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State infringement of the responsibilities and rights of parents with regard to the reproductive health of their children / Wezi SamboSambo, Wezi January 2014 (has links)
This research seeks to contribute to the debate on the state infringing upon the responsibilities and rights of parents with regards to the reproductive health of their children. The qualitative method of research is used. The researcher analysed the right of the child to participate in conjunction with best interests of the child, as well as the reproductive rights of children. Furthermore, the argument is based on the provisions of the South African legislation that deals with the reproductive rights of children. This legislation includes the Children's Act 38 of 2005 and the Choice on Termination of Pregnancy Act 92 of 1996.
The crux of the discussion is on access to contraceptives provided to children without parental consent, as it is provided for in section 134 of the Children's Act 38 of 2005, as well as the lack of consent needed in the Choice on Termination of Pregnancy Act 92 of 1996 for a girl with no specification of age. The debate is on the fact that the responsibilities and rights that parents have towards their children are not considered. They are not involved in the major decisions that the children who are under their care and guidance have to make. Due to this finding, it has been recommended that it is very imperative to allow the parents to be involved in matters that pertain to their children's reproductive rights. This means that as children are informed about their reproductive rights, the parents must be involved as well, so as to make informed decisions relevant to the issues that their children encounter. / LLM (Comparative Child Law), North-West University, Potchefstroom Campus, 2015
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Factors influencing termination of pregnancy among young women in Mafikeng, North West Province, South Africa / Grieta Rita DakadaDakada, Grieta Rita January 2012 (has links)
The purpose of the study was to explore and describe factors influencing termination of
pregnancy and describe measures that can be implemented to reduce the high rate of
Termination of pregnancy (TOP). A qualitative, exploratory, descriptive and contextual research
design was followed, in order to explore and describe factors influencing termination of
pregnancy in Mafikeng North West Province. Purposive sampling was utilized to identify
participants who met inclusion criteria for the study. The sample size was determined by data
saturation, which was reached after twenty five in-depth individual interviews with women
requesting TOP was done.
In-depth individual interviews were utilized to gather data after written approval from the Human
research Ethics committee as well as the Research Ethics Committee of the North West
University (Mafikeng Campus), North West Provincial Department of Health, Operational
manager of Montshioa Stadt Health Centre, and Hospital Manager of Mafikeng Provincial
Hospital where data was collected, and consent was also obtained from women who requested
TOP. The findings of this study indicated that factors influencing termination of pregnancy were
economic factors, the need for self development, health factors and social factors. From the
results, women requesting termination of Pregnancy think that effective use of contraceptives
and correct use of condom can reduce the high rate of termination of pregnancy.
Conclusion reached were that, non-use of contraceptives and incorrect use of condoms
influenced TOP, as it was their common problem, hence the researcher suggested that health
education on different methods of contraceptives should be given to teenage girls and other
older women by health care providers. Recommendations in the field of nursing practice,
nursing education, as well as nursing research were made. / Thesis (M.Cur) North-West University, Mafikeng Campus, 2012
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State infringement of the responsibilities and rights of parents with regard to the reproductive health of their children / Wezi SamboSambo, Wezi January 2014 (has links)
This research seeks to contribute to the debate on the state infringing upon the responsibilities and rights of parents with regards to the reproductive health of their children. The qualitative method of research is used. The researcher analysed the right of the child to participate in conjunction with best interests of the child, as well as the reproductive rights of children. Furthermore, the argument is based on the provisions of the South African legislation that deals with the reproductive rights of children. This legislation includes the Children's Act 38 of 2005 and the Choice on Termination of Pregnancy Act 92 of 1996.
