The aim of this diploma thesis was to summarize the topic of the anterior cruciate ligament (LCA) injury dependency on the menstrual cycle phase of young women with regular sport activity. The general part describes basic knowledge about connective tissue, LCA, issues of LCA injury and related risk situations. Large chapter is dedicated to sex hormones and menstrual and ovarian cycle, which is crucial for understanding the whole topic. The main part is focused on impact of sex hormones and hormonal contraception on connective tissue, but also on muscle and nervous tissues, which might be as well important for LCA injury incidence. Next part of the thesis consists of a questionnaire survey. 52 respondents aged 15-35 with rupture or partial rupture of LCA answered the non-standardized questionnaire compiled specially for this thesis and the results were statistically processed. 14 respondents were using hormonal contraception, remaining 38 had physiological menstrual cycle. Based on the theoretical findings we expected highest incidence of LCA injuries among women without contraception in phases of menstrual cycle with highest levels of oestrogen (10th -15th day). That was confirmed (P-value: 0,0218) as well as overall lower incidence among women using contraception (P-value: 0,0006). Expected higher...

Este trabalho se inscreve no campo dos estudos sobre sexualidade e práticas reprodutivas e contraceptivas, no contexto do Município de Porto Alegre onde muito recentemente passou a ser disponibilizado, na rede pública de saúde, um novo método contraceptivo, o implante subcutâneo Implanon. Partindo de um caso específico de implementação de uma ação governamental na área de saúde reprodutiva, este estudo tem como objetivo compreender, a partir de uma perspectiva antropológica, os significados da prática contraceptiva de implantes subcutâneos para as jovens residentes na região geográfica da cidade, a Restinga e seu entorno, que foi alvo privilegiado desta intervenção pública. Como pano de fundo descreve-se e apresenta-se o processo de idealização, implementação e debate em torno desta política de saúde, assim como o conjunto de atores e agencia que participaram do mesmo. Com a finalidade de conhecer o universo cultural das mulheres que optaram pela tecnologia contraceptiva oferecida pela política municipal, analisam-se as práticas sexuais, reprodutivas e contraceptivas das mulheres entrevistadas, evidenciando algumas categorias e valores imputados a estas práticas e experiências. Discutem-se, a partir do contexto específico pesquisado, os significados e o universo de relações onde se dá a prática contraceptiva de implantes subcutâneos. Enfatiza-se, nesta parte final, como é que tal prática contraceptiva se conecta com as relações afetivo-sexuais, contraceptivas e reprodutivas. A partir desta contextualização foi possível perceber que os eventos envolvidos no processo de gestar e evitar gravidez pode significar e gerar diferentes consequências para os sujeitos neles envolvidos. Igualmente, a abordagem centrada nas especificidades do grupo social "alvo" da ação governamental, evidenciou as diferentes perspectivas e apropriações desta política municipal. / Situated within the field of studies on sexuality and reproductive and contraceptive practices, this study takes as its context the municipality of Porto Alegre, where a new contraceptive method - the subcutaneous implant, Implanon - was recently made available through the public health system. Departing from a specific case of the implementation of a governmental action in reproductive health, the objective of this study is to understand, from an anthropological perspective, what the contraceptive implants mean for young female residents of a particular area of the city - Restinga and its surroundings - that was a target of this public intervention. As background, the process of the health policy's formulation and implementation, and the subsequent debates regarding it, is described, and the collection of participating actors and agencies is presented. With the aim of becoming familiar with the cultural universe of the women who opted for the contraceptive technology proffered by the municipal policy, the sexual, reproductive, and contraceptive practices of interviewed women are analyzed; these data bring to light some of the categories and values ascribed to aforesaid practices and experiences. The meanings and the universe of relationships in which the contraceptive practice of the implants takes place is discussed with specific reference to the research context. The last section emphasizes how such contraceptive practices connect with affective-sexual, contraceptive and reproductive relationships. Through contextualization, it is possible to perceive that the process of both becoming pregnant and avoiding becoming pregnant can mean different things and generate diverse consequences for the subjects involved. Likewise, an approach focused on the specificities of the target population of this governmental action makes plain the different perspectives on and appropriations of municipal policy.

