Orientador: Laurival Antonio De Luca / Resumo: O objetivo do presente estudo foi o de trazer contribuição científica através de um Modelo de Assistência Contínuo, Paliativo e Domiciliar a pacientes com câncer mamário e ginecológico fora de possibilidade de cura e em progressão, observando e respeitando as características sócio-culturais desta população atendida, criando uma metodologia de abordagem para o atendimento das mesmas, dentro de um hospital geral de atendimento à saúde da mulher. Foram avaliadas 300 pacientes, portadoras de câncer mamário ou ginecológico fora de possibilidade de cura, em primeira fase, no período compreendido de janeiro de 1993 a julho de 1996, antes da implantação do modelo completo (Fase I), comparando-as em estudo descritivo, prospectivo e aplicação de teste de significância dos parâmetros para avaliação de qualidade de vida, com 300 pacientes, em segunda fase, compreendida no período de julho de 1996 a agosto de 1998 (Fase II). Os resultados no que se refere ao controle da dor e do diagnóstico dos sinais e sintomas clínicos de infecção das vias urinárias, caquexia, fadiga e anemia demonstraram ser estatisticamente significantes (p< 0,0001, p= 0,0022, p< 0,0001, p= 0,0078), respectivamente... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The object of this study was to present a Continuous, Palliative, Home Treatment Assistance Model for patients with incurable and progressive breast and gynaecological cancer, observing and respecting their socio-cultural needs, creating a support methodology to treat these patients within a general women's hospital. We evaluated quality of life parameters of 600 incurable breast and gynaecological cancer patients in a prospective descriptive study; 300 in the first phase (Phase I) from January 1993 to July 1996 before implementing the complete model , and 300 in the second phase from July 1996 to August 1998 (Phase II). The results of pain relief and diagnosis of signs and clinical symptoms of urinary tract infections, cachexia, fatigue, and anaemia were statistically significant (p< 0.0001, p= 0.0022, p< 0.0001, p= 0.0078), respectively. As for the Karnofsky performance scale (KPS) we could see that there was significant difference, of double the frequency, of improvement of functional states KPS 80, 70, and 50, and four times the number of patients in functional state KPS 60, when the patients were under Phase II. For home-administered oxygen therapy for breast cancer and lung metastases patients there was significant difference by the Chi squared test between the 2L/min and the continuous use condition. There was significant statistical difference between patient place of death Phase I and Phase II Support Model implantation; this was also true for manner of... (Complete abstract, click electronic address below) / Doutor

Bakgrund: Kvinnlig könsstympning är en sedvänja som utförs av traditionella, kulturella eller religiösa skäl. Ökad invandring till västvärlden har inneburit att vårdpersonal kommer att möta kvinnor som könsstympats och brist på kunskap och praktiska färdigheter hos vårdpersonal kan få konsekvenser för vårdandet. Syfte: Att belysa könsstympade kvinnors erfarenheter av kulturella påverkansfaktorer i omvårdnaden. Metod: Litteraturstudie med en deduktiv riktad innehållsanalys. Det utfördes en litteratursökning i vårdvetenskapliga databaser. Resultat: Resultatet från elva vetenskapliga artiklar placerades in i de förutbestämda kategorierna vilka var; Erfarenheter av religiösa och kulturella värderingar, Erfarenheter av kommunikation och språk, Erfarenheter av teknologi, Erfarenheter av utbildning, Erfarenheter av släktskap och sociala band och Erfarenheter av lagar och politik. Slutsats: Mötet mellan könsstympade kvinnor och den västerländska sjukvården präglas ofta av kommunikationssvårigheter och kulturella skillnader. Sjuksköterskors bristande kunskap om att vårda könsstympade kvinnor kan medföra att kvinnorna känner sig osäkra och oprofessionellt bemötta vilket kan orsaka onödigt lidande. Framtida forskning bör fokusera på hur dessa kvinnor vill bli vårdade vilket kan vara till nytta för alla verksamma sjuksköterskor. / Background: Female genital mutilation (FGM) is a custom that is performed for traditional, cultural or religious reasons. The increase of immigration to the western world has caused that nursing staff will meet and care for females that have undergone FGM. Lack of knowledge and practical skills amongst the hospital personnel treating the patients may lead to implications for the caring procedures. Purpose: To highlight genitally mutilated women’s experiences of cultural factors in nursing care. Method: A literature study with a directed content analysis. A literature research was performed in health scientific databases. Results: The findings from eleven scientific articles were placed in the predetermined categories which were: experiences of religious and cultural beliefs, experiences of language and communication, experiences of technology, experiences of education, experiences of kinship and social ties and experience of politics. Conclusion: The meeting between genitally mutilated women and western healthcare is often characterized by communication problems and cultural differences. Nurses’ lack of knowledge in caring for women with FGM causes the women to feel insecure, badly threated and may cause unnecessary suffering. Future research should focus on how these women wants to be cared for which can be of benefit to all active nurses.

