Diseases of Women, Book I, is part of the Hippocratic Corpus of approximately seventy treatises, although different authors contributed to the writings, as is evident by slight changes in text. It is the first of three works by Hippocrates on gynaecological problems. Fifth century BC doctors did not dissect either humans or animals, so their theories were based purely on observation and experience. Book I deals with women who have problems with menstruation, either the lack of it or an excess, infertility and, when conception does take place, the threat of miscarriage and dealing with the stillborn child. Various remedies are given, including herbal infusions, vapour baths and mixtures that the modern day patient would shudder at, e.g. animal dung and headless, wingless beetles. One remedy, hypericum, or St John's Wort, used for depression, has become popular today as an alternative medicine. / Old Testament and Ancient Near Eastern Studies / M.A. (with specialisation in Ancient Languages and Cultures)

The purpose of this study was to analyse and describe the factors that influence the choice of site of delivery by pregnant women in Mukono district. By employing quantitative, non experimental research methods, 431 women were interviewed by using structured questionnaires. These women had either delivered at; home, TBA, private or public clinic and 72% had been delivered by skilled attendants. Choice of delivery site was influenced by the attitudes of health workers which were rather poor in public sites, proximity of site, attendance of antenatal clinic at a site, availability of supplies and drugs, plus level of care including emergency obstetric care. / Health Studies / M. A. (Public Health)

Young women working in SMEs are increasingly being affected by HIV and AIDS, and SMEs are expected to respond to HIV and AIDS through workplace policies and programmes. This requires commitment from SMEs to help young women who face various gendered vulnerabilities to HIV and AIDs. The study, whose purpose was to investigate young women workers’ experiences of the HIV and AIDS response of small and medium enterprises in a semi urban area in KwaZulu-Natal, used a qualitative approach and collected data from three SMEs in Pietermaritzburg during the period of the study. Findings of the study indicate that the majority of respondents from all three SMEs agree on experiencing limited or no HIV and AIDS policies and programmes in SMEs. With reference to incomplete or limited responses, two SMEs provide financial assistance for funerals. However, some aspects such as education and awareness, monitoring, management commitment, provision of medical aid, facilitation of peer education, appointment of an HIV officer and more were not evident. Thus recommendations were made on how SMEs should respond, and future research ideas were outlined. / Health Studies / M. A. (Social Behaviour Studies in HIV/AIDS)

