medical facilities in Gauteng that were using ethylene oxide to sterilise medical equipment. The majority of the employees working in the sterilising units included in the study were women (96.6%) and they were employed in one of the following jobs: technician (operator), instrument packer and cleaner. xiii Most of the sterilising units participating in the study used ethylene oxide sterilisation daily and only 15.4% of them reported that the employees operating the ethylene oxide steriliser used protective clothing. Recorded levels of ethylene oxide were provided by 46.2% of the sterilising units; they were all bellow 0.25 ppm (the South African long-term exposure limit for occupational exposure to ethylene oxide is 5 ppm). Changes in ethylene oxide sterilisation equipment and or technology were reported by 42.3% of the sterilising units and they were all engineering control measures aimed at reducing exposure to ethylene oxide. Measurements of the current levels of ethylene oxide were performed at the time of the study by the National Institute for Occupational Health using hydrobromic acid-coated petroleum charcoal tubes connected to calibrated Gilian pumps through which air containing ethylene oxide was drawn. The samples were analysed by the Analytical Services of the National Institute for Occupational Health. A total of 418 samples were collected (100 blank samples, 97 personal samples and 221 static samples). Quality control was ensured by the following methods: 1) verification by an Approved Inspection Authority; 2) collection of duplicate samples; 3) collection of blank samples. These measurements showed that exposure to ethylene oxide still occurred in sterilising units (ethylene oxide was detected in 9 out of the 10 public hospitals) and that the employees most exposed are the ones working with the ethylene oxide steriliser (technician or operator). There were 113 women working in the sterilising units enrolled in the study who had been pregnant after the 1st January 1992; 109 of them agreed to participate in the study and to complete the questionnaire. Information on exposure to ethylene oxide during pregnancy was obtained from three sources: walk-through survey, questionnaire-collected data and measurements of the levels of ethylene oxide in sterilising units at the time of the study. Information on the evolution and outcome of these pregnancies was gathered from the mother using a questionnaire. The questionnaire collected demographic data, reproductive history, medical data, risk factors for the adverse reproductive outcome (environmental and occupational exposures, lifestyle), and data regarding the evolution and outcome of the last recognised pregnancy. The questionnaire also collected detailed information on the job held at the time of the last recognised pregnancy (if the woman was working with ethylene oxide, she was asked to provide a complete list of daily tasks she was performing). Prior to administration, the questionnaire was tested on a small sample of working women. xiv The validity of the questionnaire-collected information on the evolution and outcome of the last recognised pregnancy was assessed by comparing this information against medical records (considered the “gold standard”). The assessment showed that mothers’ recall was accurate for the following variables: medical facility were the pregnancy was recorded, date of the reproductive event, gestation length, vital status of the newborn, number of foetuses, child gender, disease/medical problems during pregnancy and treatment received during pregnancy. There was an error in the mothers’ reporting of the birth weight of their babies. The possible misclassification of outcome resulting from this error was shown to be nondifferential (the proportion of subjects misclassified on outcome did not depend on exposure). Therefore, this misclassification could bias the effect estimate towards the null value or it could not produce any bias at all. The analysis carried out to detect possible associations between exposure to ethylene oxide and adverse reproductive outcomes included 98 of the initial 109 pregnancies on which information had been collected (11 pregnancies were excluded from the analysis for the following reasons: 2 were multiple pregnancies, 4 were conceived before 1st January 1992 and 5 were conceived while the mother was not employed). Amongst the 98 singleton pregnancies included in the analysis, 19 were classified as exposed and 79 as unexposed to ethylene oxide. The relative risk for spontaneous abortion was RR=16.63 (95%CI=1.97-140.42; p=0.004), for stillbirths RR=3.47 (95%CI=0.63-19.01; p=0.18), for pregnancy loss RR=6.24 (95%CI=1.95- 19.93; p=0.003), for low birth weight RR=0.61 (95%CI=0.09-4.30; p=0.51) and for combined adverse reproductive outcome RR=2.09 (95%CI=1.00-4.36; p=0.06). No confounders were detected for any of the associations between exposure to ethylene oxide and the adverse reproductive outcomes under study. For the association between exposure to ethylene oxide and combined adverse reproductive outcome the analysis detected three effect modifiers: paternal age (father aged 40 or older at conception), passive smoking and maternal age (mother aged 35 or older at conception). In conclusion, this study, the first in South Africa on ethylene oxide exposure and adverse reproductive outcomes, confirmed the widespread use of ethylene oxide, exposure to this agent in public sector hospitals and associations between exposure to ethylene oxide and spontaneous abortion and between exposure to ethylene oxide and pregnancy loss (either spontaneous abortion or stillbirth). xv Moreover, the study provided data on reproductive outcomes in employed women (on which scant data are available in South Africa) and added information on the validity of selfreported pregnancy data relative to medical records. The findings of the study support the conclusions of the previous studies that had suggested that exposure to ethylene oxide during pregnancy could lead to adverse reproductive outcomes. The study detected no associations between exposure to ethylene oxide and stillbirth, low birth weight or between exposure to ethylene oxide and combined adverse reproductive outcome.

