Abortion upon request has been legal in Turkey since 1983. In 2012 the Prime Minister of Turkey announced his intent to restrict or ban abortion. The public protested in response and the Turkish government did not amend the abortion law. However, recent anecdotal evidence suggests that the provision of abortion in public hospitals has diminished significantly. The purpose of this qualitative study was to explore women’s experiences obtaining abortion care in Istanbul, Turkey. We also documented key informants’ perspectives about abortion and reproductive health service availability in Istanbul. According to women and key informants, abortion availability has decreased remarkably and is now only available in one public hospital in Istanbul. Abortion care remains available in the private sector but there are nonetheless barriers to obtaining timely abortion care in Turkey. To improve abortion services, future efforts should focus on re-integrating abortion services in the public sector and making medication abortion available to Turkish women.

No description available.

No description available.

A lack of contraception use and contraceptive method discontinuation are common causes of unintended pregnancy in the Eastern Cape. The most common reason for method discontinuation among childbearing women is the unacceptable side effects of their contraceptive choices. Both depression and sexual dysfunction are given as side effects of contraceptive use; however, there is little evidence to support these effects. This randomised, single-blind controlled trial conducted in East London, South Africa, Investigated the effects of the initiation of a long-acting injectable contraceptive, Depot Medroxyprogesterone Acetate (DMP A), compared with the initiation of a copper Intrauterine Contraceptive Device (Cu-IUD) after childbirth on depression and sexual functioning. After counselling, 242consenting pregnant women were randomised to receive DMP A or a Cu IUD within 48 hours of childbirth, in a ratio of 1:1. Primary outcome measures were depression and sexual dysfunction evaluated by validated instruments. Questionnaires were administered at baseline, and telephonically at one month and three months after randomisation. The telephonic interviewer was blinded to the participants' group allocation. English and Xhosa versions of the Beck Depression Inventory and the Edinburgh Postnatal Depression Scale were used to assess depression. The Arizona Sexual Functioning Scale was used to assess sexual functioning. For these primary outcomes, median scores between the intervention groups were compared, as well as the number of events (dichotomous data) in each intervention group. There relative effects of these interventions were summarised by calculating risk ratios, with 95% confidence intervals. Statistical tests used included the Shapiro-Wilk test, T-test, and Wilcoxon test. There were not consistently statistically significant differences in the risk of depression or sexual dysfunction between the intervention groups in this study. However, there was a trend towards more depression in the DMPA group which was statistically significant for mean EPDS score at the one month and for the BDI score three month assessments compared with the IUD group. There was also a trend to more sexual dysfunction with DMPA, but the only statistically significant difference was that fewer women in the DMPA group resumed sexual intercourse within the first month of treatment than in the IUD group. The author's recommendations from the study are that, firstly, family planning providers should inform women during contraceptive counselling that there is no certainty that DMPA causes depression and/or sexual dysfunction; however, it may do so in the postpartum period. Secondly, contraceptive users can continue to use DMPA with confidence as a convenient and effective method of preventing unintended pregnancy. Thirdly, the trend towards postpartum depression and sexual dysfunction in the DMPA group of this study justifies further research with a larger sample size, to include women from various social settings, and for a longer period of follow-up. Lastly, the Cu-IUD is a good alternative to DMPA in women who experience intolerable effects with the latter.

Dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, In fulfilment of the requirements for the degree of Master of Science in Nursing Education Johannesburg, 2015 / This is an exploratory, descriptive study intending to determine factors that influence the uptake of Reproductive Health Services (RHS) by female students at the university in Johannesburg with a view to improving access and delivery of service in a more efficient manner. Despite the availability of free, accessible and confidential RHS on campus, anecdotal data shows an increased number of students who present with unintended pregnancies and soliciting termination of pregnancy. Through the survey and semi-structured interviews the researcher attempts to determine factors influencing the uptake of campus RHS by female students. The present text seeks to answer the following research questions: What is the socio-demographic profile of actual and potential users of RHS on campus and what factors influence the uptake of RHS on campus? Keywords: Reproductive health, access, utilisation, unwanted pregnancy

