This study assessed the intentions with regard to fertility and use of contraception by women living with HIV/AIDS. The study was a quantitative cross-sectional study on a sample of 362 HIV-positive women in the ART follow-up unit in Adama Hospital Medical College. Large numbers of HIV-positive women with no income, housewives, illiterates and women in the age group of 28-32 years declared their intention to fall pregnant. The most prevalent family planning method among the HIV-positive women before their HIV diagnosis was injectables. After wards the most popular method of contraception was the condom. The results suggest that the counselling about condom use that is offered to HIV positive women yields results, as more women adopt this method of contraception. This is important in view of prevention of HIV infections and re-infections. / Health Studies / M. A. (Public Health)

Contraceptive use has far-reaching social and health benefits for women in low and middle-income countries. While socioeconomic factors are known to be associated with contraceptive use, few studies on this topic have focused specifically on young women, whose reproductive health is a target of the Sustainable Development Goals and the Family Planning 2020 agenda. This study used the Kenya Demographic and Health Survey to examine the association between three social determinants (wealth, education, and residence) and two contraceptive outcomes (modern method use and long-acting reversible contraceptive [LARC] use) in women ages 15-24 in 2008-09 (n=3,211 women) and 2014 (n=4,982 women). Results showed increases in the prevalence of modern method use and of LARC use. Low wealth was associated with non-use of LARC methods, and the same wealth pattern emerged for all modern method use between the two timepoints. An education gradient was observed for both outcomes. This study provides some evidence that the urban-rural gap is closing for contraception; however, rural residence continues to be a strong predictor of non-use of LARC methods. Results indicate that continued work is needed to ensure equitable progress in contraceptive use and method choice to contribute to improved reproductive health for young Kenyan women.

The researcher observed a high incidence of pregnancy, sexually transmitted infections and abortions, including illegal abortions among adolescents in the Maluti Sub-District in the Eastern Cape Province. The researcher noted when speaking to the adolescents about contraceptives that they appeared to have a lack of knowledge as well as some misconceptions about contraceptives. The study therefore explores the knowledge, attitudes and practices of adolescents regarding contraceptives. To achieve the purpose of this study, a quantitative, explorative and descriptive survey was used to conduct this study. The research population in this study comprised all Grade 11 and 12 female adolescents enrolled at the selected senior secondary schools in the Maluti Sub-District. Simple random sampling was used to select the research sample. A structured self-administered questionnaire was used as a data collection tool. Descriptive and inferential statistics were used with the help of a statistician to analyse the data. A pilot study was conducted prior to the actual study being conducted, using the same design and research methods. The study findings revealed that participants had a low level of knowledge about contraceptive methods and there were some misconceptions regarding contraceptives prevailing among the participants. More than half (54%) of the participants are currently sexually active and less than a third of the participants indicated that they were using contraceptives The study concludes with recommendations for nursing practice, education and research. Ethical principles have been maintained throughout the study.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2015-07-27T13:13:00Z No. of bitstreams: 1 Tercio Lemos de Morais.pdf: 1272228 bytes, checksum: ed3fb7d1f441b1f6ede36571fcb2cb7a (MD5) / Made available in DSpace on 2015-07-27T13:13:00Z (GMT). No. of bitstreams: 1 Tercio Lemos de Morais.pdf: 1272228 bytes, checksum: ed3fb7d1f441b1f6ede36571fcb2cb7a (MD5) Previous issue date: 2014-02-21 / Evidence suggests the association of combined oral contraceptives (COC) with the development of hypertension, metabolic dysfunction and cardiovascular risk. The mechanisms involved in such association are not fully understood. It was demonstrated in previous studies by our group that there is an autonomic modulation imbalance before the development of hypertension in people with a positive