Unsafe abortions pose serious threats to women's health. Medical abortion provides safer abortion access to many. The lengthy interval between misoprostol and mifepristone creates multiple barriers for women and providers. A paucity of research exists about medical abortion protocols that allow single day procedures. The efficacy and the safety of 3 medical abortion protocols of varying lengths were explored in this study. A secondary data set of over 55,000 patients from the United Kingdom was retrospectively analyzed using binomial logistic regression. Efficacy results showed no significant difference between the conventional and the simultaneous protocols; when compared to those, the 6- to 8- hour protocol showed a 79% higher risk (OR = 0.210, 95% CI = 0.178 - 0.246) of failure. Safety of the simultaneous protocol was 48% lesser (OR = 0.524, 95% CI = 0.447 - 0.613) and the safety of the 6- to 8- hour protocol 61% lesser (OR = 0.386, 95% CI = 0.304- 0.489) compared to the conventional protocol. The absolute risk of complications or severe adverse events of all protocols (0.98%, 1.97%, and 2.67%) was very low. The results suggest the simultaneous protocol is a viable alternative to the conventional protocol up to 10 weeks' gestation. The results could promote the adoption of the simultaneous protocol by health systems, give millions more women access to safe and effective single day medical abortions, reduce the need for skilled clinicians, and reduce cost burdens for both women and for healthcare systems overall. Implementation of these social changes could make abortion safer globally.

Despite the availability of contraception in Canada, almost half of pregnancies are unintended and account for approximately 95% of elective, induced abortions. Nearly one-third of Canadian women will access an elective abortion in their lifetime and 30-40% of these women will access at least one further termination. Although contraceptive counselling is generally provided as part of abortion care, there is a paucity of research about the effectiveness of peri-abortive counselling methods or women’s experiences with this care. This research was designed to better understand peri-abortive contraceptive decision-making through the lens of the Ottawa Decision Support Framework and addressed gaps in previous research. The thesis was completed in two parts, a literature review and the first Canadian qualitative study on this topic. Unlike most of the available research that focused on typical outcomes such as contraceptive uptake or continuation, the data from the interpretive descriptive study described women’s informational needs, desired supports, and preferences for peri-abortive contraceptive care. The literature review described the current research and the findings from the qualitative study demonstrated that Canadian women’s experiences with peri-abortive contraceptive care are similar to those in studies published in other countries. This thesis contributes to the limited body of knowledge in understanding what women need and want when receiving contraceptive care as part of abortion services.

