Magister Curationis - MCur / It is not mandatory for the student to declare a pregnancy to her educational institution. It does however become more complicated for the student nurse, because she has to provide a health service while she is a student during her clinical placement. The researcher has noticed that student nurses do fall pregnant during their undergraduate studies at the University of the Western Cape. The researcher was unsure why this phenomenon is occurring amongst undergraduate nursing students. He identified the need to measure the level of knowledge of pregnancy prevention amongst undergraduate nurses, their level of utilization of such services and their attitudes towards falling pregnant during their studies. This study is of a quantitative nature whereby the researcher made use of a descriptive design. The method of data collection utilized was an anonymous self administered questionnaire form. The population under study was the registered undergraduate nursing students in 2008 at the University of the Western Cape. This population consisted of 1031 individuals. Their ethnic background represents the South African demography. An exhaustive sampling approach was used and 401 individuals gave consent to participate in the study. Through this research the researcher hypothysed and proved that the level of knowledge of contraception amongst undergraduate student nurses is indeed inadequate and that this low level of knowledge on the subject area leads to incorrect and inconsistent and non use of contraception in their own lives. / South Africa

Modern methods of contraception are freely available in Albania, yet contraceptive prevalence among Albanians is relatively low (11%). Abortion on the other hand has long been the mainstay of family planning in the country. Emergency contraception is not very popular in Albania either, even though two different levonorgestrel-only EC pills (NorLevo® and Postinor®) are widely available in Albanian pharmacies. This study aimed to investigate potential factors that influence women’s choices of contraception. In 2016, we conducted a multi-method qualitative study with women and service providers in Albania. Women were invited to report their knowledge of, attitudes toward, and practices surrounding contraception in an online survey. Also, we conducted in-depth semi-structured interviews with key informants to better understand the current reproductive health landscape in the country. Additionally, we conducted structured interviews with pharmacists in Tirana to assess their training and practices with regard to different available contraceptive methods. Misinformation, lack of awareness, fear of judgement and embarrassment, and lack of infrastructure are the strongest influencers of women’s choice of contraception in Albania. Training of health service providers, as well as development of materials for distribution are warranted to improve knowledge and uptake of contraception among women.

As of April 2019, there were over 650,000 Syrian refugees residing in Jordan. A combination of economic, social, and moral imperatives related to the Syrian civil war have led to a threefold increase in early marriage rates. Syrian women and girls, particularly those who marry under the age of 18, are at significant risk of sexual and gender-based violence and unwanted pregnancy. In this context, emergency contraception could play a significant role in supporting Syrian refugees prevent pregnancy. In 2016-2017 we conducted six focus group discussions with Syrian women and girls. We conducted 100 structured interviews with pharmacists in different areas of the country regarding EC provision practices. We also interviewed 13 key informants about available sexual and reproductive health services, including EC, and conducting six focus group discussions with Syrian child brides. We audio-recorded and translated all discussions from Arabic to English and conducted content and thematic analyses using deductive and inductive techniques. Most women and girls became pregnant during the first six months of their marriage, face pressure to become pregnant repeatedly, and experience or had experienced physical and sexual violence. None of the women knew of EC but all expressed curiosity and excitement about this method of pregnancy prevention. Our findings suggest that Syrian women and girls in early marriages have significant unmet contraceptive needs. Child brides, specifically those under the age of 15, reported rarely using any type of contraception, largely due to familial pressures to prove fertility. As a result of this research we undertook a multipronged initiative to respond to the sexual and reproductive health, as well as psychosocial needs, of Syrian child brides.