The crux of the discussion is on access to contraceptives provided to children without parental consent, as it is provided for in section 134 of the Children's Act 38 of 2005, as well as the lack of consent needed in the Choice on Termination of Pregnancy Act 92 of 1996 for a girl with no specification of age. The debate is on the fact that the responsibilities and rights that parents have towards their children are not considered. They are not involved in the major decisions that the children who are under their care and guidance have to make. Due to this finding, it has been recommended that it is very imperative to allow the parents to be involved in matters that pertain to their children's reproductive rights. This means that as children are informed about their reproductive rights, the parents must be involved as well, so as to make informed decisions relevant to the issues that their children encounter. / LLM (Comparative Child Law), North-West University, Potchefstroom Campus, 2015
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Comparative study of the molecular mechanism of action of the synthetic progestins, Medroxyprogesterone acetate and Norethisterone acetateAfricander, Donita Jean 03 1900 (has links)
Thesis (PhD (Biochemistry))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: Medroxyprogesterone acetate (MPA) and norethisterone (NET) and its
derivatives (norethisterone enanthate (NET-EN); norethisterone acetate (NETA)),
are used by millions of women as contraceptives and in hormone
replacement therapy (HRT). Although both progestins are widely used, very
little is known about their mechanism of action at the molecular level. In this
thesis, the differential regulation of gene expression and molecular
mechanism of action via different steroid receptors by these synthetic
progestons, as compared to progesterone (Prog) was investigated in human
cell lines. In the first part of the study, the effect of Prog, MPA and NET-A on
the expression of endogenous cytokine genes was investigated in two
epithelial cell lines of the human female genital tract, Ect1/E6E7 (an
ectocervical cell line) and Vk2/E6E7 (a vaginal cell line). Quantitative realtime
RT-PCR (QPCR) showed ligand-specific and cell-specific regulation of the
interleukin (IL)-6, IL-8 and RANTES (Regulated-upon-Activation, Normal T cell
Expressed and Secreted) genes with Prog, MPA and NET-A. Moreover, the
repression of the TNF -induced RANTES gene by MPA in the Ect1/E6E7 cell
line was found to be mediated by the androgen receptor (AR). The second
part of the study focused on elucidating the androgenic activities of these two
progestins, in comparison to Prog. Competitive binding in whole cells revealed
that Prog, MPA and NET-A have a similar binding affinity for the hAR as the
natural androgen dihydrotestosterone (DHT). Both transactivation and
transrepression transcriptional assays demonstrate that, unlike Prog, MPA
and NET-A are efficacious AR agonists, with activities comparable to DHT.
Using a mammalian two-hydrid assay, it was shown that MPA and NET-A
exert their androgenic actions by different mechanisms. NET-A, like DHT and
other well-characterised androgens, induces the ligand-dependent interaction
between the NH2- and COOH-terminal domains (N/C-interaction) of the AR
independent of promoter-context, while MPA does this in a promoterdependent
manner. In the third part of this study, competitive binding revealed
that MPA and NET-A have a similar binding affinity to each other, but about a
100-fold lower affinity than Prog for the human mineralocorticoid receptor
(hMR), while RU486 has an even lower affinity for the hMR. Promoter-reporter
assays showed that MPA, NET-A and RU486 are all antagonists of the hMR,
but unlike Prog, they have weak antagonistic activity. However, on the
endogenous MR-regulated Orm-1 (a-glycolytic protein or orosomucoid-1)
gene expressed in a rat cardiomyocyte cell line, NET-A and RU486, but not
