Este estudo, de referencial materialista histórico dialético (MHD), inserido numa perspectiva de gênero, teve dentre seus objetivos caraterizar as mulheres de acordo com a inserção social, idade, vínculo com a instituição, antecedentes ginecológicos e obstétricos; identificar as contradições acerca da percepção quanto ao primeiro exame ginecológico de prevenção de câncer de colo uterino e de mama e identificar caminhos para a transformação da atenção ginecológica. A análise dos dados foi realizada através da depreensão de temas contidos nas gravações, nas quais se identificaram como categorias empíricas à atenção à saúde, o exame ginecológico (razão, conhecimento e sentimentos) e a mulher, sua vida e saúde. Verificou-se que a atenção continua circunscrita ao “corpo biológico”, uma atitude alienante assumida pela usuária, reforçada pela mídia, pelo pessoal de saúde e pela própria mulher. Foram identificados também sentimentos ligados ao medo, à vergonha e ao sentimento de culpa. Finalmente, entre as usuárias e os trabalhadores do serviço de saúde encontrou-se uma relação dialética no olhar generificado sobre a saúde da mulher. Os resultados indicam o prosseguimento da investigação com os profissionais da área. / This study, of referencial materialistic historical and dialetic (MHD), inserted in a gender perspective, had as objective identify the women in agreement with the social insert, age, entail with the institution, gynecological and obstetric antecedents; to identify the contradictions concerning the perception with relationship to the first gynecological exam of cancer prevention and to identify ways for the transformation of the gynecological attention. The analysis of the data was accomplished through the identification of themes contained in the recordings, in which there were identified as empiric categories the attention to the health, the gynecological exam (reason, knowledge and feelings) and the woman, her life and health. It was verified that the attention continues bounded to the “biological body”, an alienating attitude assumed by the user, reinforced by the media, by the personnel of health and by the own woman. They were also identified feelings linked to the fear, to the shame and the blame feeling. Finally, a dialetic relationship was identified between the user and the health workers. The results indicate the pursuit of the investigation with the professionals of the area.

M.Tech. / Premenstrual syndrome affects millions of premenopausal women and has been described as one of the most common disorders in women. Premenstrual syndrome (PMS) is defined as the cyclic recurrence of symptoms such as anxiety, depression, food cravings, bloating, breast tenderness, and headaches during the luteal phase (from day fourteen to day one) of the menstrual cycle (Nel, 1995). PMS has been estimated to affect 75% of women of reproductive age, and there are no optimal conventional treatment options available (Steiner et al., 2006). Research has found an increased incidence of PMS in black women (Deuster et al., 1999). Due to the high number of women suffering from PMS and side-effects of conventional medicine, a safe alternative treatment for PMS is required. The homoeopathic similimum method involves prescribing one remedy at a time in optimal potency and repetition based on the totality of the individual patient’s mental, emotional and physical symptoms (Vithoulkas, 1985).

M.Tech. / Dysmenorrhoea is the most common of all gynaecological complaints, leading to absence from work or school and the inability to participate in sports or other activities (Edmundson et al, 2006). Headache, nausea, constipation or diarrhoea, and urinary frequency are common concomitant symptoms; vomiting occasionally occurs (Beers et al, 2006). In research by Klein and Litt, although black adolescents reported no increased incidence of dysmenorrhoea, they were absent from school more frequently than whites (Callis, 2006). Primary dysmenorrhoea is defined as severe or incapacitating uterine cramping during ovulatory menses, in the absence of demonstrable disorders of the pelvis (Carr and Bradshaw, 2005). Primary dysmenorrhoea is related to excessive production of prostaglandins which cause ischaemia in the myometrium of the uterus, with increased contraction and vasoconstriction (Callis, 2006). The aim of this study was to evaluate, using case studies, the effect of the homeopathic similimum in the treatment of the symptoms of primary dysmenorrhoea in black females. Evaluation was based on the evaluation of symptoms form (Appendix E), which rated the common symptoms namely lower abdominal pain, nausea, vomiting, diarrhoea, constipation, fatigue, irritability, mood swings, menstrual flow and breast tenderness, and on the history taken and follow up consultation, looking at overall symptom change of each participant. The research study used a convenience sample of ten black females, aged between eighteen and twenty-five, who had been suffering from primary dysmenorrhoea for the previous three or more months. The volunteers were recruited by advertising posters (Appendix A) on the University of Johannesburg campuses. They were given an information and consent form (Appendix B) to read, understand and complete if they agreed with the given information and explained procedures. They were then screened for suitability using a screening questionnaire (Appendix C). From this questionnaire ten suitable participants were selected. A full case history of each participant was taken and a full physical examination (Appendix F) was conducted on each of the ten suitable participants. The full case and physical examination findings were evaluated and a homeopathic similimum remedy was selected under supervision of the research supervisor.