family history of hypertension. This project evaluates the impact of combined oral contraceptives on anthropometric (BMI, abdominal circumference), hemodynamic (blood pressure, heart rate, cardiac outflow and total peripheral resistance), metabolic (serum glucose, total cholesterol and triglycerides) and autonomic (serum cathecolamines, heart rate variability) in normotensive and in hypertensive women (18 to 35 years of age) under combined oral contraceptives. We did not observe any significant change in blood pressure, hemodynamic and autonomic variables in the normotensive group under second and third generation of combined oral contraceptives. The same with hypertensive women under drospirenona (DRSP) and etinilestradiol (EE). Concerning the metabolic variables (against the control group), the normotensive women under combined oral contraceptives showed an increase in both means of total cholesterol (165.95 ± 29.21 vs 189.11 ± 28.96) and triglycerides (72.62 ± 23.44 vs 110.07 ± 40.60). Hypertensive women under DRSP+EE had also a significant increase in triglycerides when comparing basal (72.62 ± 23.44 vs 110.07 ± 40.60) with the later 6 month period( 72.62 ± 23.44 vs 110.07 ± 40.60). Moreover, in this same group of hypertensive women under Drospirenone-containing oral contraceptive, no change was found in potassium levels, the aldosterone-renin-angiotensin system or pharmacological interactions with anti-hypertensive drugs. Our conclusion is that second and third generation combined hormonal oral contraceptives causes no significant change in blood pressure or hemodynamic and autonomic variables. Also, DRSP+EE demonstrates a safe profile when used by young hypertensive women under anti-hypertensive drugs. No detectable variations in blood pressure and neuro-humoral activation, no hydro electrolyte imbalance and no metabolic change (except for a slight triglycerides augmentation) was encountered. / Existem evidências da associação entre uso de contraceptivo hormonal oral combinado (CHOC) com o desenvolvimento de hipertensão arterial, distúrbios metabólicos e risco cardiovascular. Os mecanismos envolvidos ainda não estão totalmente elucidados. Estudos prévios do nosso grupo demonstraram que há um desequilíbrio na modulação autonômica, mensurada pela análise da variabilidade da frequência cardíaca, antecedendo o desenvolvimento de HAS em filhos de hipertensos. No presente projeto, avaliamos o impacto do uso de CHOC em parâmetros antropométricos (índice de massa corpórea, circunferncia abdominal), hemodinâmicos (pressão arterial, frequencia cardíaca, débito cardíaco e resistência vascular periférica), metabólicos (glicemia, colesterol total e triglicérides), e autonômicos (dosagem sérica de noradrenalina e variabilidade da frequência cardíaca) em mulheres normotensas e hipertensas usuárias e não usuárias de CHOC, na faixa etária de 18 a 35 anos de idade. Como resultados, não observamos mudanças significativas na pressão arterial, variáveis hemodinâmicas e autonômicas na coorte de mulheres normotensas usuárias e não usuárias de CHOC de segunda e terceira geração, bem como no estudo prospectivo de mulheres hipertensas usuárias de drospirenona (DRSP) mais etinilestradiol (EE). Com relação às variáveis metabólicas, comparado ao grupo controle, a coorte de mulheres normotensas usuárias de CHOC apresentou valores médios de colesterol total (165,95 ± 29,21 vs 189,11 ± 28,96) e triglicérides (72,62 ± 23,44 vs 110,07 ± 40,60) superiores aos observados no grupo das não usuárias. As mulheres hipertensas usuárias de DRSP+EE, também apresentaram valores médios de triglicérides superiores estatisticamente significantes comparado ao momento inicial (124,3 ± 57,7 vs 174,7 ± 70,6), respectivamente basal e após 6 meses. Ainda no grupo de hipertensas, o uso de CHOC contendo drospirenona não se associou a mudanças na atividade do sistema renina angiotensina aldosterona, não alterou os níveis séricos de potássio, nem apresentou interações medicamentosas com medicamentos anti-hipertensivos usados. Concluímos que o uso de CHOC de segunda e terceira geração não causou alterações significativas na pressão arterial, parâmetros hemodinâmicos e autonômicos, com modesto impacto negativo sobre o perfil lipídico. E a DRSP+EE apresenta um perfil seguro quando usado como contraceptivo num grupo de mulheres hipertensas jovens já em uso de anti-hipertensivos, considerando-se que: não foram detectadas variações nos valores de pressão aretrial e de ativação neuro-humoral, não ocorreram distúrbios hidro eletrolíticos, e nem alterações em parâmetros metabólicos, execeto um leve aumento nos níveis de triglicérides.