MPA, has similar antagonistic activity as Prog. This study is the first to show
that, NET-A and RU486, but not MPA, can dissociate between
transrepression and transactivation via the hMR. Taken together, these
results show that natural Prog and the synthetic progestins, MPA and NET-A
display differential promoter-, cell- and receptor-specific effects on gene
expression. Furthermore they may have important implications for
cervicovaginal immune function, cardiovascular and other physiological
functions. / AFRIKAANSE OPSOMMING: Medroksieprogesteroon asetaat (MPA), noretisteroon (NET) en derivate
daarvan (noretisteroon enantaat (NET-EN); noretisteroon asetaat (NET-A),
word deur miljoene vroue gebruik as voorbehoedmiddels en vir hormoon
vervangingsterapie (HVT). Tenspyte daarvan dat beide hierdie progestiene
algemeen gebruik word, is min bekend oor hulle meganisme van werking op
molekulêre vlak. In hierdie proefskrif word die differensiële regulering van
geenuitdrukking asook die molekulêre meganisme van werking deur middel
van steroïedreseptore van beide hierdie sintetiese progestiene, ondersoek, en
vergelyk met progesteroon (Prog), in menslike sellyne. In die eerste deel van
die studie is die effek van Prog, MPA en NET-A op die uitdrukking van
endogene sitokinien gene ondersoek in twee epiteel sellyne van die menslike
vroulike geslagskanaal, Ect1/E6E7 (‘n ektoservikale sellyn) en Vk2/E6E7 (‘n
vaginale sellyn). Kwantitatiewe intydse RT-PKR het ligand-spesifieke en selspesifieke
regulering van interleukien (IL)-6, IL-8 en RANTES (Regulering-na-
Aktivering, Normale T-sel Uitgedrukte en Afgeskei) gene getoon met Prog,
MPA en NET-A. Verder is gevind dat die onderdrukking van die TNF- -
geïnduseerde RANTES geen deur MPA in die Ect1/E6E7 sellyn bemiddel
word deur die androgeen reseptor (AR). Die tweede deel van die studie het
gefokus op die toeligting van die androgeniese aktiwiteit van die twee
progestiene in vergelyking met Prog. Kompeterende binding in volselle het
getoon dat Prog, MPA en NET-A ‘n soortelyke bindings affiniteit vir die
menslike AR as die natuurlike androgeen dehidrotestosteroon (DHT) vir die
menslike AR het. Beide transaktiverings en transonderdrukkings
transkripsionele analieses toon dat, anders as Prog, MPA en NET-A
effektiewe AR agoniste is met aktiwiteite wat vergelykbaar is met die van
DHT. Deur die gebruik van ‘n soogdier twee-hibried toets, kon gewys word dat
MPA en NET-A hul androgeniese effekte uitoefen deur verskillende
meganismes. NET-A, soos DHT en ander goed gekarakteriseerde androgene,
induseer die ligand-afhanklike interaksie tussen die NH2- en COOH-terminale
domeine (N/C-interaksie) van die AR, onafhanklik van die promoter-konteks.
MPA, aan die ander kant, doen dit op ‘n promoter-afhanklike manier. In die
derde deel van die studie het kompeterende binding getoon dat MPA en NETA
soortelyke relatiewe bindings affiniteite vir die menslike mineralokortikoïed
reseptor (hMR) het, maar dat hierdie affiniteit ongeveer 100-voud laer is as
die van Prog en dat die affiniteit van RU486 vir hMR selfs nog laer is.
Promoter-rapporteerder toetse het getoon dat MPA, NET-A en RU486 almal
antagoniste van die hMR is, maar anders as Prog, is hierdie ‘n swak
antagonistiese aktiwiteit. Nietemin, op die endogene MR-gereguleerde Orm-1
( -glikolitiese proteïen of orosomukoïed-1) geen, uitgedruk in ‘n rot
kardiomiosiet sellyn, het NET-A en RU486, maar nie MPA nie, ‘n soortgelyke
antagonistiese aktiwiteit as Prog. Hierdie studie is die eerste om te wys dat
NET-A en RU486, maar nie MPA nie, kan onderskei tussen transrepressie en
transaktivering deur middel van die hMR. Samevattend toon die resultate dat
natuurlike Prog en die sintetiese progestiene, MPA en NET-A, ‘n differentiële
promoter-, sel- en reseptor-spesifieke effek op geenuitdrukking het. Verder
mag die resultate belangrike implikasies vir servikovaginale immuunfunksie,
asook kardiovaskulêre en ander fisiologiese funksies, inhou.
