Thesis (Ph. D.)--Illinois State University, 1997. / Title from title page screen, viewed June 29, 2006. Dissertation Committee: Roberta Seelinger Trites (chair), Jan Susina, Bruce W. Hawkins. Includes bibliographical references (leaves 170-177) and abstract. Also available in print.

Orientador: Luis Guillermo Bahamondes / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-15T23:50:03Z (GMT). No. of bitstreams: 1 Doria_RaquelFerreiraFerrazdoLago_D.pdf: 2578074 bytes, checksum: 341c6ac9f1772c408e5a1ea2a499da58 (MD5) Previous issue date: 2010 / Resumo: Avaliar a prevalência de sinais e sintomas no local de inserção no braço e a opinião das mulheres com relação à satisfação com o método e com o novo padrão de sangramento em usuárias de implantes subdérmicos liberadores de levonorgestrel (LNG; Jadelle®) e etonogestrel (ENG; Implanon®). Métodos: Os totais de 233 e 226 mulheres foram aceitas nos grupos de implantes liberadores de ENG e LNG, respectivamente. Os sinais locais foram avaliados pela inspeção e as mulheres foram questionadas sobre queixas relacionadas ao local do implante aos 14 dias e 3, 6, 12, 24 e 36 meses após a inserção no Brasil e na República Dominicana. O mesmo grupo, somente de mulheres brasileiras, sendo 120 no grupo das usuárias de implantes liberadores de ENG e 127 no grupo liberador de LNG, deu sua opinião com relação à satisfação com o método contraceptivo e com o novo padrão menstrual, através de um questionário desenvolvido para o estudo. Os questionários foram aplicados pessoalmente aos 3 e 6 meses, e em seguida a cada 6 meses, até 36 meses após a inserção. Resultados: Dor e outros sintomas (principalmente prurido) foram as queixas mais frequentemente relatadas (~20%) e foram observadas em uma proporção semelhante entre as usuárias de Implanon® e Jadelle®, e parestesia foi relatada com menos frequência Hiperpigmentação foi três vezes maior entre as usuárias de Jadelle® do que em usuárias de Implanon® (p< 0,0001) e foi mais prevalente entre as usuárias nãobrancas. Todos os sintomas e sinais foram relatados muito mais frequentemente por mulheres dominicanas. Embora todos os sinais locais apresentassem uma tendência a diminuir com o tempo de uso, não houve diferenças significativas quando comparadas as ocorrências aos 12, 24 e 36 meses de uso de ambos os tipos de implantes. No entanto, as usuárias do Jadelle® não apresentaram declínio na ocorrência de hiperpigmentação. O modelo de regressão logística ajustada pela cor e índice de massa corporal (IMC; kg/m2) mostrou que as mulheres brancas usuárias de Implanon® apresentaram risco (OR) menor de hiperpigmentação quando comparadas às usuárias de Jadelle® (OR 0,26; IC 95% 0,14-0,48; OR 0,34; IC 95% 0,14-0,81), respectivamente. Não houve correlação entre dor, parestesia e hiperpigmentação e a utilização dos dois tipos de implantes. Hiperpigmentação foi mais prevalente entre usuárias de Jadelle® de pele escura. Em relação à satisfação foram analisados 1200 questionários. A maioria das usuárias dos dois tipos de implantes estava satisfeita com o método, e a insatisfação foi de aproximadamente 15% ao longo dos 3 anos de observação. Além disso, cerca de 70% das mulheres declararam que a utilização dos implantes trouxe benefícios e só aproximadamente 5% referiram que o uso provocou danos. Com relação ao novo padrão menstrual, as usuárias estavam muito satisfeitas ou satisfeitas em aproximadamente 70%, independente do tipo de implante. A vida sexual das usuárias não apresentou alteração em mais de 70% das usuárias, independentemente do tipo de implante. As usuárias indicariam o método para outra mulher e em sua grande maioria o método foi aprovado pelo marido. Conclusões: Informar as usuárias de implantes sobre sinais e sintomas no local de inserção do implante indica uma boa qualidade de atendimento; no entanto não é necessário avaliar o local de inserção a cada visita em usuárias assintomáticas. Os resultados sobre a opinião das usuárias quanto à satisfação com o método foram similares aos de trabalhos anteriores. No entanto, os resultados devem ser interpretados com cautela porque as mulheres que participaram deste estudo não eram usuárias comuns de uma clínica de planejamento familiar, o que levou a maior orientação durante todo o estudo. Não se pode ignorar a possibilidade de que a alta satisfação seja uma consequência da insatisfação com outros métodos contraceptivos / Abstract: Objectives: The study was conducted to assess the prevalence of local signs and symptoms at the insertion site in the arm, and the evaluation of the women's satisfaction with the method and with the new bleeding patterns among users of subdermal releasing-implants, levonorgestrel (LNG, Jadelle®) and etonogestrel (ENG, Implanon®) systems. Methods: A total of 226 and 233 women were enrolled in the ENG and the LNG group, respectively. Local signs were evaluated and women were questioned regarding complaints related to the insertion site at 14 days and 3, 6, 12, 24, and 36 months after insertion in Brazil and Dominican Republic. The same Brazilian women were randomly enrolled in the satisfaction study of ENG group (120) and the LNG group (127), respectively. The opinion of satisfaction with the bleeding pattern and with the method was evaluated through a questionnaire developed for the study. The questionnaires were applied face- toface at the 3, 6, and every 6 months thereafter up to 36 months after insertion. Results: Pain and other symptoms (mostly pruritus) were the most frequently reported complaints (~20%), and were observed in a similar proportion among both Implanon® and Jadelle® users; paresthesia was less frequently reported. Hyperpigmentation was three fold higher among users of Jadelle® than Implanon® users (p< 0.0001) and was more prevalent among non-white users. All symptoms and signs were reported much more frequently by Dominican women. The logistic regression model adjusted by race and body mass index (BMI; kg/m2) showed that users of Implanon® and white women presented lower risk of hyperpigmentation when compared to Jadelle's users (OR 0.26, 95% CI 0.14-0.48; OR 0.34, 95% CI 0.14-0.81, respectively). There was no relation between pain, paresthesia and hiperpigmentation and the use of the implants. Hiperpigmentation was more prevalent between users of Jadelle® in non-white women. The total number of questionnaires for the satisfaction study was 1,200. The results showed that most of these users of contraceptive implants were satisfied with both implants at the different visits and the regret with the method did not reach ~15% at any time through the 3 years of observation. In addition, almost 70% of the women declared that the use of the implants offered benefits for her and only ~5% referred that the use provoke harm for her. Regarding the women's response to changes in their bleeding patterns following insertion of the implant, the percentage who stated that they were very satisfied or satisfied was 70% in both methods. There was no change in the reported frequency of sexual interc urse during use of the implants and no change in their libido. Moreover, all the women in both groups stated that they would recommend the method to a friend or relative and most of them declared that their partner approved of this contraceptive method. Conclusions: Although information relating to local symptoms and signs at the implant site should be provided to current and potential users as a component of good quality of care, we do not recommend evaluation of the insertion site at every visit in women with no complaints. The results about satisfaction with the method are in agreement with previous findings. However, the results must be interpreted with caution because the women are participating in a research study and were not common clients of a family planning clinic. We cannot ignore the possibility that the high satisfaction was a consequence of dissatisfaction with alternative methods / Doutorado / Tocoginecologia / Doutor em Tocoginecologia