Charles University Faculty of Pharmacy in Hradec Králové Department of Pharmacology and Toxicology Student: Veronika Ackermannová Supervisor: prof. Radomír Hrdina, MD, CSc. Title of diploma thesis: Topic and systemic treatment of acne vulgaris Acne vulgaris is a skin disease affecting the hair follicles and sebaceous glands. The disease manifests itself by increased sebum production, non-inflammatory (comedones) and inflammatory lesions (papules, pustules, nodules, cysts). It occurs predominantly in adolescents, but may persist into adulthood. It is a multifactorial disease, which is caused by several factors (internal and external stimuli). The major pathogenetic factors include increased sebum production, hyperkeratosis, P. acnes colonization and inflammation present. First, it is necessary to diagnose the type of acne in order to choose the right and effective therapy, because there is not only one type of acne. There are many types and variants of acne, and although they show similar symptoms (affecting the follicles of sebaceous glands), their cause often differs. There is no uniform classification system for acne vulgaris and it varies between authors. Some authors classify acne vulgaris according to severity into mild, moderate and severe, others into comedonic, papulopustular, nodulocystic...

Kvinnor har länge använt olika metoder för att skydda sig mot graviditet. Omkring 1,1 miljarder kvinnor världen över är i behov av preventivmedelsrådgivning och familjeplanering. Ett av de vanligaste reversibla preventivmedlen är intrauterina preventivmedel. Det är ett säkert preventivmedel och ett allt mer populärt sådant. Samtidigt florerar negativa uppfattningar och erfarenheter kring preventivmedlet vilket gör att kvinnor inte vill använda det. Trots att det finns kunskap om ämnet finns det begränsat med kunskap om vilka faktorer som påverkar kvinnans val av preventivmetod. Genom att identifiera olika faktorer kan detta bidra till en förbättrad sexuell och reproduktiv hälsa för kvinnor. Syftet är att beskriva och sammanfatta faktorer som påverkar kvinnors beslut om att använda och inte använda intrauterina preventivmedel. Systematisk litteraturöversikt valdes som metod, där tretton artiklar med kvalitativ och kvantitativ design granskades. Två huvudteman med tillhörande subteman identifierades; Faktorer som relaterar till beslut om att använda intrauterina preventivmedel och Faktorer som relaterar till beslut om att inte använda intrauterina preventivmedel. Faktorerna kategoriserades vidare in i subteman och benämns som ett säkert preventivmedel, en trygg relation till vårdpersonal, rädsla för preventivmetodens egenskaper, negativ påverkan från samhället och kunskapsbrist hos patient och professionell vårdare. Resultaten visar att flera olika faktorer spelar in i kvinnans val gällande att använda eller inte använda intrauterina preventivmedel som preventivmetod. Ojämlikhet rörande ansvarstagande inom preventivmedel kan ses. Delaktighet och informerat val behövs för att skapa en god vårdrelation. / Women have used various methods to protect themselves against pregnancy. Around 1.1 billion women worldwide are in need of contraceptive counseling and family planning. One of the most common reversible contraceptives is intrauterine contraception. This contraceptive is a safe method and an increasingly popular one. At the same time, negative perceptions and experiences about the contraceptive abound, which means that some women do not want to use it. Although there is in-depth knowledge of the subject, there is limited knowledge about the factors that influence a woman's choice of contraceptive method. By identifying various factors, it can contribute to improved sexual and reproductive health for women. The aim of this study is to describe and summarize factors that influence women's decisions to use and non-use intrauterine contraceptives. A systematic literature review was selected where thirteen articles with qualitative and quantitative design have been reviewed. Two main themes and associated sub-themes were identified; Factors related to decisions to use intrauterine contraceptives and Factors related to decisions to not use intrauterine contraceptives. The factors were further categorized into sub-themes and are referred to as a safe contraceptive, a trusting relationship with healthcare staff, fear of the qualities of the contraceptive method, negative impact from society and lack of knowledge among patients and professional careers. The results show that several different factors play a role in a woman’s choice to use or non-use intrauterine contraceptives as a method of contraception. Inequality regarding responsibility in contraception can be seen. Participation and informed choice are needed to create a good care relationship.