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Creating Recommendations for Long Acting Reversible Contraceptive Use for AdolescentsStrawn, Katie, Strawn, Katie January 2017 (has links)
The purpose of this research project is to develop a clinical practice guideline for contraceptive counseling to include long acting reversible contraceptive (LARC) recommendations for the adolescent population. LARCs, which include intrauterine devices and implants, are the top-tier contraceptive for nulliparous women yet they are only used in less than 6% of women under 19 years old. There is no LARC clinical practice guideline that addresses the adolescent’s unique developmental and psychosocial needs that arise. A clinical practice guideline with adolescent-specific recommendations will strengthen counseling especially for long-acting reversible contraceptives. The review of literature searched PubMed, CINHAL, National Guideline Clearinghouse, Google Scholar and the Cochrane Library using search terms "LARCs," and "contraceptive counseling." The search yielded over 35,000 results; titles and abstracts were reviewed using pre-determined inclusion and exclusion criteria. The final source documents included forty-eight applicable manuscripts, which were graded using the United States Preventative Task Force (USPSTF) scale. The evidence was then sorted by similar findings and practice recommendations. The findings were used to formulate practice statements, which were then input into the Bridge-wiz software. The program generated recommendations and assigned a strength rating, and the clinical practice guideline was written from these recommendations. Finally, four clinical experts were identified using snowball sampling; they each participated in the final appraisal using the AGREE II tool. Based on the analysis of the review of literature, fifteen evidenced-based recommendations emerged. The recommendation topics included: best-practices for recommending LARCs, using developmentally appropriate teaching, providing youth-friendly services, and eliminating potential barriers to LARC uptake in adolescents. There are fifteen practice recommendations that increase adolescent uptake of LARCs. Limitations for the project included the absence of an internal review committee to grade the evidence and assign a strength to each recommendation. The use of Bridge-wiz software and the USPSTF evidence scale minimized bias. Providers can facilitate use of LARCs among adolescents by using developmentally appropriate and comprehensive contraceptive counseling. If more adolescents chose a LARC as their primary form of contraception, then overall teenage pregnancies may decrease. Further research is needed to understand other barriers and possible interventions.
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Contextual Factors and Reproductive Control in U.S. WomenMagnusson, Brianna 25 April 2011 (has links)
Introduction: Access to family planning services is a major public health issue. State policies and funding for family planning services may increase access to contraceptive services and help women avoid unintended pregnancies. Study Design: We identified sexually active, fertile women participants of the National Survey of Family Growth (2006-2008). Women were categorized as consistent or inconsistent users of contraceptives based on self-report. States were classified based on 2006 Medicaid family planning waiver status (income expansions, limited expansions, or no Medicaid family planning expansions), 2006 public funding for family planning in dollars per woman, and insurance coverage of contraceptive mandate status (comprehensive mandate, partial mandate, or no mandate). Multi-level logistic regression was used to estimate the extent to which state-level constructs increase consistent contraceptive use among reproductive aged women at risk of unintended pregnancy. Results: Women living in states with an Medicaid family planning income expansion waiver had 44% increased likelihood of consistent contraceptive use relative to women living in states with no Medicaid expansions (adjusted odds ratio (aOR): 1.44; 95% confidence interval (CI): 1.06-1.96). Limited Medicaid expansion was also associated with consistent contraceptive use (aOR: 1.30; 95% CI: 0.91-1.87). Nationwide a median of $86 (Interquartile range: $59-$133) of total public family planning funding was spent per woman in 2006. Higher levels of total public funding per woman for family planning services were not associated with an increase in the odds of consistent contraceptive use among all women (OR:1.05; 95% CI:0.98-1.12) or among women with incomes <250% of the federal poverty level (OR:1.06; 95%CI: 0.96-1.17). Comprehensive insurance coverage of contraceptives mandates increased the likelihood of consistent contraceptive use for privately insured women (aOR: 1.64; 95% CI: 1.08-2.50). Partial mandates were not associated with consistent contraceptive use. No association was observed among uninsured women (aOR: 0.77; 95%CI: 0.38-1.55). Conclusions: Comprehensive insurance mandates and income-based Medicaid eligibility expansions are associated with increased likelihood of consistent contraceptive use. More research is needed to understand the association between public funding for family planning and contraceptive use among women in need of publicly funded services.