O tumor venéreo transmissível (TVT) é uma das neoplasias de maior incidência na espécie canina acometendo principalmente o trato genital masculino e feminino. Embora o tratamento de escolha seja a quimioterapia, a resistência às drogas tem sido um fenômeno freqüentemente observado na prática clínica. A determinação dos receptores esteróides (estrógeno e progesterona) por imunoistoquímica em tecidos normais e tumorais de humanos e várias espécies animais, tem mostrado grande importância tanto na avaliação prognóstica da doença tumoral, como também na possibilidade de tratamentos hormonais como adjuvantes à quimioterapia. Os objetivos desta pesquisa foram avaliar a expressão e comparar a concentração dos receptores de estrógeno &#945; (RE-&#945;) e progesterona (RP4) no tecido vaginal íntegro de fêmeas hígidas e no tecido vaginal e tumoral de fêmeas portadoras de TVT, nas fases do ciclo estral. Foram utilizadas 58 cadelas divididas em grupo experimental (portadoras de TVT) e grupo controle (fêmeas hígidas), agrupadas segundo a fase do ciclo estral determinada por citologia vaginal, dosagem hormonal e aspecto macroscópico dos ovários. Sob anestesia geral, foram colhidos fragmentos da vagina e do tecido tumoral e estes fixados, blocados em parafina e posteriormente submetidos a imunoistoquímica. Nas cadelas do grupo controle houve maior expressão dos RE-&#945; no anestro, proestro e estro (p<0,05) em relação ao diestro. Nas fêmeas do grupo experimental houve maior expressão dos RE-&#945; no diestro (p<0,05) em relação ao estro, porém não mostrou diferença significante quando comparada com o anestro. Não houve diferença estatística para os RP4, nas fases do ciclo estral para os animais do grupo controle e no epitélio vaginal das fêmeas do grupo experimental não houve positividade em nenhum dos fragmentos avaliados. Não se observou positividade para RE-&#945; e RP4 no TVT, porém o endotélio de vasos sanguíneos do tumor apresentou expressão de RE-&#945; em algumas amostras. Concluiu-se que a expressão dos RE-&#945; nos tecido vaginal das cadelas hígidas e de cadelas portadoras de TVT, tem expressão diferente em função do hormônio esteróide circulante, porém não se expressa no tecido tumoral / One of the most frequent canine neoplasias is the Transmissible Venereal Tumour (TVT) which affects male and female genital tract. In clinical routine the standard treatment is chemotherapy, to which nevertheless drug resistance is a common feature. Immunohistochemical determination of steroid hormone receptors (estrogen and progesterone) in normal and tumoral tissues of humans and several other species is of great relevance for prognostic evaluation of oncological patients, as well as for the decision of whether to make use of hormonal therapy in association to chemotherapy. The aim of this research was to determine immunohistochemically estrogen (ER-&#945;) and progesterone (PR4) receptors expression in vaginal tissue of non-affected bitches and in vaginal and tumoral tissues of TVT affected bitches. Fifty-eight bitches were equally divided in 2 groups: experimental group (TVT) and control group (non-affected). Canine estrous cycle phases were determined by means of vaginal cytology, hormonal assay and macroscopic appearance of ovaries. Samples from vaginal and tumoral tissues were obtained with bitches submitted to general anesthesia. Samples were fixed in 10% buffered formaldehyde and then mounted in paraffin-embedded sections. Anestrous, proestrous and estrous control females presented higher ER-&#945; expression than diestrous bitches. Within the experimental group, there was statistical difference between estrous and diestrous phases, being ER-&#945; expression higher for diestrous bitches. However, no significant difference in relation to anestrous females was established. In relation to RP4 expression, no difference among estrous cycle phases of the control group was verified. Furthermore, no RP4 expression was noted in vaginal tissue of TVT affected females. In tumoral tissues ER-&#945; and RP4 were not expressed, although some samples presented ER-&#945; expression in blood vessels’ endothelium. In conclusion, different ER-&#945; expression was verified in vaginal tissue of experimental and control bitches under distinct steroid influence, whereas no ER-&#945; expression in tumoral tissues was evidenced