Emotion, as well as cognition, are often understood as a manifestation of brain activity. However, bodily processes are also involved in mental functioning, referring to the concept of embodiment. Embodied emotion, traditionally, implies that experiencing an emotion involves perceptual, somato-visceral, and motor aspects. Within the frame of the Research Training Group “Situated Cognition”, we here extend the concept of embodiment by considering the role of hormones in the processing of emotional content. Importantly, hormones allow a bidirectional body-to-brain and brain-to-body coupling. The endocrine system, e.g., steroid sex hormones, produced in the gonads, send feedback to the brain by binding at their receptors. These receptors are relatively abundant in the brain regions associated with emotional processing, memory, and executive functions (i.e., amygdala, hippocampus, and prefrontal cortex). Moreover, peripheral hormone secretion is modulated via actions from the central nervous system. We intended to characterize the role of sex hormones, and partly also of stress hormones, on different components of emotion as a hormonal embodiment of emotion. Thus, we examined emotional processing in different sex hormone-status groups. To account for different levels of sex hormones, we used a quasi-experimental approach by comparing women in different cycle phases, women using hormonal oral contraceptives (Study 1), and additionally men (in Study 2). The female menstrual cycle is characterized by fluctuating sex hormone levels. On the peripheral gonadal level, these are 17β-estradiol and progesterone. These hormones are low at the beginning of the cycle (early follicular phase). Estradiol rises towards the middle of the cycle (mid-cycle) and stays moderately high until the next cycle. Progesterone levels are high after mid-cycle in the luteal phase until the end of the cycle. Hormonal contraceptives suppress the endogenous production of estradiol and progesterone, keeping the hormone levels low during the whole cycle. Estradiol and progesterone are also present in males, however, at low levels with no sign of cyclical fluctuations. In Study 1, we examined three independent groups of women in the mid-cycle (n = 24), in the luteal phase (n = 24), and women using hormonal oral contraceptives (n = 24). We assessed different measures of emotional processing, i. e. emotional memory, cognitive and affective empathy-related measures (emotion recognition and ratings for feeling with a protagonist´s emotion, respectively), as well as mimic and skin-conductance responses to affective stimuli. Additionally, we addressed interactions of experimental stress (cold pressor test vs. control) with sex hormones in emotional memory. Our data demonstrated the role of hormones in empathy-related measures and skin-conductance responses depending on the stimulus characteristics (valence, the gender of the protagonist). Emotional memory was not affected by hormone status, stressor or salivary hormone levels. In the cognitive empathy-related measure, women in the luteal phase, as well as oral contraceptive users, identified emotions depicted by female protagonists more accurately than those by male protagonists. On the other hand, estradiol correlated positively with recognition of emotions depicted by males in the total sample. In the affective empathy-related measure, oral contraceptive users rated negative emotions higher than the positive ones. Finally, in the luteal phase skin-conductance responses to negative stimuli were heightened, also supported by a positive correlation with the salivary progesterone levels. The mimic responses remained unaffected. None of the remaining associations with the salivary hormone levels were significant. These results indicate that sex hormones modulated emotional processing by interacting with the stimulus features, as evident in the negativity bias under oral contraceptive use and in the luteal phase in the affective empathy-related measure and sympathetic autonomous reactivity, respectively. However, emotional memory and mimic activity to affective stimuli were not affected. In Study 2, we extended the initial scope to examine the role of sex hormones and olfaction in empathy-related measures. Reports of female advantage in empathy-related measures suggest a role for sex hormones, although data are inconsistent. Studies also report similar sex differences in human olfactory perception. In rodents, olfaction is involved in detecting and integrating socially-relevant information and is modulated by the brain-actions of estrogens. Based on this background, we hypothesized that olfaction may untangle the mixed evidence regarding the relationship between sex hormones and empathy-related measures (cognitive, affective). Thus, we measured odor discrimination ability, empathy-related measures, and facial mimic activity (also associated with affective empathy-related measures) in free-cycling women in high sex-hormone phases (n = 20), oral contraceptive users (n = 19), and men (n = 21). Free-cycling women outperformed only men in the recognition of emotions depicted from the eye region. Oral contraceptive users showed higher scores in the affective empathy-related measure towards negative emotions. Free-cycling women exhibited the strongest facial mimicry (viewing female, but not male protagonists), positively associated with progesterone. Finally, the groups differed in odor discrimination, with free-cycling women outperforming men. However, odor discrimination ability and empathy-related performance were not correlated. Our results support the role of sex hormones in odor perception and empathy-related measures, to a certain extent. However, no common underlying mechanism