Made available in DSpace on 2016-12-23T13:56:03Z (GMT). No. of bitstreams: 1 Dissertacao de CHIARA MUSSO RIBEIRO DE OLIVEIRA SOUZA.pdf: 3219731 bytes, checksum: 4e9cda14fdff3b61520c40dd1db90c92 (MD5) Previous issue date: 2009-02-27 / A saúde vaginal depende de complexas interações entre a microbiota vaginal, a histofisiologia da mucosa escamosa, o estado hormonal e os mecanismos de defesa do hospedeiro. Muitos fatores podem alterar essas relações, induzindo citólise, infecção e inflamação, genericamente denominados infecção vaginal (IV). A IV manifesta-se por graus e combinações variáveis de ardor, prurido, dispareunia, disúria, mau odor e aumento e modificações do conteúdo vaginal. A abordagem clínica tem sido orientada apenas empiricamente e há pouca percepção do risco potencial das IV. Isso se deve a vários fatores, incluindo uma complexa rede de causas, inespecificidade das manifestações, discordâncias conceituais, dificuldade diagnóstica, natureza íntima da prática sexual e limitados recursos diagnósticos e terapêuticos. Objetivos: Avaliar em nosso meio o uso dos intrumentos autocoleta do conteúdo vaginal, diário de hábitos, sintomas e práticas sexuais e descrever as variações diárias da microbiota, da citólise, do exsudato inflamatório e dos sintomas. Casuística: 18 mulheres no menacme, não grávidas, recrutadas em clínicas ecológicas na região metropolitana de Vitória, ES. Métodos: Estudo descritivo com exame ginecológico inicial, registro diário de hábitos de vestuário, higiene, práticas sexuais e sintomas e autocoleta vaginal por um mínimo de trinta dias. Os esfregaços vaginais foram examinados (Gram e Papanicolaou), sumarizando-se os achados como grau lactobacilar, candidíase, citólise e inflamação. Os achados históricos, do exame ginecológico e do estudo seqüencial foram registrados em um quadro pictórico individual e sumarizados por freqüência simples. Resultados: A mediana dos dias com respostas às perguntas do diário foi maior que 87% em todas as participantes. A autocoleta do conteúdo vaginal garantiu espécimes adequados em mais de 85% dos dias em todas as participantes. Microbiota bacteriana anormal, candidíase, citólise e inflamação foram observadas em 27,8%, 50,0%, 83,3% e 94,4% das participantes em algum momento durante o estudo. Os hábitos de vestuário, higiene, e práticas sexuais e os sintomas, microbiota, citólise e inflamação variaram marcadamente tanto entre as mulheres como ao longo dos dias em uma mesma mulher. Conclusão: O registro diário e a autocoleta foram bem aceitos e garantiram dados e espécimes adequados que, sumarizados em um quadro pictórico, mostram que há marcadas variações diárias entre os elementos das redes de causas e efeitos de IV, indicando que somente com estudos seqüenciais é possível identificar todo o espectro das IV. / Vaginal health depends on complex interactions between the vaginal microbiota, the squamous mucosa histophysiology, hormonal status and host defense mechanisms. Several factors can alter these relationships, inducing cytolisis, infection and inflammation, generally named vaginal infection (VI). VI manifests itself by changeable degrees and combinations of burning, itching, dispareunia, disuria, offensive odour and increase and change of the vaginal content. The clinical approach has been taken only empirically and there is few perception of the potential risk of VI. This is due to several factors, including a complex net of causes, few specific manifestations, concept disagreements, difficulties on diagnostic approach, intimate nature of sexual practices and limited diagnostic and therapeutic resources. Objective: To evaluate in our environment the use of the following tools: self collect of the vaginal content and diary of habits, symptoms and sexual practices and to describe the diary changes of the microbiota, cytolisis, inflammatory exsudate and symptoms. Casuistic: 18 non pregnant women during menacme, enlisted at gynecological offices in metropolitan region of Vitória, ES. Study design: Descriptive study consisted of an initial clinical evaluation, daily register of clothing, hygiene, sexual practices and symptoms and self collect of vaginal content by at least 30 days. The vaginal smears were evaluated (Gram and Papanicolaou) and the findings were summarized as lactobacillary grade, candidiasis, cytolisis and inflammation. The historical, gynecological and sequential findings were registered on an individual pictorial table and were summarized by simple frequency. Results: The median of days with diary answers replys was higher than 87% in all of the participants. The self collect of the vaginal content guaranteed adequate smears in more than 85% of the days of the study in all of the participants. Anormal microbiota, candidiasis, cytolisis and inflammation were observed in 27,8%, 50%, 83,3% and 94% of the participants in any moment during the study period. The clothing and hygiene habits, sexual practices, symptoms, anormal bacterial microbiota, candidiasis, cytolisis and inflammation varied markedly between the participants and across the days in a single woman. Conclusion: The daily register and the self collect were well accepted and guaranteed adequate data and smears which, summarized on an individual pictorial table, show that there are marked daily variation between the elements of the nets of causes and effects of the VI, indicating that only sequential studies allow the identification of the whole VI spectre.

The purpose of the study was to investigate the cardiovascular disease (CVD) risk profile of black African females in the Makana region, Eastern Cape, South Africa. Baseline measures from 40 participants, who met the criteria, were compared against the 2003 South African Demographic and Health Survey (SADHS) and the 2013 South African National Health and Nutritional Examination Survey (SANHANES-1). The risk factors measured were anthropometric (stature, body mass and body mass index (BMI)), morphological (waist circumference (WC), fat mass and lean mass), cardiovascular (heart rate and blood pressure (BP)), physical activity (step count and energy expenditure), biochemical (glycated haemoglobin and full blood lipid profile) and behavioural (alcohol and tobacco use). Results showed significantly higher (p≤0.05) values for overweight/obesity (BMI 37.60 kg.m⁻²; WC 1130.58 mm; fat mass 45.23%) and high BP (130/88 mmHg) compared to the previous national surveys, highlighting these CVD risk factors as problematic. The subsequent sub-study aimed to assess the efficacy of a pedometer-based walking intervention on high BP. The walking programme (n=25) was based on individual step goals to be completed at a moderate-intensity on five days.week⁻¹ for 12 weeks. The same measurements were taken at monthly intervals, Week 0, Week 4, Week 8 and Week 12, with the addition of dietary intake and fitness level, and the exclusion of the behavioural variables. There were no significant differences (p≤0.05) in systolic and diastolic BP with the exercise intervention, although there was a strong, negative relationship with time for diastolic BP (r²=0.9857). This trend suggests that the lack of significance may be a result of poor compliance and/or the small sample size. Individual results, however, showed no compliance-result relationship for the two risk factors of interest: overweight/obesity and high BP. Future recommendations include supervised or group-based exercise interventions to improve compliance, and the addition of resistance training to the aerobic programme.