In order to determine the effects of aerobic fitness on pregnancy and the newborn 20 primigravid subjects were studied throughout their gestational period and immediately post-partum. The subjects were classified as trained (T=10) or untrained (UT=10) based on the heart rate response to submaximal cycle ergometry testing done in each trimester. Case room reports were reviewed after delivery. There was no difference between groups in the length of gestational period (T=40.75;UT=40.75 weeks) nor weight gained versus prepregnancy measures (T=13.92; UT=13.30 kgs). The first stage of labour was extended in the UT, 13hrs.58.8min. vs 1lhrs.18.Omin. UT had a longer second stage, 90.57 vs 70.0 mins. for T. Stage 3 was also prolonged in UT, 15.17 vs 7.43 mins. In both groups analgesia and/or anaesthesia was used equally. Two of the 10 T females had caesarean sections vs 3 of the 10 in the UT group. The mean apgar scores at 1 and 5 minutes were: T=7.70, 9.20; UT=7.90, 9.33, respectively. The birth weights of the T babies were marginally larger than the UT newborns (3733.00 vs 3679.97 gms). The T newborns were 8 males and 2 females, and the UT were 5 males and 5 females. All babies were healthy and without apparent abnormalities. There appears to be no positive or negative effects of maternal fitness on the newborn. The reduction in the active stage of labour in the T group may reflect their improved fitness levels. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate

To date, the undertaking of health promoting behaviors in working women is an issue which has not been explored in any depth. This issue has become particularly important because of two parallel phenomena - the rapid expansion of the numbers of women in the workforce, and the growing interest in health promotion - which have emerged in Canada in the last twenty years or so. As well, factors which may relate to the undertaking of health promoting behaviors have been hypothesized and investigated to some extent, but have not yet been fully determined. Self-esteem has been proposed as one motivational factor in the undertaking of health promoting behaviors. The present study has sought to determine the extent to which self-esteem, working conditions, and demographic factors, are related to the undertaking of health promoting behaviors in working women. The conceptual model used is a modified version of Pender's (1982) Health Promotion Model in which a feedback mechanism operates, reinforcing the performance of health promoting behavior as self-esteem levels grow, and equally, reinforcing self-esteem levels according to the extent to which health promoting behaviors are undertaken. Subjects of a random sample of 500 female union members working in the greater Vancouver area were mailed a questionnaire package. The questionnaires asked for data on present levels of self-esteem, health promoting behaviors presently undertaken, and demographic and working condition factors. Following a repeat mailing, the final number of responses available for analysis was 229 (46%). Simple linear regression analysis revealed that self-esteem was predictive of health promoting behaviors in a global sense, and, in particular, of self-actualization, health responsibility, exercise, and nutrition. However, neither demographic variables, nor the number of hours worked per week, were found to be predictive of health promoting behaviors. Although the study suffered from a limitation due to a low response rate, the sample was determined to be broadly representative of the union population. Therefore, these study results may be generalized to other urban, unionized females sharing similar demographic characteristics. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

A lot of attention has been focused on reducing cholesteric problems before individuals reach middle age, but is it not possible to reduce the risk factors for CHD after middle age? This study was initiated to determine id moderate exercise had an effect on the serum lipoproteins in postmenopausal women. Plasma concentrations of glucose, triglyceride (TRIG), TC, HDL, and LDL were measured before and after a monitored regime of moderate exercise.