Introdução: A dinâmica do uso dos métodos contraceptivos é importante entre os universitários, pois estes apresentam altas aspirações educacionais e profissionais, o que afeta a intenção reprodutiva. Ainda, por serem na maioria solteiros, os jovens alternam os métodos de acordo com o tipo de relacionamento. Neste contexto, a anticoncepção de emergência é uma opção, sobretudo nos casos de descontinuidades. Porém, pouco se sabe sobre as descontinuidades e sua relação com o uso da anticoncepção de emergência no Brasil. Objetivo: Analisar a frequência e os determinantes da descontinuidade contraceptiva em um período de 12 meses; avaliar o uso da anticoncepção de emergência após as descontinuidades, e avaliar as descontinuidades após o uso da anticoncepção de emergência. Métodos: Estudo de coorte retrospectivo, realizado com amostra probabilística de mulheres universitárias da Universidade de São Paulo. As alunas foram selecionadas por amostragem aleatória simples sem reposição (n=1.679). Os dados foram coletados através de um questionário de autopreenchimento respondido online. No Stata 14.2, os dados foram analisados por meio de regressão logística multinomial e multivariada, e equações de estimação generalizadas. Resultados: Primeiro, observou-se que as jovens com relacionamentos casuais, com menor nível socioeconômico, matriculadas nos cursos de Humanas e Ciências da Saúde, com menos anos de experiência sexual, com múltiplos parceiros sexuais e que usavam métodos menos eficazes, apresentaram maior probabilidade de descontinuar uma ou várias vezes. Segundo, as usuárias de pílula e preservativo que tinham relacionamentos casuais, com menor nível socioeconômico e que tiveram gravidez anterior, foram mais propensas a descontinuar, abandonar ou mudar para um método menos eficaz. Terceiro, uma proporção significativa de mulheres não usou anticoncepção de emergência após descontinuarem ou abandarem o método. Quarto, a anticoncepção de emergência foi mais utilizada após inconsistências no uso do método. Quinto, as jovens que usaram um método antes do uso da anticoncepção de emergência, sem religião, com um relacionamento estável, e que tiveram um parceiro sexual na vida, foram mais propensas a usar contracepção após a anticoncepção de emergência. Sexto, as jovens com relacionamento estável, de nível socioeconômico mais baixo, matriculadas nos cursos de Humanas e que tiveram um parceiro sexual na vida tiveram maior probabilidade de mudar para um método menos eficaz após o uso da anticoncepção de emergência. Por fim, poucas jovens apresentaram descontinuidades dentro de 30 dias após o uso da anticoncepção de emergência. Conclusões: A descontinuidade contraceptiva difere por tipo de método. A anticoncepção de emergência é subutilizada após as descontinuidades. A parceria influência na dinâmica do uso de contraceptivos. Ainda, aspectos educacionais, nível socioeconômico e número de parceiros sexuais são características importantes a serem consideradas na implementação de programas de planejamento familiar focados em mulheres jovens. / Introduction: Contraceptive use dynamics is relevant to undergraduate students as they present high educational and professional aspirations, which affects reproductive intention. Also, they are mostly single, so they alternate the contraception according to their relationships. In that case, emergency contraception is an option, mainly in situations of discontinuation. However, little is known about discontinuation and its relation to the use of emergency contraception in Brazil. Objective: To analyze the frequency and correlates of contraceptive discontinuation within 12-months; to assess emergency contraception use after discontinuation, and evaluate dicontinuation after emergency contraception use. Methods: We conducted a 12-month retrospective cohort study on a sample of undergraduate women at University of São Paulo, Brazil. Students were selected by simple random sampling without replacement (n=1,679). Data were collected online using a self-administered questionnaire. In Stata 14.2, we used multinomial and multivariate logistic regression, and generalized estimating equation to analyze the data. Results: First, we observed that women with casual relationships, lower socioeconomic status, enrolled in Human and Health Sciences programs, with less years of sexual experience, with multiple sexual partners in lifetime, and who use less effective method were more likely to discontinuation one or several times. Second, pill and condom users who had casual relationships, with lower socioeconomic status, and who had previous pregnancy were more likely to discontinue and to abandon or switch to a less effective method. Third, a significant proportion of women did not use emergency contraception after discontinuing or abandoning contraception. Fourth, emergency contraception was mostly used after inconsistent use of contraception. Fifth, women who used contraception prior to emergency contraception use, had no religion, were in stable relationships, and had only one sexual partner were more likely to use contraception after emergency contraception. Sixth, women with stable relationships, from lower socioeconomic status, enrolled in Human Sciences programs, and who had one sexual partner were more likely to switch to a less effective method after emergency contraception use. Lastly, few women presented gaps in contraception within 30- days after emergency contraception use. Conclusions: Discontinuation does differ by type of method. Emergency contraception is underutilized after discontinuation. Partnership has an important influence on contraceptive use dynamics. Also, educational background, socioeconomic status, and number of lifetime sexual partners are important characteristics that should be considered when implementing family planning programs focused on young women.