INTRODUÇÃO: As células-tronco mesenquimais são capazes de regenerar diferentes tipos de tecidos, no entanto, a maioria dos métodos para sua obtenção são invasivos. Recentemente, foi descoberta a existência destas células no sangue menstrual. OBJETIVO: Padronizar as técnicas de coleta e transporte do fluido menstrual, bem como a caracterização, isolamento, expansão e criopreservação de células-tronco do fluido menstrual e avaliar a disponibilidade de células tronco mesenquimais no fluido menstrual. MÉTODOS: No período de agosto de 2011 a março de 2012 foram selecionadas 20 voluntárias com ciclo menstrual regular, sem doença ginecológica. O fluido menstrual foi coletado no dia de maior fluxo e submetido a imunofenotipagem e cultivo celular. Foram realizadas duas passagens em meio de cultura até atingir semi-confluência das células-tronco, as quais foram, em seguida, criopreservadas. RESULTADOS: Os parâmetros analisados apresentaram os seguintes valores médios: volume de fluido menstrual 6,90±5,60mL; tempo de transporte 17,20±5,50h; número de células totais 3,95 x106±3,88 x106 com 76,05%±24,57 de células viáveis. Após a cultura, as células mesenquimais aumentaram de 0,14%±0,26 para 96,19%±2,14. Na primeira passagem de cultura, após 15 a 21 dias, as colônias formaram grupos que atingiram a confluência, que a partir da segunda passagem ocorreu em cerca de 3 dias. As células-tronco mesenquimais criopreservadas eram viáveis. CONCLUSÃO: As células-tronco do fluido menstrual podem ser obtidas sem métodos invasivos. O fluido menstrual pode ser transportado em condições ideais de temperatura até 24 horas após a coleta. As células tronco mesenquimais podem ser caracterizadas por imunofenotipagem, isoladas, cultivadas e expandidas e, em seguida, criopreservadas. O fluido menstrual contém células tronco mesenquimais viáveis e apropriadas para cultivo / INTRODUCTION: Mesenchymal stem cells may renovate different tissues, but techniques to obtain these cells are invasive. Recently, those cells were detected in menstrual blood. OBJECTIVE: Patterning techniques of collection, transportation, characterization, isolation, expansion and cryopreservation of stem cells in menstrual fluid. METHODS: From August 2011 to March 2012 twenty volunteers were selected with regular menstrual cycle without gynecological diseases. They collected menstrual fluid on the most intense flux day to analysis by immunophenotyping and cellular culture. Culture was made in 2 stages until reached semi-confluence of stem cells and these cells were cryopreserved. RESULTS: Average of menstrual fluid volume was 6,90±5,60mL, transportation time was 17,20±5,50h, and total number of cells was 3,95 x106±3,88 x106 witch 76,05%±24,57 were viables. After culture, mesenchymal stem cells increased from 0,14%±0,26 to 96,19%±2,14. After 15 to 21 days of culture in first passage, colonies formed clusters that reached confluence. In second passage, it happens after 3 days of culture and stem cells were cryopreserved. CONCLUSION: Stem cells of menstrual fluid may be easily obtained without invasive methods. Menstrual fluid can be transported in good conditions of temperature up to 24 hours of collection. Mesenchymal stem cells of menstrual fluid may be characterized by immunophenotyping, as well as it is possible to isolated, cultivate and cryopreserved them. Menstrual fluid has viable and proper for culture mesenchymal stem cells