Includes bibliographical references. / This thesis examines the social determinants of women's health status, health knowledge and knowledge and use of health services in a peri-urban area, using Kbayelitsha in Cape Town, South Africa as a case study. It argues for the importance of women's health as a specific focus, looks at some trends in women's health internationally over the past two decades and reviews the main factors affecting women's health. Some key issues in women's health of special relevance to developing countries such as South Africa are discussed. There is a special focus on newly urbanised women in peri-urban areas. Against this background the results of a community-based survey, preceded by indepth interviews, and conducted amongst 659 women in Kbayelitsha in 1989 and 1990 are presented. Data collected were statistically analysed using unIvariate,, bivariate and multivariate analysis. A number of priority social and health problems are identified: poverty; poor environmental conditions; lack of education, partlcularly skills training appropriate for finding work and the subordinate social status of women. Major health concerns included reproductive tract infections, especially sexually transmitted diseases, infertility, contraceptive use and ante-natal care during pregnancy. There were inadequacies in cervical screening conducted by health services and deficiencies in respondents' knowledge of AIDS. cervical smears and where to obtain various health services . Young, newly urbanised women, living in the poorly serviced and unserviced informal housing areas were partlcularly vulnerable in their socio-economic and health status within a peri-urban African community such as Khayelitsha. They also had poorest health knowledge and least knowledge of where to acquire health services. Some recommended interventions focussing on certain of these areas are suggested. It is argued that changes in the provision of women's health services within a primary health care setting can only be part of the process of improving women's health. Improvements in women's economic status and their social status are fundamental to any initiatives to improve their health status.

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Overweight and obesity are a growing national concern, particularly among women and selected minority populations (Ayala, Elder, Campbell, Slymen, Roy, Engelberg, et al., 2004; NHANES, 2003). Pregnant women bear a disproportionate risk of becoming overweight or obese (Greene, Smickikias-Wright, Scholl, & Karp, 1988; Gunderson et al., 2000; Rossner, 1999). Although exercise is a key factor in preventing overweight and obesity, women often decrease their exercise levels during pregnancy (McTigue, Garrett, & Popkin, 2002; Viau, Padula, & Eddy, 2002; Zhang & Savitz, 1996). Reported percentages of regular exercise during pregnancy have been documented as low as 5% in a predominately White population (Steele, 2002). Although there is ample evidence demonstrating that Hispanic women exercise less than White women during every other stage of life, little is known about how pregnant Hispanic and White women compare in exercise behaviors (Crespo, Smit, Andersen, Carter-Pokras, & Ainsworth, 2000). The purpose of this research was to study low-income White and Hispanic pregnant women to (1) determine the nature and the extent of exercise behaviors both before pregnancy and during pregnancy (2) identify factors that influence exercise behaviors (3) determine if there are differences in factors that influence exercise between ethnicities. Data were collected via a questionnaire developed by the author. A sample of 301 White and Hispanic pregnant women were recruited through the Women, Infants, and Children [WIC] agencies in four selected counties in Oregon. Although ACOG guidelines provide clear information on the benefits of exercise, over 90% of the women surveyed did not exercise at ACOG guidelines. A majority of the women, 57.8%, actually decreased exercise during pregnancy. Although ethnic differences did not exist in the prevalence of exercise during pregnancy, differences between ethnicities were found in the variety of exercise activities performed and behavioral factors that predicted exercise behavior. Analysis of these differences and the factors contributing to the overall low levels of exercise may provide critical information for future intervention program planning. Well targeted programs will ultimately decrease the excessive weight gain and subsequent increased risk for overweight or obesity that pregnant women face. / Graduation date: 2006