Basic Antenatal Care (BANC) is a way of training or upgrading the knowledge and skills of all nurses, midwives and doctors involved in antenatal care at the primary health care level so that the minimum care can be provided effectively. This study was conducted to investigate the implementation of the BANC program by midwives in the Mdantsane clinics during February 2009. Methods: A descriptive study design was undertaken targeting midwives providing antenatal care to pregnant women, in 14 clinics of Mdantsane. Data was collected from 25 midwives in the clinics, and from 140 ANC cards of women attending ANC on the day of their visit to the clinic. Results: The majority of midwives providing BANC in Mdantsane clinics were not trained in BANC. There were 10 trained midwives and 15 not yet trained. A total of twenty five midwives were involved in the study. The number of visits according to the BANC schedule was well known by the midwives in the study. The content of the visits was well known for the first visit, but for subsequent visits, the participating midwives could not state exactly what they do on these visits. They perceived BANC as something beneficial for both midwives and pregnant women with 24 of the participating midwives rating BANC as advantageous. In completing an ANC card, the midwives scored between 48 percent and 100 percent. Under examination, they scored between 52 percent and 100 percent. Lastly on interpretation and decision making, they scored between 0 percent and 92 percent. This could have troubling consequences for the health status of the mother and baby. Weaknesses in providing antenatal care identified in the study included participating midwives failing to fill in the last normal menstrual period (LNMP) and the estimated date of delivery (EDD), which was a worrying observation. Plotting of the gestational age at first visit was also not carried out well as only 47 percent of the midwives in the study did this, meaning that there would be a miscalculation of the gestational age thereafter throughout the pregnancies. The body mass index (BMI) was not calculated as the maternal height and weight were not written on the ANC card. This should be completed in order to check the nutritional status of the pregnant woman to help supplement, if malnourished, and educate on diet, if overweight. Only 17 percent of the midwives in the study plotted the foetal presentation. Failure to plot foetal presentation could lead to complications during delivery because women with abnormal presentations could end up delivering in a clinic instead of the hospital.Conclusion: This study showed that even though midwives are implementing BANC among pregnant women, it is not being carried out correctly. Therefore the programme will not be as beneficial as it would be if put into practice correctly. This is highlighted by the lack of knowledge from the untrained midwives regarding the content of care on subsequent visits. Thus there is an urgent need for BANC training to be conducted and monitored at various sites.

Utilizing a mixed methods approach in assessing cities and metropolitan areas with the highest rates of breast cancer disparities in African-American communities, this study presents the Affiliate perspective of the Susan G. Komen non-profit organization in combination with available socioeconomic data and academic literature. Analyzed through an anthropological lens, qualitative and quantitative data illuminate the lived experiences and dynamic circumstances in which breast cancer disparities are disproportionately experienced in 21 of the nation’s populations of African-Americans. Two main recommendations arose from this research: prioritization of granting to activities such as patient navigation, usage of patient narrative messaging, community-based participatory research methods of program development and implementation, mobile mammography delivery, usage of lay health educators, and self-advocacy education to alleviate barriers to healthcare and supplementation of the current educational activities of the Komen Affiliates through program sharing and leverage of current assets with consideration of current Affiliate capacity. These recommendations may help in alleviating breast cancer disparities present in African-American communities with the highest levels of disparities in the nation.