was found. Finally, we conducted a systematic review (Study 3) aiming to elucidate factors contributing to the inconsistent results concerning the role of sex hormones in the two most addressed areas of emotional processing, emotion recognition (empathy-related measure) and emotional memory. Thereby, we extended previous reviews that address single areas of emotion processing. Moreover, we systematically addressed the role of situational features (mainly emotion-type and/or stimulus valence). All studies included healthy women of reproductive age either in stages of their natural menstrual cycle or using oral contraceptives, and measured or at least estimated levels of ovarian sex hormones. We document the methodological diversity in the field, presumably contributing to the heterogeneity of results. We recognized the need for studies explicitly contrasting the early follicular, mid-cycle, and mid-luteal phases, as well as OC-intake and using standardized tasks. Research would take advantage of using within-subject design more frequently and account for the recognition of complex emotions. In sum, our data suggest that sex hormones differentially modulate the cognitive and affective empathy-related performance and skin-conductance responses by interacting with situational variables, such as the emotional valence of the stimuli and the gender of the protagonist. Women in the luteal phase and under oral contraceptive use demonstrated better recognition of emotions depicted by female protagonists. By contrast, estradiol levels positively correlated with the recognition of emotions depicted by male protagonists. Sex-hormone status main effects only manifested in the emotion recognition advantage of free-cycling women over men (Reading the Mind in The Eyes Test; Study 2). In both studies, affective empathy ratings towards negative emotions were higher in the oral contraceptive users. Moreover, although mimic activity was not associated with sex hormones, skin-conductance responses to negative stimuli were heightened in the luteal phase. On the other hand, the performance in empathy-related measures in different hormone-status groups was not related to odor discrimination ability. Additionally, the inconsistencies of the sex hormone and emotion research could be the result of variations of designs and tasks used across studies from a similar field. This is also indicated in our findings from the empathy-related measures differing in tasks and hormone-status groups in two studies. Finally, our findings provide evidence that emotional processes under sex-hormone modulation are situated, i.e., subject to the influence of the stimulus valence. Furthermore, they are embodied via coupling between the endocrine system and the brain as evident in hormone status and valence interactions in empathy-related measures and sympathetic reactivity.

Thesis( MPH.) -- University of Limpopo, 2021 / Title: The Perceptions of Postgraduate Students About Female Condoms at The University of Limpopo Background: The female condom is one of the safest and effective female-initiated methods of contraceptives that has been promoted as an integral part of inventions that provide protection against the widespread of Human Immunodeficiency Virus and other Sexual Transmitted Infections among the youth, including at institutions of higher learning. A number of university students in South Africa are at risk of contracting HIV because of their risky sexual behaviours. How one perceives the female condom can have greater potential to influence its use. There is a gap in literature about this condom. Therefore, this study seeks to understand and document perceptions of postgraduate students about the female condom at the University of Limpopo. Objectives: To explore demographic characteristics of postgraduate students at the University of Limpopo regarding female condoms. To describe perceptions of postgraduate students at the University of Limpopo about female condoms. Methods: The study used the qualitative research approach. Participants of the study were full-time male and female postgraduate students at the University of Limpopo. Data was collected through semi-structured interviews, participants were interviewed one by one using an interview guide. The sample size of the study was 10 participants which was determined by saturation of data. An audiotape was also used to record interviews with participants, and field notes were also taken during the interview. Data was analysed through Thematic Content Analysis. Results: Literature suggests that students are aware of the female condom and its potential to reduce the risk of contracting HIV and STI but are still reluctant to use it in preference of the MC which is well marketed and promoted. The observed discarding and misuse of female condoms among students is associated with lack of knowledge and their perceptions of it. Although this study does not generalise the overall students’ perceptions regarding the female condom, but as a qualitative research, the study provides a useful qualitative enquiry of postgraduate students at the University of Limpopo about the female condom. Conclusion: Many studies have concluded that a female condom is a female-initiated method that is developed to empower and educate women to take control of their sexual health issues as well as to develop other programmes that prioritise women against HIV/AIDS and other STI. There is a need for effective interventions and campaigns to improve student knowledge in order to minimise wasteful expenditure in the process of the procurement and distribution of female condoms. There is also a need to increase the availability and accessibility of these condoms at institutions of higher learning.