Orientador: Ruben Bresaola Junior / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Civil, Arquitetura e Urbanismo / Made available in DSpace on 2018-08-11T06:31:37Z (GMT). No. of bitstreams: 1 Fernandes_Roberto_M.pdf: 1490135 bytes, checksum: 28ec6cd0c6b627114af37a1ee1c25693 (MD5) Previous issue date: 2007 / Resumo: O 17'alfa'-Etinilestradiol é um princípio-ativo sintético presente na formulação dos contraceptivos utilizados por parcela expressiva da população feminina. Por ser um composto persistente, o 17'alfa'-Etinilestradiol não absorvido pelo organismo da mulher, fração que pode chegar a 80%, é eliminado pela usuária, principalmente pela urina. Na rede de esgotos, mesmo sobre a existência de tratamento, este não é removido completamente, alcançando, posteriormente, mananciais que podem ser utilizados para abastecimento público. Nesse sentido, o presente trabalho teve por objetivo estudar as eficiências de remoção do 17'alfa'-Etinilestradiol de águas para abastecimento, quando empregadas as tecnologias: pré-oxidação com Hipoclorito de Sódio ou Dióxido de Cloro, adsorção em carvão ativado em pó (CAP) e tratamento físico-químico composto de coagulação, floculação, sedimentação e filtração rápida. A metodologia empregada para as determinações do estrogênio foi a cromatografia líquida de alta eficiência (CLAE), aplicada após processo de extração em fase sólida (EFS) do analito presente na água. O cromatógrafo HPLC utilizado, possuía coluna cromatográfica modelo C18, de fase reversa e detector de arranjo de diodos com UV. O trabalho mostrou que o Hipoclorito de Sódio foi mais efetivo que o Dióxido de Cloro, na oxidação do 17'alfa'- Etinilestradiol. Sua maior ação foi observada sob dosagens de 5 e 10 mg/L e tempos de oxidação entre 3 e 5 horas. Esta combinação de parâmetros experimentais impactou na redução da concentração do estrogênio na água, em níveis superiores a 97,5%. Este nível de remoção também foi observado, quando aplicado carvão ativado em pó, sob dosagens a partir de 50 mg/L e tempo de contato de 60 minutos. O tratamento físico-químico apresentou melhores resultados quando aumentada a dosagem de carvão para 5 mg/L. Os resultados alcançados constituem-se de fundamental importância na formação de base para futuras soluções dedicadas ao problema, dada a escassez de estudos de remoção de fármacos contaminantes da água / Abstract: The 17'alfa'-Etinilestradiol is a synthetic active pharmaceutical ingredient presents in the formulation of contraceptives used by a large amount of the female population. As a bioaccumulative molecule, the 17'alfa'-Etinilestradiol is not completely absorbed by woman organism; up to 80% can be eliminated by user, mainly by urine. Even after sewage treatment, the residual of 17'alfa'-Etinilestradiol it is not totally removed reaching, later, water sources that can be used for public supplying. In this direction, the present work has for objective the study of 17'alfa'-Etinilestradiol removal efficiency in waters supplies, using different technologies such as: pre-oxidizing with Sodium Hypochlorite or Chlorine Dioxide, adsorption in powder activated carbon (CAP) and physic-chemical treatment composed by coagulation, flocculation, sedimentation and fast filtration. The methodology used for the estrogen determination was the High Performance Liquid Chromatography (HPLC), applied after solid phase extraction process (SFE) of the hormone present in water. The HPLC equipment used was composed by a model C18 chromatographic column with reverse phase, and diodes arrangement detector, with UV. The work showed that the Sodium Hypochlorite was more effective than the Chlorine Dioxide, to the 17'alfa'-Etinilestradiol oxidizing. Its higher action was observed when applying 5 and 10 mg/L of oxidants in a time of reaction between 3 and 5 hours. This interaction between concentration of oxidant and time of reaction provided estrogen concentration reduction in water, in levels upper to 97.5%. This same removal level also was observed when applied powder activated carbon, mainly when 50 mg/L in a contact time of 60 minutes was performed. The physic-chemical treatment presented better results when 5 mg/L of activated carbon was applied. The present results consist of fundamental importance in the base formation for future solutions dedicated to the problem, due to lack of studies present now a days in pharmaceutical products removal from water / Mestrado / Saneamento e Ambiente / Mestre em Engenharia Civil