Indiana University-Purdue University Indianapolis (IUPUI) / Rates of chronic disease and physical inactivity are disproportionately high among African American women. Despite the known benefits of physical activity and an increasing number of programs designed to increase activity, attendance rates to many exercise programs remain low. There is much to learn about program types, such as healthy lifestyle programs (HLP); individual factors, such as self-efficacy; and mediating variables that may influence exercise program attendance. An observational study design was used to compare exercise self-efficacy and attendance in a community-based exercise program in African American women who were enrolled in a HLP (N = 53) to women who were not (N = 27). Exercise program attendance was gathered across six months; demographics, self-efficacy and physical activity behaviors were assessed through surveys; and physiological variables (resting heart rate and blood pressure, height, and weight) and physical fitness (muscular strength and endurance and cardiovascular endurance) were measured at baseline. Descriptive statistics were used to describe participants and groups were compared using T-tests, chi-square and non-parametric statistics. Finally, mediation analyses were conducted using multiple regression models to assess self-efficacy as a potential mediator to exercise program attendance. Women who enrolled in this study were of low income (61% having an annual income less than $20,000), obese with a mean (standard deviation) body mass index (BMI) of 37.7 (7.6), pre-hypertensive with a mean (standard deviation) systolic blood pressure of 125.9 (14.4), and scored poorly and marginally on two fitness tests. On average, women reported being Moderately Confident in their ability to exercise regularly, yet had low attendance in the exercise program with a median number .5 days over six months and there were no significant differences in exercise self-efficacy (p = .23) or attendance in the exercise program between groups (p = .79). Additionally, exercise self-efficacy was not a mediating variable to program attendance. Women in this study had little discretionary income and several chronic disease risk factors, yet exercise program attendance was low even in those enrolled in a HLP. Identifying factors that increase exercise self-efficacy and factors that influence attendance beyond self-efficacy may help future program design and attendance.

Indiana University-Purdue University Indianapolis (IUPUI) / This thesis project aims to address the following question: How do women who were planning a vaginal birth with limited medical intervention experience an unplanned c-section? Specifically, this research project involved: completing in-depth interviews with 15 women who planned a vaginal birth with limited medical intervention but instead experienced an unplanned c-section between six months and two years ago; discovering and describing the nature of the birth the mothers originally envisioned for their child; exploring the women’s experiences with, and feelings about, the birth itself and how it might differ from what they envisioned; developing a better understanding of how these experiences and feelings affected the women during the first two years following the birth; describing any challenges they faced and how, if at all, they managed such challenges; and identifying strategies that could be used to improve the experience of women recovering from an unplanned c-section who envisioned a vaginal birth with limited medical intervention.

Indiana University-Purdue University Indianapolis (IUPUI) / The Catholic Church is widely known for its opposition to birth control. Yet statistics show that the vast majority of American Catholics use birth control. While multiple studies have been conducted on a larger quantitative scale about the use or attitudes of American Catholics toward birth control, there have not been qualitative studies to understand the experiences of Catholics who use contraception. This study is particularly timely given the recent Catholic opposition to the Affordable Care Act’s mandate of employee healthcare provided birth control as well as, the extraordinary synod of bishops to discuss pastoral challenges to family life in October 2015. Fourteen married Catholic women were interviewed about their religious identities and experiences using contraception. Analysis demonstrated how these women constructed a religious identity by maximizing certain aspects, such as prayer and service, while minimizing other aspects, such as individual autonomy and denominational distinctions, of their religious identity. However in order to cope with the tension between their salient religious identity and their contraceptive decision making women utilizing multiple mechanisms. Specifically, they made boundaries around which types of contraception were acceptable and limits to church or individual authority; they justified their decisions based on medical necessity or betrayal they felt from the church; they legitimated their decisions by discussing God’s control and their husband’s perceptions of NFP; and they normalized their decisions through their desire to care for their children and be sexually intimate with their husbands. This research illuminates unique challenges that religious women face in their sexual decision making and sexual health practices that can help sex educators and health care providers care for women. Additionally, the Catholic Church and American Catholics make up huge forces in education, health care, charity, politics, and employment. However, not all Catholics follow the rules of the church. Those members who remain an active part of the Catholic Church, such as the practicing Catholics in this study can influence the way the church changes. By better understanding the experience of these dissenters, social researchers may be able to better understand the future of the Catholic Church.