Accompaniment models have been used globally to help address barriers to abortion access. Access to abortion is an important issue facing individuals in Canada today. In Canada, abortion doulas provide accompaniment services, even though they are not formally integrated into the abortion care system. This thesis explores the concept of accompaniment in the context of abortion care and provides insight into the experiences and perspectives of abortion doulas active in Canada. This is accomplished through a scoping review and in-depth interviews with abortion doulas across Canada. Results suggest that accompaniment models are beneficial to abortion care and can improve accessibility. Further, abortion doula support helps abortion seekers overcome barriers to care and empower those providing the support. Abortion doulas have many suggestions for improvements to the abortion care system in Canada and have valuable insights into the barriers which exist today. Abortion care can be improved by integrating abortion doula support into the abortion care system, but further research is needed to develop and evaluate interventions. This research is a starting point and aims to contribute to the literature in an under-researched area. -- Des modèles d'accompagnement ont été utilisés dans le monde entier pour aider à lever les obstacles à l'accès à l'avortement. L'accès à l'avortement est une question importante auquel les individus au Canada sont confrontés. Au Canada, les doulas spécialisées dans l'avortement fournissent des services d'accompagnement, même si elles ne sont pas officiellement intégrées au système de soins lié à l'avortement. Cette thèse explore le concept d'accompagnement dans le contexte des soins liés à l'avortement et donnera un aperçu des expériences ainsi que les points de vue des doulas spécialisées dans ce domaine au Canada. Afin de démontrer ceci, la thèse s'appuie sur un examen de la portée de l'étude et sur des entretiens approfondis avec des doulas spécialisées dans l'avortement au Canada. Les résultats suggèrent que les modèles d'accompagnement sont bénéfiques aux soins liés à l'avortement et peuvent en améliorer l'accessibilité. De plus, le soutien des doulas aide les personnes qui cherchent à se faire avorter à surmonter les obstacles aux soins et renforce l'autonomie de celles qui offrent ce soutien. Les doulas d'avortement ont de nombreuses suggestions pour améliorer le système de soins en matière d'avortements au Canada et ont des idées précieuses au sujet des obstacles qui existent aujourd'hui. Les soins liés à l'avortement peuvent être améliorés en intégrant le soutien des doulas dans le système de soins liés à l'avortement, mais d'autres recherches sont nécessaires afin de développer et évaluer les interventions. Cette recherche est un point de départ et vise à apporter une contribution à la littérature sur un domaine peu étudié.

It is estimated that 38 million people currently live with HIV-1. Of the 38 million currently infected, 19.2 million women are infected compared to 17 million men, indicating a clear disproportion. As such, understanding mechanisms that result in increased susceptibly in women is critical to develop more efficacious prevention strategies. The epithelial cells that line the lower female reproductive tract are the first line of defense against invading pathogens. The current consensus in the field is that HIV-1 can cross the mucosal epithelium in two ways: paracellular passage and transcytosis. There are several endocytic pathway associated proteins within vaginal epithelial cells that may have a role in viral transcytosis, however, little is known about their role. One of these is Lysosomal Associated Membrane Protein 3 (LAMP3), which has been shown to be upregulated following viral exposure and involved in viral trafficking. The mechanisms regarding the early events of transmission of HIV-1 across vaginal epithelial cells remains unclear and warrant further investigation. This study was designed to examine the mechanism of how HIV1 crosses vaginal epithelial cells and potential interactions of LAMP3 and HIV-1. / Thesis / Master of Science (MSc)