<p>The overall aim of this thesis was to investigate the knowledge of, attitudes toward, and experiences of the emergency contraceptive pill (ECP), sexual behaviour, and pornography consumption among high school students and young people. Data were obtained by questionnaires (studies I, II, and III), and by qualitative in-depth interviews (study IV). </p><p>A majority of 16-year old high-school students were aware that ECP existed, and knew where to obtain it. Attitudes toward using ECP were generally positive, but more girls than boys were hesitant as to whether ECP should be available without a prescription. Of those having experienced sexual intercourse, more than one fourth stated that they themselves or their partner had ever used ECP (I). </p><p>Almost half of the 16-year old high-school students surveyed (46%) had had sexual intercourse, a number similar in studies conducted 10 and 20 years earlier. Use of contraceptives at first intercourse had increased (to 76%) and use of alcohol had decreased (to 23%). More students in practical rather than theoretical programs smoked, had sexual intercourse at an earlier age, had more partners, and used contraceptives at first intercourse less often (II).</p><p>Three out of four 18-year old students had had sexual intercourse, of which almost three quarters reported contraceptive use at first intercourse. Anal intercourse was reported by one sixth, with infrequent condom use. Males who consumed more pornography were more likely than males who consumed less pornography to engage in a variety of sexual activities, as were males with an early age at first sexual intercourse (III).</p><p>The core category that emerged in the interviews was “Living with the current sexual norm”, pornography created sexual expectations and demands. The interviewees expressed contradictory feelings towards pornography and felt that sexuality was separated from intimacy. In order to deal with the current sexual norm, participants had different individual handling strategies, including liberal-, normalization-, distance-, feminist- and conservative strategies (IV).</p><p>Overall, the studies highlight several differences between genders and between students attending practical- and theoretical study programs in questions concerning ECP, sexual behaviour and pornography. These differences should be addressed while planning for counselling and sex education. We suggest that health- and school personnel discuss how sexuality is portrayed in pornographic material with young people.</p>

The overall aim of this thesis was to investigate the knowledge of, attitudes toward, and experiences of the emergency contraceptive pill (ECP), sexual behaviour, and pornography consumption among high school students and young people. Data were obtained by questionnaires (studies I, II, and III), and by qualitative in-depth interviews (study IV). A majority of 16-year old high-school students were aware that ECP existed, and knew where to obtain it. Attitudes toward using ECP were generally positive, but more girls than boys were hesitant as to whether ECP should be available without a prescription. Of those having experienced sexual intercourse, more than one fourth stated that they themselves or their partner had ever used ECP (I). Almost half of the 16-year old high-school students surveyed (46%) had had sexual intercourse, a number similar in studies conducted 10 and 20 years earlier. Use of contraceptives at first intercourse had increased (to 76%) and use of alcohol had decreased (to 23%). More students in practical rather than theoretical programs smoked, had sexual intercourse at an earlier age, had more partners, and used contraceptives at first intercourse less often (II). Three out of four 18-year old students had had sexual intercourse, of which almost three quarters reported contraceptive use at first intercourse. Anal intercourse was reported by one sixth, with infrequent condom use. Males who consumed more pornography were more likely than males who consumed less pornography to engage in a variety of sexual activities, as were males with an early age at first sexual intercourse (III). The core category that emerged in the interviews was “Living with the current sexual norm”, pornography created sexual expectations and demands. The interviewees expressed contradictory feelings towards pornography and felt that sexuality was separated from intimacy. In order to deal with the current sexual norm, participants had different individual handling strategies, including liberal-, normalization-, distance-, feminist- and conservative strategies (IV). Overall, the studies highlight several differences between genders and between students attending practical- and theoretical study programs in questions concerning ECP, sexual behaviour and pornography. These differences should be addressed while planning for counselling and sex education. We suggest that health- and school personnel discuss how sexuality is portrayed in pornographic material with young people.