O uso de álcool entre mulheres é uma questão atual e preocupante, face a maior vulnerabilidade destas aos danos hepáticos, cerebrais, entre outros, quando comparadas aos homens com padrões semelhantes de consumo. Sendo assim, investigaram-se as possíveis variações na farmacocinética do etanol em mulheres, considerando duas fases do ciclo menstrual (pré-folicular e lútea), bem como o uso de anticoncepcionais orais (AO). Participaram voluntários dos sexos feminino (n=22) e masculino (n=14), administrando-lhes 0,3 g/kg de etanol, na forma de uísque. Os resultados indicaram: a) os parâmetros farmacocinéticos do etanol não variam em função do ciclo menstrual (fase pré-folicular e lútea); b) as mulheres que tomavam AO levam menos tempo para atingir a concentração máxima e eliminam o etanol mais rapidamente do que as que não faziam uso; c) não houve diferença nos parâmetros farmacocinéticos entre o grupo de homens e o de mulheres que utilizavam AO, porém os homens apresentam maior velocidade de eliminação do que as mulheres que não faziam uso e d) os parâmetros farmacocinéticos relacionados com a biodisponibilidade (área sob a curva) e com o volume de distribuição não apresentaram diferenças entre os grupos analisados. / After drinking equivalent amounts of alcohol, women appear to be more vulnerable than men to many adverse consequences of alcohol use, including liver and brain damage. This study investigated the influence of menstrual cycle and female sex steroids levels on ethanol pharmacokinetics, as a possible mechanism for these effects. Twenty-two female and 14 male volunteers were given a moderate dose of ethanol (0.3 g/kg) in the morning after an overnight fast. The results indicated: a) no evidence that the tested menstrual cycle phases (pre-follicular and luteal) significantly influence ethanol pharmacokinetics; b) the time required to reach peak BAC was shorter and the ethanol elimination rate was increased for women taking oral contraceptives (OC) as compared to women not taking them; c) there is no difference on ethanol pharmacokinetics between men and women taking OC, but men showed increased ethanol elimination rate compared to women not taking OC; d) no gender-related differences relating to bioavailability of ethanol were found.

O objetivo deste trabalho foi analisar a influência do ciclo menstrual nas alterações de limiar de dor à pressão (LDP) na musculatura mastigatória de mulheres com sinais e sintomas de Disfunção Temporomandibular (DTM). Inicialmente 47 voluntárias entre 18 e 40 anos participaram do estudo, das quais 36 foram incluídas no experimento: 15 com sinais e sintomas de DTM (7 sob terapia com contraceptivos orais (CO) e 8 sem CO) e 21 saudáveis, sem sinais e/ou sintomas de DTM (8 com CO e 13 sem CO). Os LDPs dos músculos masseter e temporais (anterior, médio e posterior), e do tendão de Aquiles foram medidos bilateralmente, por meio de um algômetro, durante 2 ciclos menstruais consecutivos, nas 4 diferentes fases: menstrual (dias 1-3), folicular (dias 5-9), periovulatória (dias 12-16) e lútea (dias 19-23). Em cada fase do ciclo, as voluntárias relataram sua dor em uma Escala de Análise Visual (EVA). Os resultados foram submetidos à análise de variância a 3 critérios para mensurações repetidas, a um nível de significância de 5%.Foram encontrados LDPs significativamente menores nos músculos temporal e masseter e no tendão de Aquiles das mulheres com DTM quando comparado às mulheres assintomáticas, independentemente da fase do ciclo e do uso de contraceptivos (p < 0,05). De uma maneira geral, os LDPs foram maiores em mulheres em terapia com contraceptivos orais, quando comparado às mulheres sem terapia. Parece não existir influência das diferentes fases do ciclo menstrual no LDP, independentemente da presença ou não de DTM. / The aim of this study was to investigate the influence of the menstrual cycle on the Pain Pressure Threshold (PPT) figures of the masticatory muscles in women with signs and symptoms of Temporomandibular Disorders (TMD). Forty-seven volunteers (ages between 18-40 years-old) were initially recruited for this purpose. According to the criteria adopted, 36 were included. The experimental group was composed of 15 women with myofascial pain (RDC/TMD) (7 under oral contraceptive medication), while 21 women with no TMD signs or symptoms (8 under oral contraceptive medication) composed the control group. The PPT values of masseter and temporalis (anterior, middle, and posterior regions) muscles, as well as the Achilles? tendon were bilaterally screened during two consecutive menstrual cycles, in the following phases: menstrual (day 1-3), follicular (day 5-9), periovulatory (day 12-16) and luteal (day 19-23). A visual analog scale (VAS) was used to address subjective pain in each menstrual phase. Data were submitted to 3-way ANOVA for repeated measurements, with a 5% significant level. The PPT values were significantly lower in the temporalis, masseter, and the Achilles? tendon of TMD patients when compared with the asymptomatic controls, regardless of the menstrual cycle phase or the use of oral contraceptives (p<.05). Overall, the PPT values were higher for patients under oral contraceptive therapy, while VAS was, in general higher at the menstrual phase (p<.05). It appears that the different phases of menstrual cycle have no influence on the PPT values, regardless of the presence of a previous condition, as myofascial pain.