A caça comercial de grandes baleias, os emalhes de pequenos odontocetos e a poluição são alguns dos fatores que contribuíram para a redução de muitas populações de cetáceos. No entanto, enquanto algumas populações de misticetos se recuperaram mais rapidamente do que outras, os odontocetos foram menos resilientes. Os motivos que levaram algumas populações de misticetos a se recuperarem mais rápido, enquanto outras ainda se recuperam, não são muito bem compreendidos, da mesma forma ainda não se compreende o motivo pelo qual os odontocetos se recuperam mais lentamente. Nesse sentido, o estudo do sucesso reprodutivo pode auxiliar a elucidar os principais fatores que interferem na recuperação dessas espécies. O objetivo da presente dissertação foi levantar dados da literatura científica que indicassem quais são os principais fatores que influenciam o sucesso reprodutivo, causando acréscimo ou decréscimo da taxa de reprodução dos cetáceos de vida-livre, e apresentar os métodos mais utilizados nesse tipo de estudo. Para tanto, foram considerados os artigos científicos publicados a partir de 2000. Nos cetáceos o cuidado parental é exclusivamente materno, portanto, os estudos sobre o sucesso reprodutivo são baseados em dados de observações em campo de fêmeas com filhote, usando a foto-identificação, as análises de parentesco, as imagens de ultrassons e as dosagens hormonais. Comparando populações da mesma espécie, algumas possuem machos com variação no sucesso reprodutivo, ou seja, machos que produzem mais descendentes do que outros, e existem populações que o sucesso reprodutivo não varia, todos os machos geram quase o mesmo número de descendentes. De acordo com a teoria da seleção sexual de Darwin, a seleção das características vantajosas dos parceiros sexuais explica a variação do sucesso reprodutivo. Essas características podem ser comportamentais, morfológicas ou fisiológicas. Tanto em odontocetos quanto em misticetos, quando há variação no número de descentes gerados, os machos mais velhos parecem possuir vantagens sobre os mais novos. Alguns autores sugerem que isso ocorre devido ao desenvolvimento físico e da concentração mais alta de hormônios andrógenos nos machos mais velhos, outros sugerem que é devido à experiência. Com relação às estratégias reprodutivas, alguns odontocetos além de utilizarem estratégias que sejam favorecidas por conta de seus atributos corporais, o sucesso reprodutivo é também favorecido por formações de grupos sociais estáveis, os quais muitas vezes são constituídos por indivíduos com algum grau de parentesco. Já os misticetos utilizam mais as estratégias reprodutivas que são favorecidas em função de seus atributos corporais. Finalmente, alguns fatores como o aumento da temperatura da superfície do mar e a diminuição da disponibilidade de presas impactam o crescimento populacional de algumas espécies de misticetos; e a poluição tem diminuído o sucesso reprodutivo das fêmeas, sobretudo dos odontocetos que vivem próximos à regiões costeiras. / The commercial whaling, small odontocetes bycatch, and pollution are some of the factors contributing to the decline of many cetacean populations. However, while some populations of mysticetes recovered faster than others, odontocetes were less resilient. The reasons that led some populations to recover faster while others are still recovering are not well understood, likewise do not understand yet why the odontocetes appear to recover more slowly. The study of reproductive success can help to elucidate the main factors that interfere with the recovery of these species. The aim of the present dissertation was to collect data of scientific literature that could indicate the main factors influencing reproductive success, causing an increase or decrease of free-ranging cetaceans reproductive rate, and present the most used methods in this type of study. Therefore, the scientific articles published since 2000 were considered. In cetaceans, parental care is exclusively maternal, so reproductive success studies are based on data from field observations of females with calves, using photo-identification, kinship analysis, ultrasound imaging, and hormonal dosages. Comparing cetaceans populations of the same species, some populations have males with variation in reproductive success (i.e. males that produce more offspring than others), and there are populations that reproductive success does not vary (i.e. all males generate almost the same number of offspring). According to Darwins theory of sexual selection, the mate selection with advantageous characteristics explains the reproductive success variation. These characteristics can be behavioral, morphological or physiological. In odontocetes and mysticetes, when there is variation in the number of descendants generated, the older males seem to have advantages over the younger. Some authors suggest that this occurs because of the physical development and the highest concentration of androgen hormones in older males, other authors suggest that is due to the experience. Regarding reproductive strategies, some odontocetes besides using strategies that are favored since their physical attributes seem to have reproductive success favored by a formation of stable social groups, which often are made up of individuals with some degree of kinship. While the mysticetes seem to use more reproductive strategies that are favored according to their corporal attributes. Finally, factors such as the increase in sea surface temperature, and the decrease reduction of prey availability, impact the population growth of some mysticetes; and the pollution has decreased the female reproductive success, especially in odontocetes that living close to the coastal regions.