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Oral contraceptives, weight control, and fat patterning in young college womenLitchfield, Ruth Edson January 2011 (has links)
Typescript (photocopy). / Digitized by Kansas State University Libraries / Department: Foods and Nutrition.
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Hormonal contraceptives as a risk factor for invasive breast cancer in black women in Johannesburg, South AfricaRubanzana, Wilson 10 October 2008 (has links)
Background: Black South African women are known to have a high usage rate of
injectable contraceptives. Breast cancer is the second leading cancer after malignant
cervical neoplasms in black South African women. There is evidence that sex
hormones are associated with an increased risk of developing breast cancer. In the
Western Cape, investigators suggested that injectable contraceptives, more
specifically DMPA, may increase breast cancer risk. In another study conducted in the
same province, a weak association between breast cancer and women taking
combined oestrogen/progesterone oral contraceptives was found, though no risk
associated with injectable progestogen contraceptives (DMPA) was confirmed.
Study Objective: This study aimed to determine whether there is an association
between hormonal contraceptive use and an increased risk of cancer of the breast.
Methods: Data was obtained from an ongoing case control study set up by
MRC/Wits/NHLS Cancer Epidemiology Research Group (CERG) in 1995 to
investigate risk factors associated with cancer among the black population in
Johannesburg. Data was processed using STATA, version8 and analysed using
univariate, bivariate and multivariate unmatched logistic regression models.
Results: There was evidence that an overall use of oral contraceptives increases the
risk of breast cancer; cases (n= 221), controls :( n= 153), OR=2.01 (95% CI:1.45,
2.80), p<0.0001.
There was evidence of an association between use of injectable contraception and the
risk of breast cancer; cases (n=244), controls (n=202), OR=1.51(CI: 1.14, 2.01),p=0.004 Surprisingly, no other use characteristic of either hormonal contraceptive method was
statistically significantly associated with the risk of breast cancer in our dataset.
The combined use of both oral and injectable contraception was associated with an
increased risk of breast cancer, OR=1.68(1.21, 2.33), p =0.002. There was a strong
effect modification (interaction) between oral contraceptive use and injectable
progesterone associated with the risk of breast cancer, (p=0.008).
Conclusion: After adjusting for all potential risk and confounding factors, as
collected in the dataset, there was evidence of an association between combined oral
contraceptive use and breast cancer. An association between cancer of the breast and
overall use of injectable progesterone use was also established. There was evidence of
association between the use of both hormonal contraceptive methods and an increased
risk of breast cancer. However, whether these findings reflect the reality in terms of
causal relationship or are the result of bias must be ascertained.
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Couple asymmetries and its impact on modern contraceptive use among young (15-24) married women in NigeriaOjoniyi, Olaide Olawumi January 2017 (has links)
A dissertation submitted in partial fulfillment of the requirement for the award of Master of Arts in Demography and Population Studies, University of the Witwatersrand, 2017 / BACKGROUND: Nigeria has a very low level of modern contraceptive use; with resultant effects of high fertility, and maternal and child mortality. It is Africa’s most populated country, and with a rapid growth rate. Modern methods of contraception is a crucial strategy to reduce the high fertility rate, halt population growth, lessen child mortality, and enhance maternal health. This study aims to assess partner’s economic and demographic asymmetries as barriers contributing to the uptake of modern contraceptives among young married and cohabiting women aged 15-24 years in Nigeria.
METHOD: This study used data from the Nigerian Demographic and Health Survey 2013, with a sample of 4,981 young (15 – 24 years) married and cohabiting women. The Health Belief Model was used to explain partner’s socio-economic and demographic differences as barriers to the utilisation of modern contraceptives. Frequency distributions and binomial logistic regression were carried out using STATA v12 to answer the research questions.