Orientador: Luis Guillermo Bahamondes / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T05:07:00Z (GMT). No. of bitstreams: 1 Hermanny_Alexia_D.pdf: 843759 bytes, checksum: 4b2ff42ff4ef1f995e85e5f8b86bf7f2 (MD5) Previous issue date: 2011 / Resumo: O mecanismo de ação do levonorgestrel (LNG) na anticoncepção de emergência (AE) ainda não está totalmente esclarecido e seu efeito nas funções espermáticas também não está explicado. Os objetivos deste trabalho foram avaliar se o LNG, em dose igual à observada após a ingestão oral para AE, poderia afetar espermatozoides expostos in vitro à tuba uterina humana e realizar uma revisão bibliográfica sobre o efeito do LNG nas diferentes funções espermáticas. Foram realizados 15 experimentos. As tubas uterinas foram removidas através de mini-laparotomias e foram perfundidas com uma suspensão contendo 1x106 espermatozoides móveis, com e sem LNG. A tuba correspondente ao lado onde o folículo dominante estava presente recebeu a suspensão com LNG em pacientes alternados. Após um período de incubação de 4 horas, o istmo e a ampola de cada tuba foram separados. Cada segmento foi lavado separadamente e o material obtido foi avaliado quanto ao número de espermatozoides móveis recuperados, número de espermatozoides aderidos ao epitélio tubário e taxa de reação acrossômica (RA). A presença do LNG não afetou significativamente o número de espermatozoides móveis recuperados do istmo e da ampola, e não afetou o número de espermatozoides aderidos ao epitélio tubário. O LNG também não influenciou a taxa de RA. Diferenças significativas também não foram observadas quando o lado ovulatório foi considerado. A revisão bibliográfica realizada deixou evidente que existem poucos estudos que analisam a influência do LNG como AE sobre as funções espermáticas, apesar de este ser um possível mecanismo de ação. Além disso, os estudos revisados utilizam diferentes métodos de avaliação e os resultados são, muitas vezes, contraditórios. De acordo com os resultados observados na literatura, quando o LNG é usado na AE, provavelmente não atinge concentração plasmática suficiente para ser reconhecido pelos receptores de progesterona (P). Resultados positivos só foram observados quando a dose de LNG utilizada nos experimentos foi comparável ao sistema intrauterino liberador de LNG (SIU-LNG), ou seja, muito maior que a utilizada na AE. O LNG, em dose similar à observada no plasma após a ingestão oral para AE, não afetou o número, a aderência ao epitélio tubário, a distribuição e a taxa de RA de espermatozoides na tuba uterina humana, in vitro. De acordo com os resultados observados na literatura, se o LNG, na concentração utilizada para AE, afeta ou não a função espermática ainda não está claro, e mais estudos são necessários / Abstract: The mechanism of action of levonorgestrel (LNG) as emergency contraception (EC) is still under debate and the effect upon sperm function is partially explained. The aim of this study was to assess if LNG in a similar dose to those observed in serum after oral intake for EC could affect the spermatozoa when exposed in vitro to human tubes and also to give an overview of the effect of LNG as EC on several sperm functions. Fifteen mini-laparotomies were performed, the ovulatory side was recorded and both tubes were removed and perfused with a suspension of 1x106 of motile spermatozoa, one with LNG and the other without it. After an incubation period of 4hours the tubes were cut to separate the isthmus and the ampulla. Each segment was flushed and the material was evaluated regarding the motile sperm number, the number of spermatozoa adhering to the oviductal epithelium and acrosome reaction (AR) rate. The addition of LNG did not significantly affect the number of recovered spermatozoa neither at the isthmus nor at the ampulla or the number of recovered spermatozoa adhered at the human tubal epithelium. Additionally, LNG did not influence the rate of AR. There were no significant differences even when the ovulatory side was taken into account. The present review showed that there are few studies which focus on the influence of LNG as EC upon sperm functions; albeit it is a plausible mechanism of action. Additionally, the different studies used different methods of evaluation and the results were in many cases contradictories. According to the results observed at the literature, when LNG is used as EC, it is probable that the drug does not achieved sufficient serum concentrations in order to be recognized by the progesterone (P) receptors. Positive results only were observed when the dose of LNG used in the experiments was much higher (comparable to the LNG-IUS) than the proposed for EC. LNG in a similar dose to that observed in serum after oral intake for EC did not affect the number, the adhesion to tubal epithelium, distribution, and AR rate of spermatozoa at the human Fallopian tubes in vitro. According to the results observed at the literature, if the LNG in doses used for EC, affects sperm function or not, it is still uncertain and warrants further studies / Doutorado / Fisiopatologia Ginecológica / Doutor em Ciências da Saúde