Bakgrund: Barnmorskor på ungdomsmottagningar spelar en viktig roll i att informera och utbilda ungdomar om pubertetsutveckling och sexualitet. Under puberteten sker fysiska förändringar med unga tjejers kroppar. I underlivet sker tillväxt och en ökad sekretion vilket ger upphov till flytningar.  Trots att detta är en normal process är det något som unga tjejer har frågor om då de söker sig till ungdomsmottagningar. Syfte: Syftet med denna studie var att undersöka barnmorskors erfarenheter av hur unga tjejer på ungdomsmottagningen informeras om normala flytningar. Metod: Kvalitativ innehållsanalys användes som metod. Semistrukturerade intervjuer genomfördes och totalt inkluderades sju barnmorskor verksamma inom ungdomsmottagning. Resultat: Resultatet presenteras genom två kategorier; Information om vad som är normala flytningar och hur kroppen fungerar samt Information för ungdomar i olika åldrar vid utåtriktat arbete. Underliggande dessa fanns tre underkategorier; Normala flytningars förändringar genom menstruationscykeln, Stärkande gynekologisk undersökning och egenundersökning samt Konkret information genom visuella hjälpmedel. Konklusion: Genom att ge hälsofrämjande information kan barnmorskor ge unga tjejer en tydlig bild över vad som är normalt och även ge en uppfattning om vad som avviker från det normala. Ökad kunskap och förståelse bör kunna ge unga tjejer en starkare självkänsla.