O Lobo-marinho-sul-americano (A. australis) apresenta particularidades em seu ciclo reprodutivo que revelam sua interação com o ecossistema onde habita. Dentre estas podemos citar o intervalo entre partos de 12 meses, a sincronização dos partos e cópulas no início do verão, umlongo período de diapausa e uma implantação do blastocisto no inicio do inverno, que ocorre 4 a 5 meses após a cópula. A anatomia e fisiologia reprodutivas desta espécie ainda não foram profundamente estudadas. O presente trabalho tem como objetivo, a partir do emprego de métodos não invasivos de pesquisa, descrever a anatomia, histologia, quando possível a ultraestrutura, e a vascularização arterial dos órgãos genitais femininos, bem como investigar proteínas e RNAs mensageiros de fatores de crescimento relacionados à vascularização nestes tecidos. Os dados morfológicos foram correlacionados com dados ambientais, oriundos de estações climatológicas próximas à área da colônia estudada. O A. australis apresenta especializações morfológicas passíveis de correlação com o ambiente, hábitos reprodutivos e ciclo reprodutivo sazonal. Estas estruturas foram identificadas como importantes em momentos específicos da biologia reprodutiva e auxiliam na manutenção do status de conservação da espécie. Análises dos dados climatológicos e sua relação com as variações durante o ano revelam que os eventos do parto, cópula e implantação embrionária, ocorrem em momentos onde as maiores variações ambientais acontecem. Os dados morfológicos revelam que existe uma interação entre o ciclo reprodutivo e as especializações anatômicas dos órgãos genitais femininos / The South-American-fur-seal (A.australis) presents unique features in its reproductive cycle, which reflect their interaction with the ecosystem where it lives. The parturition interval of 12 months, synchronization of parturition and copulation in the beginning of the summer, long diapause and implantation of the blastocyst in the beginning of the winter, which occurs 4 to 5 months after copulation are some of these features. The anatomy and reproductive physiology of this species have not been widely studied. This work describes the anatomy, histology, some ultrastructural characteristics, and the main arterial vascularization of the female genital organs using non invasive methods. Moreover, this study investigates the proteins and messenger RNAs of growth factors which are related to vascularization in these tissues. An association between morphological and environmental data from climatology stations near the area of the studied colony was investigated. A. australis presented morphological specialization in genital organs, which might be related to the environment, reproductive habits and seasonal reproductive cycle. Some of these identified structures are essential in specific stages of A. australis reproductive biology, and play an important role in the maintenance and conservation status of this species. Analysis of climatological data and their relation with changes over the year showed that parturition, copulation and embrionary implantation occur in time periods where the highest environmental variations take place. Morphological data revealed an interaction between the reproductive cycle and the anatomic specialization of female genital organs

Publicación a texto completo no autorizada por el autor / Estudia a un marcador del potencial de fertilidad, la dicarbonilo, L-xilulosa reductasa (DCXR) cuya utilidad ha sido descrita para explicar hasta el 14% de casos de infertilidad, según lo descrito en estudios clínicos para humanos. Se evalúa la expresión del gen DCXR, mediante RT-qPCR, en epidídimos de machos de alpaca en edad fértil (n = 39) y, se determinó la correlación con parámetros de fisiología espermática evaluados en el laboratorio. Al igual que en humanos, DCXR muestra asociación estadística únicamente con la capacidad de los espermatozoides de alpaca de unirse a la zona pelúcida homóloga (prueba de Spearman, p< 0,05). No se encuentra asociación significativa (prueba de Spearman, p>0,05) con otros parámetros de fisiología espermática. El gen DCXR puede, entonces, ser utilizado en alpacas macho como un marcador del potencial de fertilidad, que junto a otros marcadores moleculares, formaría parte del panel de biomarcadores predictivos para determinar el potencial de fertilidad en alpacas. / Tesis