No description available.

MCur / Department of Advanced Nursing Science / See the attached abstract below

Ethiopia has one of the largest populations in the world, an estimate of 114 million inhabitants. With more than 40% of the population below the age of 15 the country has to make further progress in meeting its family planning needs. The fertility rate has slowly declined, but the population continues to grow. Efforts to reduce gender disparities and empower women have fallen short in many parts of the world. Evidence suggesting a link between women’s empowerment, health outcomes and health care service utilization. A secondary analysis of the 2016 Ethiopian Demographic and Health Survey was conducted. The aim of this study was to determine the association between women’s empowerment, sociodemographic and reproductive factors and contraceptive use among married women and women living with partner aged 15-49 in Ethiopia. Logistic regression, bivariate, and descriptive analysis was conducted. Decision-making role in regard to husband’s money was a strong predictor for contraceptive use. Women who alone or jointly made decision were more likely to use contraceptives. The state of wealth of women was a significant determinant for contraceptive use. Those with lower education were more likely to use contraceptives compared to those with higher education. Women who did not intend to have more children were more likely to use contraceptives. This study showed that contraceptive use is associated with women’s economic decision-making age, and several sociodemographic and reproductive factors. Improving women’s empowerment, through decision making power can improve contraceptive use and therefore achieve better maternal health.

No description available.

La migration interne est la principale forme de migration humaine et est sensible aux changements environnementaux, économiques et politiques. En Afrique de l'Ouest, les pressions environnementales et démographiques entraînent une précarité croissante pour les populations rurales dépendantes de l'agriculture pluviale, qui optent pour la migration temporaire vers les zones urbaines pour diversifier leurs moyens de subsistance. Ceci soulève deux questions : d’une part, il est important d’identifier les facteurs facilitant la migration et donc, la capacité d’adaptation des ménages vulnérables. Par ailleurs, dans les pays en pleine transition démographique, les écarts dans les niveaux de fécondité entre régions rurales et urbaines sont généralement élevés et les migrations entre ces milieux peuvent contribuer à la diffusion et l’homogénéisation de la fécondité. Ceci soulève la seconde question de comprendre si et comment la migration interne, surtout temporaire, s’associe à des changements dans les croyances et préférences de fécondité et de contraception chez les migrants. Malgré la pertinence de ces questions, nous constatons que la migration interne demeure le ‘parent pauvre’ en démographie et dans l’étude plus large des migrations; une position qui ne reflète pas son importance. Ainsi, pour contribuer à nos connaissances sur la migration interne dans le contexte de pays à faible et moyen revenu, cette thèse propose trois articles abordant les deux problématiques précédemment étalées. Pour y répondre, nous accordons une attention particulière au concept de réseaux sociaux; un concept central dans l’étude de la prise de décision de migrer et de la diffusion de la fécondité, mais qui fut mal intégré à l’étude de la migration interne et virtuellement absent du champ d’étude s’intéressant à la fécondité des populations migrantes. Nous utilisons un jumelage inédit de données, croisant les données longitudinales de l’observatoire de population de Niakhar, au Sénégal, à celles du projet Réseaux Sociaux et Santé à Niakhar. Conjointement, ces données permettent une analyse approfondie des trajectoires des migrants, leurs réseaux sociaux, ainsi que leur croyances et préférences de fécondité. Nos études se focalisent sur un seul village situé dans la zone d’étude de l’observatoire de population de Niakhar et s’intéressent aux migrants se dirigeant vers la capitale, Dakar. Dans le premier article, nous profitons des outils descriptifs et multivariés de l’analyse de survie afin d’explorer l’association entre l'exposition à du capital social migratoire dans les