Abstract Heavy menstrual bleeding causes significant health and social problems for up to 30% of women at some point of their lives. Medical treatment is not always sufficient or tolerated by women. Hysterectomy is a definitive solution, but it is a major operation associated with long disability and potential severe complications. Endometrial ablation techniques have been developed to avoid the risks related to hysterectomy. Further evolution of these techniques also offers a possibility of a quick and simple outpatient procedure. This study evaluated the long-term effects of endometrial ablation on heavy menstrual bleeding and later endometrial diagnostics. Another aim was to compare the costs when the procedure was performed in different settings. Finally, the effect of hyaluronic acid gel on intrauterine adhesion formation was assessed. Endometrial ablation had a good long-term effect on heavy menstrual bleeding in a retrospective study of 172 women, and up to 84% avoided hysterectomy during the follow-up time mean of 5 years. Seventy-six per cent of the patients were satisfied with the procedure. Due to the formation of intrauterine adhesions, prior endometrial ablation compromised later diagnostics of endometrium, and outpatient endometrial sampling failed in 23% of 57 women who had undergone endometrial ablation a mean of 6 years earlier, but that did not seem to have clinical importance. In a prospective, randomized and double-blind pilot study of 36 patients, hyaluronic acid gel did not prevent the formation of intrauterine adhesions. In a cost-minimisation analysis based on real resource use, performing endometrial ablation as an outpatient procedure under local anaesthetic instead of a day case procedure performed in the operating theatre under general anaesthetic reduced the costs significantly, from 1,865 to 1,065 euros. In conclusion, the results of this study suggest that endometrial ablation is a good alternative for the treatment of heavy menstrual bleeding, and remarkable cost savings can be achieved by taking the procedure out of the operating theatre. The formation of intrauterine adhesions is common and cannot be prevented with hyaluronic acid gel. / Tiivistelmä Runsaat kuukautiset aiheuttavat merkittävää terveydellistä ja sosiaalista haittaa jopa kolmasosalle naisista jossain elämänvaiheessa. Lääkehoito ei aina ole riittävä, eivätkä kaikki naiset voi tai halua käyttää sitä. Kohdunpoisto on lopullinen ratkaisu, mutta se on iso leikkaus, johon liittyy pitkä työkyvyttömyys ja vakavien komplikaatioiden riski. Näiden riskien välttämiseksi on kehitetty kohdun limakalvon tuhoavia tekniikoita, joista nykyisin eniten käytetty on limakalvon tuhoaminen lämpöhoidon avulla. Nykytekniikoilla toimenpide voidaan myös tehdä helposti ja nopeasti polikliinisesti. Tässä tutkimuksessa arvioitiin kohdun limakalvon lämpöhoidon pitkäaikaisvaikutuksia runsaiden kuukautisten hoidossa ja sen vaikutusta myöhemmin tapahtuvaan kohdun limakalvon diagnostiikkaan. Niin ikään verrattiin päiväkirurgisen ja polikliinisen toimenpiteen kustannuksia. Lopuksi tutkittiin pystytäänkö hyaluronihappogeelin avulla estämään kohdunsisäisten kiinnikkeiden muodostumista. Lämpöhoidolla oli hyvä pitkäaikaisvaikutus runsaisiin kuukautisiin 172 naista käsittäneessä retrospektiivisessä tutkimuksessa, ja kohdunpoistolta välttyi keskimäärin 5 vuoden seuranta-aikana 84&#160;% naisista. 76&#160;% naisista oli tyytyväisiä hoitoon. Lämpöhoidon aiheuttamat kohdunsisäiset kiinnikkeet vaikeuttivat myöhempää kohdun limakalvon diagnostiikkaa. Polikliininen imunäytteen otto ei onnistunut 23&#160;%:lla 57 potilaasta, joille oli tehty lämpöhoito keskimäärin 6 vuotta aikaisemmin. Tällä ei kuitenkaan näyttänyt olevan juurikaan kliinistä merkitystä. 36 potilasta käsittäneessä, prospektiivisessa, satunnaistetussa kaksoissokkotutkimuksessa hyaluronihappogeelin avulla ei pystytty estämään kohdunsisäisten kiinnikkeiden muodostumista. Todelliseen resurssien käyttöön perustuvassa kustannusten minimointianalyysissa todettiin, että tekemällä lämpöhoito polikliinisesti paikallispuudutuksessa leikkaussalissa nukutuksessa tehtävän toimenpiteen sijasta, kustannukset laskevat 1865 eurosta 1065 euroon. Tämän tutkimuksen perusteella kohdun limakalvon lämpöhoito tarjoaa hyvän vaihtoehdon runsaiden kuukautisten hoitoon, ja sen kustannuksia voidaan merkittävästi pienentää tekemällä toimenpide polikliinisesti. Kohdunsisäisten kiinnikkeiden muodostuminen on tavallista, eikä sitä pystytä estämään hyaluronihappogeelin avulla.

We don’t sit and talk about this, aims at quite the opposite. While societies such as the Catalan and Swedish have become more gender equal and seem to advance towards being more welcoming for menstruating bodies, there are still many discomforts and oppressions related to the menstrual experience. The research in this subject has been primarily focused on menstrual health and hygiene management issues, while ignoring the social and cultural aspects related to this natural bodily process. Indeed, the menstrual cycle is a biological and psychological journey, throughout women lifespan. Acknowledging the complexity and uniqueness of the menstrual experience, this study aims at exploring and comparing the menarche and menstruation experiences of Primary school teachers. Aiming at examining two specific settings, this research sampled National and International teachers, specifically 9 teachers working and living in Catalonia and 9 teachers working and living in Sweden. Drawing from these two samples, in-depth interviews were conducted, and the resulting findings were analyzed through thematic analysis. The diverse sample of this investigation shows differences and similarities among the two settings, mainly referring to their current embodied experience of menstruation and their way of approaching menstrual-related issues within the school context. It appears, then, that the women that participated in this study faced menarche without the adequate support and information. Besides, menarche was the period where they learnt and interiorized the social and cultural norms of hiding and concealing menstruation and faced physical restrictions. As they grew older, some of these women changed their way of managing and communicating about their period. However, the topic was still difficult to share and discuss, not only in their private life but in their role as teachers, where they attempt to promote a period positive image and help their daughters and students have a comforting menstrual experience. The findings are further discussed considering the concepts of menstrual etiquette, institutional non-acceptance,and the pollution theory and the development theory of embodiment.