Bakgrund: Kvinnlig könsstympning innebär att av icke-medicinska skäl utföra en partiell eller total borttagning av de yttre kvinnliga könsorganen. Det finns fyra olika typer av könsstympning med olika allvarlighetsgrader. Sannolika orsaker är att kontrollera kvinnans sexliv samt kulturella strukturer. Varje år genomgår 3,9 miljoner kvinnor en könsstympning i Afrika, Mellanöstern samt Asien. Ingreppet görs oftast på flickor mellan fyra och 14 år.  Syfte: Syftet med denna litteraturöversikt var att belysa sjuksköterskans kunskap, attityd samt erfarenhet gällande kvinnlig könsstympning.  Metod: En litteraturöversikt enligt Fribergs metod som inkluderade tio vårdvetenskapliga artiklar med olika metoder, fem kvalitativa och fem kvantitativa artiklar. Databaserna som användes för att hitta artiklarna var Cinahl Complete och PubMed. Analysen gjordes med hjälp av en tematisk syntes för att identifiera olika teman.  Resultat: Resultatet presenterades i tre separata teman samt tre subteman. Kunskapsnivån gällande ingreppet varierade, olika attityder gentemot kvinnlig könsstympning identifierades och majoriteten av hälso- och sjukvårdspersonalen uttryckte svårigheter i mötet med och vårdandet av kvinnor som genomgått en könsstympning.  Diskussion: Generellt besitter sjuksköterskan låg kunskap kring kvinnlig könsstympning, där attityden till ingreppet varierar världen över. Detta kan bland annat bero på bristande utbildning, låg medvetenhet, ett icke-jämställt samhälle, kulturell påverkan och ekonomisk vinning. Madeleine Leiningers soluppgångsmodell ligger till grund för diskussionen. / Background: Female genital mutilation (FGM) involves performing, for non-medical reasons, a partial or total removal of the external female genitalia. There are four different types of female genital mutilation with varying degrees of severity. Plausible reasons are to control the woman's sex life as well as cultural structures. Every year, 3.9 million women undergo FGM in Africa, the Middle East and Asia. The practice is most often done on girls between the ages of four and 14. Aim: The aim of this literature review was to enlighten the knowledge, attitudes and experiences of female genital mutilation among nurses.  Method: A literature review according to Fribergs method that included ten articles with different methods, five qualitative and five quantitative articles. The databases used to find the articles were Cinahl Complete and PubMed. The analysis was done using thematic synthesis to identify different themes.  Results: Results were presented in three separate themes together with three subthemes. The level of knowledge regarding FGM varied, different attitudes towards female genital mutilation were identified and the majority of the health personnel expressed difficulties in caring for women with FGM.  Discussion: In general, nurses have low knowledge of FGM, where the attitude towards the practice varies worldwide. This due to, among other things, the lack of education, awareness, a non-equal society, cultural influence and financial gain. Madeleine Leininger's sunrise model forms the basis of the discussion.

Persistent Genital Arousal Disorder (PGAD) is a complex, poorly understood condition characterized by unremitting, unwanted, distressing genital arousal which occurs frequently and for extended periods of time, often in the absence of sexual stimuli. The pathophysiology is unknown. Researchers have hypothesized underlying disorders of neurological, vascular, pharmacological and psychological origins. Possible causalities have been suggested including anxiety disorder, SSRI use, and pudendal nerve neuropathies among others. Despite the uncertainty of etiology, other aspects of the disorder are clearer, including distress and poor quality of life for many. In this study, I used a biopsychosocial model to examine three potential psychological predictors 'depression, stress, and anxiety' as well as moderators including erotophobia and perceived partner support on a sample of 51 women with PGAD. Quantitative survey methodology was used to collect information from women with PGAD who had sought care for their condition from a sexual medicine specialty clinic (San Diego Sexual Medicine) and members of an online PGAD support group. Results of the study indicated depression as the most significant predictor of distress of the three psychological variables under study. Neither erotophobia nor perceived social support moderated any of the psychological factors studied. Scores on the Female Sexual Distress Scale-Revised demonstrated clinically important levels of distress. The findings highlight the need for a biopsychosocial treatment approach to the condition, including psychological therapy. Implications for social change include the preservation of quality of life and reduced depression rates in women with PGAD.