réseaux et la probabilité d’une première migration vers Dakar. Nous avons décomposé les réseaux de migrants selon les liens à des migrants de retour, des migrants actuels et des résidents non-migrants de la destination afin de capturer l'hétérogénéité du capital social lié à la migration. Nous testons également l'influence de la force des liens, évaluée subjectivement, et des liens structurellement faibles mesurés par les connexions de second ordre ("ami d'un ami"). Nous arrivons ainsi à revisiter certains des principaux postulats des théories de la causalité cumulative, du capital social (en migration) et de la force des liens. Par exemple, alors que les réseaux sont considérés être moins importants pour la migration interne, surtout dans des contextes où elle est généralisée, cette étude permet de revoir de tels constats en adoptant une définition élargie et plus complète du capital social migratoire, incluant des catégories de liens généralement sous-représentées ou absente dans la littérature empirique : les liens avec des non-migrants au lieu de destination et les liens faibles. Dans le second article, nous avons examiné comment la migration rurale-urbaine s’associe à des différences durables dans les croyances et les préférences en matière de fécondité et de contraception. À l’aide de quelques innovations méthodologiques et conceptuelles, nous avons distingué les effets d’adaptation et de sélection sur la fécondité des migrants temporaires à Dakar à l’aide de modèles de régression, malgré une approche transversale. Ceci fut notamment accompli grâce à l’inclusion d’un groupe de contrôle composé de futurs migrants et l’utilisation comme variables dépendantes de mesures idéationnelles de la fécondité, celle-ci étant moindrement affectées par les facteurs perturbants le calendrier génésique. Nous nous sommes également attardé aux migrants de retour, afin d’évaluer si l’adaptation persiste, une fois que les migrants réintègrent leur communauté d’origine. Enfin, nous avons ajouté une mesure des réseaux sociaux en ville, afin de tester son effet sur l’adaptation. Dans le dernier article, nous adoptons une approche ‘translocale’, mesurant les réseaux sociaux aux lieux de destination et d’origine, pour explorer à l’aide de modèles de régression, leur association avec la fécondité idéationnelle des migrants actuels à Dakar. L’analyse accorde une attention particulière aux liens maintenus avec la communauté du lieu d’origine, leur composition et leur structure, afin d’explorer la socialisation, ou l’influence des valeurs et normes acquises avant la migration, une hypothèse souvent peu approfondie dans l’étude de la fécondité des migrants. Plutôt que de concevoir la socialisation comme l’hypothèse nulle, nous l’identifions comme un phénomène continuant après la migration et s’opérant simultanément à l’adaptation. Dans l’ensemble, nos résultats confirment l’importance du rôle des réseaux sociaux comme déterminants de la migration interne, même dans des contextes où elle est généralisée. La migration semble aussi se placer comme un important vecteur de diffusion de la fécondité, par son influence sur les croyances et préférences des migrants actuels et de retour. Cette association est toutefois modérée par les relations maintenues au lieu d’origine. Plus largement nos résultats soulèvent quelques (re)questionnements théoriques et insistent sur l’importance d’adopter une approche centrée sur les réseaux sociaux multilocalisés dans l’étude de la migration interne. Enfin, nos résultats ont des implications substantielles sur le rôle potentiel des migrations rurales-urbaines dans les transformations sociodémographiques des pays du Sud et mettent en évidence les contradictions qui existent entre certaines politiques visant à limiter les migrations rurales-urbaines et celles voulant réduire la fécondité. / Internal migration is the main form of human migration and is sensitive to environmental, economic, and political changes. In West Africa, environmental stresses and rapid population growth are pressuring rural populations dependent on rain-fed agriculture into diversifying their livelihood strategies; this diversification largely depends on migration to urban areas. This raises two questions: firstly, it is important to identify the factors that facilitate migration and therefore the adaptation of vulnerable households. Secondly, in countries undergoing demographic transition, the gaps in fertility rates between rural and urban areas are generally high, and migrations between these regions can contribute to the diffusion and homogenization of fertility. This raises the second question of whether and how internal migration, especially temporary migration, is associated with changes in fertility and contraceptive