iAbstractThis exploratory study aims to investigate the connection between menstrual perceptions,knowledge and education about menstruation as well as the period product choice. Using thefeminist approach, research data were gathered from three focus groups of girls between 14 and15 years old that went to the same high school in Visby (Sweden). Thematic analysis was usedto analyse the data. The findings show that the stigma surrounding menstruation affects girls’everyday lives, forcing them to hide and control their periods and emotions. This results inconstant stress in school. Menstrual concealment also has an impact on period products girlschoose. Participants were lacking knowledge regarding period products and showed nointention to use sustainable period products. Thus, menstrual knowledge is important to reducenegative perceptions and attitudes toward menstruation and period products as well as thefeeling of shame about women’s reproductive functions. Girls gain this knowledge by talkingto other females, especially moms, but also via the Internet and social media. In school, sexeducation starts too late and does not cover emotions, menstrual pain, the different periodproducts, how the menstrual cycle affects girls’ lives and the fact that menstruation is differentfor every girl.

No description available.

Denna uppsats har undersökt hur Libresse har använt sig av det retoriska tilltalet för att nå ut och påverka sin avsedda målgrupp i reklamkampanjen #wombstories. En semiotisk filmanalys har genomförts där resultatet har analyserats utifrån teorier om kommodifierad feminism, wokeness och femvertising. Frågeställningen i uppsatsen har varit, Hur används känslomässiga retoriska tilltal i förhållande till kommodifierad feminism, wokeness och femvertising i Libresse reklamfilm #wombstories? Som avgränsning har enbart en sekvens i reklamfilmen analyserats som porträtterar missfall hos ett lesbiskt par. Resultatet visade att Libresse använder sig av musik, ljud, tystnad, animation och skådespeleri för att förhöja känslan av det retoriska tilltalet där patos var det tilltal som var mest påtagligt. Kommodifierad feminism, wokeness och femvertising representerades genom tecken som kännetecknar termen. Slutsatsen blev att representationen blir ett ställningstagande av Libresse där de vill visa att de är allierade med de individer som möts av de största strukturella orättvisorna och sociala diskrimineringarna i samhället. / This paper has examined how Libresse have used the rhetorical appeal to reach out and influence their intended target group in the advertising campaign #wombstories. A semiotic film analysis has been carried out where the results have been analysed based on theories of commodified feminism, wokeness and femvertising. The question in the essay has been, How are emotional rhetorical appeals used in relation to commodified feminism, wokeness and femvertising in Libresse commercial #wombstories? As a delimitation, only one sequence in the commercial has been analyzed that portrays miscarriage in a lesbian couple. The result showed that Libresse used music, sound, silence, animation and acting to enhance the sense of the rhetorical appeal in which pathos was the most noticeable. Commodified feminism, wokeness and femvertising were represented by signs that distinguish the terms. The conclusion was that the representation shows that Libresse wants to be allies of the individuals who face the greatest structural injustices and social discrimination in society.

The portrayal of women in commercials is intertwined with patriarchal structures and power hierarchies found in Western contemporary society, which stem from the Judeo-Christian binary of a ‘clean/messy’ body as introduced by St. Augustine (354 – 430 CE). This portrayal of women and its effect on their self-esteem, as well as consumerism, have considerable implications for the gender dynamics in modern Western societies. Therefore, the aim of this thesis is to explore the interdependent relationship between feminine hygiene product commercials, feminist movements and women’s self-esteem.The goal of this thesis is twofold. First, a multimodal discourse analysis of four advertisements from Always and Venus will be performed to uncover to what extent feminine hygiene product commercials are adjusting their portrayal of the female body according to feminist movements. Secondly, four qualitative semi-structured interviews will be conducted to examine how the portrayal of women in these commercials affect women’s self-esteem. This thesis’ research draws from feminist theories, Representation Theory, Consumer Culture Theory (CCT), and the Hierarchy of Effects Theory (HET).The findings of the analysis imply that the companies have made some adjustments in the way they are portraying women in accordance with the feminist movements. However, both the analysis of the commercials and the interviews imply that more improvements are necessary. The thesis comes to the conclusion that feminine hygiene product commercials can affect the self-esteem of women by creating (unrealistic) norms about how a female body should look and function. / <p>B</p>