Thesis (MA. (Clinical Psychology)) -- University of Limpopo, 2013 / The current study aimed at investigating the relationship between attitudes towards termination of pregnancy (TOP) and family structure and functioning, religiosity, and death anxiety. Participants of this study consisted of 330 school-going, adolescent, female participants aged 12 to 19 years. The results indicated that no relationship exists between attitudes towards TOP and the type of family structure from which an individual stems. The relationship between attitudes towards TOP and the Family Assessment Device (FAD) general family functioning scale did not reach statistical significance either. When attitudes towards TOP were correlated with the more specific family functioning subscales, the FAD problem-solving subscale was negatively associated with attitudes towards TOP. Additionally, the relationship between attitudes towards TOP and death anxiety was not statistically significant. However, analysis indicated that there is a statistically significant, negative relationship between attitudes towards TOP and intrinsic religiosity among school-going adolescents. Final analysis involved the regression of variables of FAD problem-solving and intrinsic religiosity on attitudes towards TOP. Both intrinsic religiosity and FAD problem-solving scores were predictors of attitudes towards TOP.

Australia has a lower teenage fertility rate than other industrialised English-speaking countries. However, with over 11,000 births and 12,000 abortions to teenagers each year, the resolution of teenage pregnancy is an issue faced by many young Australian women. ¶ This research seeks to explore the factors that discriminate between those who terminate and those who continue a teenage pregnancy. To achieve this aim a survey was conducted on young ever-pregnant women throughout New South Wales and the Australian Capital Territory. The survey sought information on young women’s characteristics on three different levels: individual; institutional; and societal or cultural. ¶ The findings suggest that, at each of the three levels proposed, there are factors that discriminate between young women who choose abortion and those who choose motherhood. At the individual level, attitudes to abortion and career aspirations were found to affect pregnancy resolution. At the institutional level factors relating to education, family, relationships and religion were found to discriminate between the two groups. Finally, at the cultural level, ethnicity and area of residence were found to be associated with pregnancy resolution, in addition to modifying the effect of characteristics at other levels.

In this work, I argue that the Alexandiran position on feticide found in Hellenistic Judaism and appropriated by patristic, medieval and reformed theologians is defensible in the 21st Century. I formulate an argument from the Alexandrian position as it appears in several representative Christian traditions. This argument contends that that: [1] killing a human being without justification violates the law of God, [2] a formed conceptus (i.e. a fetus) is a human being and [3] that in the case of feticide (at least in the majority of cases) no justification is forthcoming. In developing my case, I argue that the objections raised against the premises of this argument by contemporary philosphers are unsound. I defend the intellectual acceptability of belief in and appeals to the existence of a divine law, the notion that a formed fetus is a human being and the claim that feticide lacks any justification in the vast majority of cases. In addition, I examine and critique theologians who claim the Alexandrian position is motivated by misogyny and those who claim it appropriates a translation error found in the Septuagint. I conclude that the traditional position is defensible and that contemporary dismissals of it are unconvincing.

<p>The aim of this work is to present and examine the ruling on which the Colombian Constitutional Court declared the blanket criminalization of induced abortion to be unconstitutional: ruling C-355/061; all of this based in the understanding I have achieved of the Courts’ reasoning.</p><p>In the first section I will present the norms that constituted the blanket prohibition of abortion, as well as the likely situation of its practice, both by the time the Constitutional Court took up the analysis of the former. This will provide a good understanding of the importance of the ruling and its starting point. In the second section I will put forth the general nature of the Court and its rulings, inscribed in the Colombian social, political and legal transformation brought by the 1991 constitutional change. I will also bring in the specific decisions the Court made regarding the conditioned constitutionality of induced abortion and the unconstitutionality of the legal expression that equated an abortion performed on a woman less than fourteen years of age to an abortion without consent, thus punishing it harder than a consented one. Such verdict is the starting point of an effort to trace, present and examine the ethical arguments the Court has woven to reach it, all of which will be undertaken in the third section.</p><p>In the fourth section I shall elaborate on two of the common ethical elements that work as corner stones for the Court’s arguments: human dignity and the belief that fundamental rights and constitutional protected goods are not absolute; I will particularly point out how they play a role in the Court’s argumentation. As a conclusion I will offer a final general appraisal of the Court’s work.</p>