A caça comercial de grandes baleias, os emalhes de pequenos odontocetos e a poluição são alguns dos fatores que contribuíram para a redução de muitas populações de cetáceos. No entanto, enquanto algumas populações de misticetos se recuperaram mais rapidamente do que outras, os odontocetos foram menos resilientes. Os motivos que levaram algumas populações de misticetos a se recuperarem mais rápido, enquanto outras ainda se recuperam, não são muito bem compreendidos, da mesma forma ainda não se compreende o motivo pelo qual os odontocetos se recuperam mais lentamente. Nesse sentido, o estudo do sucesso reprodutivo pode auxiliar a elucidar os principais fatores que interferem na recuperação dessas espécies. O objetivo da presente dissertação foi levantar dados da literatura científica que indicassem quais são os principais fatores que influenciam o sucesso reprodutivo, causando acréscimo ou decréscimo da taxa de reprodução dos cetáceos de vida-livre, e apresentar os métodos mais utilizados nesse tipo de estudo. Para tanto, foram considerados os artigos científicos publicados a partir de 2000. Nos cetáceos o cuidado parental é exclusivamente materno, portanto, os estudos sobre o sucesso reprodutivo são baseados em dados de observações em campo de fêmeas com filhote, usando a foto-identificação, as análises de parentesco, as imagens de ultrassons e as dosagens hormonais. Comparando populações da mesma espécie, algumas possuem machos com variação no sucesso reprodutivo, ou seja, machos que produzem mais descendentes do que outros, e existem populações que o sucesso reprodutivo não varia, todos os machos geram quase o mesmo número de descendentes. De acordo com a teoria da seleção sexual de Darwin, a seleção das características vantajosas dos parceiros sexuais explica a variação do sucesso reprodutivo. Essas características podem ser comportamentais, morfológicas ou fisiológicas. Tanto em odontocetos quanto em misticetos, quando há variação no número de descentes gerados, os machos mais velhos parecem possuir vantagens sobre os mais novos. Alguns autores sugerem que isso ocorre devido ao desenvolvimento físico e da concentração mais alta de hormônios andrógenos nos machos mais velhos, outros sugerem que é devido à experiência. Com relação às estratégias reprodutivas, alguns odontocetos além de utilizarem estratégias que sejam favorecidas por conta de seus atributos corporais, o sucesso reprodutivo é também favorecido por formações de grupos sociais estáveis, os quais muitas vezes são constituídos por indivíduos com algum grau de parentesco. Já os misticetos utilizam mais as estratégias reprodutivas que são favorecidas em função de seus atributos corporais. Finalmente, alguns fatores como o aumento da temperatura da superfície do mar e a diminuição da disponibilidade de presas impactam o crescimento populacional de algumas espécies de misticetos; e a poluição tem diminuído o sucesso reprodutivo das fêmeas, sobretudo dos odontocetos que vivem próximos à regiões costeiras. / The commercial whaling, small odontocetes bycatch, and pollution are some of the factors contributing to the decline of many cetacean populations. However, while some populations of mysticetes recovered faster than others, odontocetes were less resilient. The reasons that led some populations to recover faster while others are still recovering are not well understood, likewise do not understand yet why the odontocetes appear to recover more slowly. The study of reproductive success can help to elucidate the main factors that interfere with the recovery of these species. The aim of the present dissertation was to collect data of scientific literature that could indicate the main factors influencing reproductive success, causing an increase or decrease of free-ranging cetaceans reproductive rate, and present the most used methods in this type of study. Therefore, the scientific articles published since 2000 were considered. In cetaceans, parental care is exclusively maternal, so reproductive success studies are based on data from field observations of females with calves, using photo-identification, kinship analysis, ultrasound imaging, and hormonal dosages. Comparing cetaceans populations of the same species, some populations have males with variation in reproductive success (i.e. males that produce more offspring than others), and there are populations that reproductive success does not vary (i.e. all males generate almost the same number of offspring). According to Darwins theory of sexual selection, the mate selection with advantageous characteristics explains the reproductive success variation. These characteristics can be behavioral, morphological or physiological. In odontocetes and mysticetes, when there is variation in the number of descendants generated, the older males seem to have advantages over the younger. Some authors suggest that this occurs because of the physical development and the highest concentration of androgen hormones in older males, other authors suggest that is due to the experience. Regarding reproductive strategies, some odontocetes besides using strategies that are favored since their physical attributes seem to have reproductive success favored by a formation of stable social groups, which often are made up of individuals with some degree of kinship. While the mysticetes seem to use more reproductive strategies that are favored according to their corporal attributes. Finally, factors such as the increase in sea surface temperature, and the decrease reduction of prey availability, impact the population growth of some mysticetes; and the pollution has decreased the female reproductive success, especially in odontocetes that living close to the coastal regions.

The focus of this thesis is the current policy situation in relation to assisted reproductive technologies (ART) in Aotearoa/New Zealand. I explore how government policies (and lack of policy) have shaped access to ART. I also explore the policy initiatives of funding agencies, the National Ethics Committee on Assisted Human Reproduction (NECAHR), managers, healthcare professionals, and interest groups. My investigation into ART policy issues critically examines the various formal mechanisms and policies used to regulate and control ART in Aotearoa/New Zealand. Drawing on my analysis of policy-focused documents and material from in-depth interviews with key actors in the policy debate, I demonstrate how the ad hoc and contingent approach to ART developments, practices, funding, and access has contributed to inconsistent and inequitable access to ART services. I argue that the lack of an ART-specific policy organisation contributes to fragmented, and possibly discriminatory, policy decisions. I examine how the use of restrictive access criteria to manage the increasing demand for publicly funded ART services disadvantages certain groups wishing to use these services. By investigating the influence of rationing strategies on the allocation of resources and regulation of access, I provide some appreciation of the 'messy reality' of policy creation, interpretation, and implementation. I argue that the criteria used to limit access to public ART services obscure the use of social judgements and provider discretion. Likewise, they succeed in limiting publicly funded ART treatments to those who conform most effectively to the normative definition of family. My analysis of the ART policy discourse identifies silences and gaps in relation to specific ART practices, particularly the use of ART by Maori. I highlight the invisibility and marginalisation of Maori within the ART policy debate. After examining the broader issues concerning Maori access to health services, I explore how these may affect Maori using ART services to overcome infertility. I argue that the gathering of information about the utilisation of ART services is crucial for the accurate identification of the needs of Maori. It is also fundamental for effective monitoring of state health policy decisions and outcomes.