RESULTS: Only 6% of young married and cohabiting women use modern contraceptives. In the unadjusted analyses, women who were in less homogamous unions were less likely to practise modern method contraception. Respondents younger than their partners by 6-10 years and respondents younger by 11 or more years were less likely to use modern contraceptives (UOR= 0.357, CI 0.135-0.943; UOR= 0.223, CI 0.084-0.595). Respondents whose partners want more children were less likely to use modern contraceptives while respondents whose partners want fewer number of children compared to them were more likely to use modern contraceptives (UOR= 0.325, CI 0.240-0.439; UOR= 1.812 CI 1.1082.963 respectively). However, these associations were no longer significant after adjusting for women’s age, highest level of education, place of residence, religion, and region of residence and other differences.
CONCLUSION: This study concluded that socio-economic and demographic differences between married partners are not associated with young women's contraceptive use in Nigeria, after adjusting for women’s characteristics. Further studies, especially qualitative studies, are needed to understand this finding.
Keywords: Modern contraceptives, young married women, partner asymmetries, Health Belief Model, Nigeria / GR2018
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Avaliação hemodinâmica e da função endotelial em mulheres jovens normotensas em uso de anticoncepcional hormonal combinado oral contendo drospirenona / Assessment of hemodynamic and endothelial function in normotensive young women using a combined hormonal oral contraceptive containing drospirenoneGiribela, Cassiana Rosa Galvão 25 October 2011 (has links)
Importância. Anticoncepcionais hormonais combinados orais (AHCO) podem levar ao aumento do risco da doença cardiovascular, que pode estar associado a alterações na pressão arterial e na função endotelial. Objetivos. O objetivo deste estudo foi avaliar o impacto do uso de AHCO contendo 20 mg de etinilestradiol (EE) e 3 mg de drospirenona (DRSP) por mulheres jovens normotensas sobre a função endotelial arterial, pressão arterial sistólica (PAS, mmHg) e diástólica (PAD, mmHg), frequência cardíaca (FC, bpm), débito cardíaco (DC, L/min), e sobre a resistência periférica total (RPT, NU). Métodos. Setenta e uma mulheres jovens saudáveis com idade média de 29 ± 1 ano foram avaliadas. Quarenta e três foram analisadas antes da introdução do AHCO e ao final de 6 meses de uso (grupo-caso) e vinte e oito, não usuárias de nenhum método hormonal de contracepção, foram avaliadas quanto aos mesmos parâmetros no mesmo intervalo de tempo (grupo-controle). Resultados. Não se observaram mudanças significantes na função endotélio-dependente (VMF%) e independente (VIE%) e nas medidas de PAS, PAD, FC, DC e da RPT com o uso do AHCO (p> 0,05 para todas as variáveis). Não houve variações significantes nestes parâmetros no grupo-controle. Conclusão: O uso desta formulação de AHCO não causou alterações deletérias na reatividade vascular, e nas variáveis hemodinâmicas em mulheres jovens normotensas. / Background: Combined oral contraceptives (COCs) may lead to a rise in cardiovascular disease risk, possibly associated with changes in blood pressure and endothelial function. Objective: The objective was to evaluate the impact of COC containing 20 mcg of ethinyl estradiol (EE) and 3 mg of drospirenone (DRSP) on the arterial endothelial function, systolic and diastolic blood pressure (SBP and DBP), heart rate (HR), cardiac output (CO), and total peripheral resistance (TPR) of normotensive young women. Methods: Of the 71 women in the study, 43 were evaluated before the introduction of COC and after 6 months of its use (case group) and 28, COC nonusers, were assessed for the same parameters at the same time interval (control group). Results: No significant changes in endothelium-dependent and -independent functions or in measures of SBP, DBP, HR, CO, and TPR caused by COC use were observed in the case group (P> 0.05 for all variables) or in the control group. Conclusion: These data suggest COC with 20 mcg EE and 3 mg DRSP does not alter arterial endothelial function or hemodynamic parameters in normotensive young women
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