Sexual conflict over mating duration drives the evolution of male and female adaptations that facilitate the manipulation of mating interactions in their favor. This conflict drives the evolution of traits that improve the fitness of the focal sex despite inflicting costs on mates. However, males can express multiple traits that increase and decrease female fitness simultaneously. When the effects of male traits on female fitness increase or decrease with duration of exposure, females traits that influence mating duration are selected upon. Females of Callosobruchus maculatus, a bruchid bean beetle, kick mates to forcefully end copulation. Although both negative effects of male genital spines and positive of effects ejaculatory materials on female fitness have been documented, it is not yet clear how these male traits interact to influence the timing of female kicking. In this study, we observed the effect of male genital spine size, ejaculate size and mating history, and manipulated mating duration to disentangle the effects of male traits on the timing of female kicking behavior. We found that male mating history and mate body size dimorphism predicted the timing and duration of female kicking, but that male ejaculate size and spine length did not predict female kicking timing.

Female genital mutilation (FGM) is a public health challenge because it jeopardizes the health of women and girls. FGM is condemned worldwide but, it is still practiced in the Odi community of Nigeria. The literature on women's lived experiences of FGM in other parts of the world was reviewed, but knowledge is lacking on the lived experiences of women from Odi community in Nigeria. The purpose of this phenomenological study was to explore their lived experiences, their perspectives on the current legislation for the prevention of FGM, and their perspectives on the cultural myths surrounding the practice. The phenomenological lens was used both as the study design and as the theoretical framework which states that humans know the world through their experiences. This theory guided the study on how the women of Odi community attached meaning to their experiences with FGM. Nine women, 18 and older, who had experienced FGM, were recruited through a snowball technique. Data were collected through semi-structured, in-depth, face-to-face interviews. Colaizzi's method was used for data analysis. Five major themes emerged: (a) FGM is a traditional rite, (b) challenges of FGM, (c) FGM cultural myth instills fear, (d) ignorance of legislation against FGM, and (e) needs government intervention to halt FGM. Participants recommended the enforcement of the legislation against FGM. The findings of this study will be communicated to stakeholders of FGM in the Odi community and in public health journals to serve as a basis for further research. The implication for social change is that maternal and child health will be improved.

Female genital mutilation or cutting (FGM/C), a common practice among Sierra Leonean women, carries significant psychological and physical risks. Prior to this study, a substantial need existed for inquiry of the experiences and belief systems within this cultural group to better understand the effects of FGM/C on women and girls. Guided by feminist theory and the theory of cultural relativism, the goal of this phenomenological study was to review the cultural perspectives and experiences of Sierra Leonean women who underwent FGM/C to investigate their concerns about safety and their perceptions of the practices. In addition, this study explored concerns among Sierra Leonean women about the procedure performed on their daughters and to what they attributed the continued practice of FGM/C. Participants included a purposeful sample of 12 women from Sierra Leone who had experienced FGM/C. Data were collected via in-person, semi-structured interviews and analyzed thematically. Analysis revealed differences in participant definitions of FGM/C, cultural and social aspects of the procedure, personal beliefs and perceptions of the procedures. Results provide new understandings to help health and human rights organizations implement proactive safety measures for these women and girls. Positive social change from this investigation may occur via proper education about FGM/C. Goals include helping women understand the risks associated with the practice and to make their own informed decisions regarding the procedure. Findings revealed that a powerful strategy for protecting women's health and well-being related to FGM/C may be through education on the facts of the procedure.