beliefs and preferences among migrants. Despite the relevance of these questions, we find that internal migration remains the “stepchild” in demography and in the broader study of migration; a position that does not reflect its importance. Thus, to contribute to our understanding of internal migration in the context of low- and middle-income countries, this thesis proposes three papers addressing the two issues previously discussed. To answer them, we focus on the concept of social networks; a central concept in the study of the determinants of migration and the diffusion of fertility, but which was poorly integrated into the study of internal migration and virtually absent from the study of migrant fertility. We combine longitudinal data from the Niakhar Health and Demographic Surveillance System (NHDSS), in Senegal, with data from the Niakhar Social Networks and Health Project (NSNHP). Together, these data allow for an in-depth analysis of migrant trajectories, their social networks, as well as their fertility and contraceptive beliefs and preferences. Our studies focus on a single village located in the NHDSS study area and exclusively examine migrants to the capital, Dakar. In the first paper, we use descriptive and multivariate tools from survival analysis to explore the association between exposure to migratory social capital in networks and the probability of a first migration to Dakar. Taking advantage of our rich data, we disaggregated migrant networks into ties to returning migrants, current migrants, and non-migrant residents of the destination to capture the heterogeneity of social capital related to migration. We also tested the influence of the strength of ties, subjectively measured, and structurally weak ties measured by second-order connections ("friend of a friend"). We thus revisit some of the main hypotheses of the theories of cumulative causation, social capital (in migration), and strength of ties. For example, while networks are considered to be of lesser importance for internal migration, especially in contexts where it is widespread, this study allows us to reconsider such findings by adopting a broader and more comprehensive definition of migrant social capital, including categories of ties that are generally underrepresented or absent in empirical literature, such as ties to non-migrants at the destination and weak ties. In the second paper, we examined how rural-urban migration is associated with lasting differences in fertility and contraceptive beliefs and preferences. Using methodological and conceptual innovations, we distinguished the effects of adaptation and selection on the fertility of temporary migrants in Dakar through linear regression models, despite using a cross-sectional approach. This was achieved by including a control group consisting of future migrants and using ideational measures of fertility as dependent variables, which are less influenced by factors affecting the fertility calendar. We also focused on returning migrants to evaluate whether adaptation persists after migrants reintegrate into their community of origin. Additionally, we included a measure of urban social networks to test its effect on adaptation. In the last paper, we adopt a 'translocal' approach by measuring networks at both destination and origin to explore the association between social networks and the fertility ideation of current migrants in Dakar. The analysis pays particular attention to ties maintained with the community of origin and their composition and structure to explore socialization, or the influence of values and norms acquired before migration, an often-underexplored hypothesis in the study of migrant fertility. Rather than conceiving of socialization as the null hypothesis, we identify it as a phenomenon that continues after migration and operates simultaneously and interactively with adaptation. Our results confirm the importance of the role of social networks as a determinant of internal migration, even in contexts where it is widespread. Internal migration also appears to be an important vector for the diffusion of fertility, through its influence on the beliefs and preferences of current and returned migrants. However, this association is moderated by the relationships maintained at the place of origin. More broadly, our results raise some theoretical questions and emphasize the importance of adopting a multilocal social networks approach in the study of internal migration. Finally, our results have substantial implications for the potential role of rural-urban migration in sociodemographic transformations in the LMICs, highlighting the contradictions between public policies aiming to limit rural-urban migration and those aiming to reduce fertility.