The purpose of this study was to explore and describe the contributory factors to the high teenage pregnancy rate within a district hospital in the Ehlanzeni district of the Mpumalanga Province, South Africa. Quantitative, non-experimental, descriptive and exploratory research was conducted to explore the contributory factors to the high teenage pregnancy rate. Data collection was done using a self-designed structured interview schedule. The findings of the study supported the assumptions that there are factors related to biography, individual perceptions, knowledge and awareness of; and practices, perceptions regarding the use of contraception. Perceived seriousness and barriers to the use of safeguards that could have prevented pregnancy contribute to the high teenage pregnancy rate thus emphasise the need to develop strategies to prevent teenage pregnancies / Health Studies / M.A. (Health Studies)

The purpose of this study was to explore and describe the contributory factors to the high teenage pregnancy rate within a district hospital in the Ehlanzeni district of the Mpumalanga Province, South Africa. Quantitative, non-experimental, descriptive and exploratory research was conducted to explore the contributory factors to the high teenage pregnancy rate. Data collection was done using a self-designed structured interview schedule. The findings of the study supported the assumptions that there are factors related to biography, individual perceptions, knowledge and awareness of; and practices, perceptions regarding the use of contraception. Perceived seriousness and barriers to the use of safeguards that could have prevented pregnancy contribute to the high teenage pregnancy rate thus emphasise the need to develop strategies to prevent teenage pregnancies / Health Studies / M. A. (Health Studies)

<p>The overall aim of this thesis was to study knowledge, attitudes and experience of emergency contraceptive pills among women and providers.</p><p>Both quantitative and qualitative methods were used. Focus-group interviews were conducted with teenage-girls (I) and with women who had purchased ECP without prescription (IV). Self-administered waiting-room questionnaires were administered to women presenting for induced abortion in three large hospitals (II, III), and after the deregulation of ECP, a postal questionnaire was sent to pharmacy staff and nurse-midwives in three counties in mid-Sweden (V). </p><p>Overall, women showed high basic awareness of ECP although specific knowledge such as the level of effectiveness, time-frames and how the method works was lacking. Approval of the method was high and most women were positive to use the method if they needed. Contradictory views as to whether ECP undermines contraceptive behavior were expressed. As many as 43% of women requesting induced abortion had a history of one or more previous abortions. Among the abortion applicants, one out of five, 22%, had previously used ECP and 3% had used it to prevent the current pregnancy. Media and friends were the two most common sources of information on ECP. Half of the women, 52%, were positive to having ECP prescription-free. Those women who had purchased ECP in a pharmacy without prescription, appreciated this possibility, and the major benefits expressed were time saving aspects. No severe side-effects were reported. The women's experiences of interaction with pharmacy staff were both positive and negative. The importance of up-to-date information about ECP and the OTC-availability from the health care providers was emphasized. Both pharmacy staff and nurse-midwives had positive attitudes towards ECP and the OTC availability. Of pharmacy staff, 38% reported that they referred women to nurse-midwives/gynecologists for further counseling and follow-ups. The need for increased communication and collaboration between pharmacies and local family planning clinics was reported by both study groups with suggestions of regular meetings for information and discussions.</p><p>The results suggest that ECP is still underused and that more factual information is needed before the method is becoming a known, accepted and integrated back-up method to the existing family planning repertoire. Longitudinal research to assess the long-term effects of ECP is needed. </p>