Objetivo: Determinar la asociación entre los factores sociodemográficos y reproductivos, y la fecundidad adicional no deseada (FAND) en el Perú según la Encuesta Demográfica y de Salud Familiar (ENDES) del 2018. Materiales y métodos: Se realizó un estudio observacional, analítico transversal, a partir de la ENDES del Perú del año 2018. La FAND es una variable que se creó a partir de la diferencia numérica entre la fecundidad obtenida y la fecundidad deseada. Se categorizó la variable FAND en dos categorías: la diferencia numérica positiva correspondió a presencia de FAND; y la diferencia numérica negativa o nula correspondió a ausencia de FAND. Se realizó una regresión de Poisson, tanto cruda como ajustada. Resultados: Se analizaron los datos de 6944 mujeres entre 40 y 49 años, con una edad promedio de 44,3. Se halló una prevalencia de FAND de 72,5% (IC95%: 70,4%-74,4%). En el modelo ajustado, se observó que pertenecer al quintil superior de riqueza (RPa: 0,80; IC95%: 0,69-0,93) disminuía la probabilidad de FAND con respecto al quintil intermedio. Por otro lado, provenir del ámbito rural (RPa: 1,07; IC95%: 1,01-1,14), aumenta la probabilidad de FAND con respecto al provenir del ámbito urbano. Conclusiones: La prevalencia de FAND en mujeres peruanas de 40 a 49 años que participaron de la ENDES 2018 es alta. Provenir del área rural aumenta la probabilidad de FAND; y el pertenecer al quintil superior de riqueza, la disminuye. / Objectives: To establish sociodemographic and reproductive factors associated with unwanted additional fertility (UAF) in Peru, as measured in the 2018 Demographic and Health Survey (DHS). Methods: An observational, analytical cross-sectional study was carried out based on Peru’s 2018 DHS. UAF is a variable that was created by subtracting the desired fertility from the obtained fertility. Then, it was categorized as present (positive) or absent (negative or null). Multivariable analysis was done through a Poisson regression, both crude and adjusted. Results: This study included 6944 women between 40 and 49 years old, with a mean age of 44,3. We found a prevalence of UAF of 72,5% (CI95%: 70,4%-74,4%), mainly in the coastal region and in urban areas. In the adjusted model it was found that, belonging to the top welfare quintile (aPR: 0,85; CI95%: 0,76-0,95) was associated with less probability of UAF when compared with the intermediate quintile. On the other hand, coming from rural areas (aPR: 1,07; CI95%: 1,01-1,14), was associated with increased UAF risk. Conclusions: The prevalence of UAF in Peruvian women from 40 to 49 years old who responded to DHS 2018 is high. Coming from rural areas is associated with a higher chance of UAF, whereas belonging to the top welfare quintile is associated with lower UAF probability. / Trabajo de investigación

Fluctuating ovarian hormones have been shown to affect decision-making processes in women. While emerging evidence suggests effects of endogenous ovarian hormones such as estradiol and progesterone on value-based decision-making in women, the impact of exogenous synthetic hormones, as in most oral contraceptives, is not clear. In a between-subjects design, we assessed measures of value-based decision-making in three groups of women aged 18 to 29 years, during (1) active oral contraceptive intake (N = 22), (2) the early follicular phase of the natural menstrual cycle (N = 20), and (3) the periovulatory phase of the natural menstrual cycle (N = 20). Estradiol, progesterone, testosterone, and sex-hormone binding globulin levels were assessed in all groups via blood samples. We used a test battery which measured different facets of value-based decision-making: delay discounting, risk-aversion, risk-seeking, and loss aversion. While hormonal levels did show the expected patterns for the three groups, there were no differences in value-based decision-making parameters. Consequently, Bayes factors showed conclusive evidence in support of the null hypothesis. We conclude that women on oral contraceptives show no differences in value-based decision-making compared to the early follicular and periovulatory natural menstrual cycle phases.