Thesis (M.A.)--East Carolina University, 2009. / Presented to the faculty of the Department of Health Education and Promotion. Advisor: Sharon M. Knight. Title from PDF t.p. (viewed May 4, 2010). Includes bibliographical references.

The purpose of this study was to explore the needs of women experiencing menopause. Since women at this time experience physical, social and emotional changes, they may have a special need for services. Doctors were selected as the population for study because they treat so many women at this age and because they are powerful transmitters of our culture. This exploratory study was designed to provide descriptive information about the doctors' perceptions. Results are reported from interviews with seventeen gynecologists from the Portland metropolitan area in Oregon. Attempts were made to interview all female gynecologists in the area. Male gynecologists were randomly sampled and the sample was stratified to ensure representation of doctors from a pre-paid medical plan. Doctors were questioned about definitions of menopause, treatment, and use of community resources. Overall, it was found that doctors hesitated to make generalizations about patients. This seemed especially true in regard to questions about the effects of menopause or the problems women experience. When speaking about both their definition of menopause and the types of problems associated with it, female physicians tended to limit responses to the biological aspects of menopause. Generally, it was the male doctors who stressed the social or emotional aspects. The major forms of primary treatment used by doctors were: hormone replacement therapy; talking to the patient (i.e. providing education or reassurance about menopause); or some combination of the two depending upon the individual patient's problem. Degree of hormone use varied among doctors. Yet, at some time, with some patients - all doctors used some form of hormone treatment. Generally, Kaiser doctors appeared to use a lower rate of hormone therapy than doctors in private practice. Most doctors were aware of the existence of community resources. Kaiser doctors tend to most frequently use their own social service department or mental health clinic to handle the other-than-medical problems patients might experience. The community resources which received the highest mention overall were mental health clinics and members of the clergy. The next most frequent category was other mental health professionals. Six of the seventeen doctors interviewed named services, not now in existence, which they would use if available. Those most frequently mentioned were groups and information & referral services. Most doctors believed that the needs of women at the time of menopause were different from the needs of other women. Most frequently mentioned were changes in the women's family structure, changes in her activities, and feelings of being no longer needed. Several doctors who were interviewed echoed researchers such as Bernice Neugarten and Pauline Bart in stressing the negative attitudes which our society has towards women at the age of menopause. In addition, many of the gynecologists expressed awareness of social needs. The results of the study indicate that doctors' services are primarily involved with treatment of medical or biological concerns, and referrals are generally to mental health resources. Several doctors mentioned social needs of the women; and as has been noted, the need for attitudinal change. Social workers can play important roles to bring about these changes. Two possible approaches are suggested: education to increase awareness of medical and social work professionals and the establishment of new resources to advocate for women at the time of menopause. Suggestions for further research are also given.

Background: Cervical cancer may be fatal to women if not identified and treated early. In Iraq, cervical cancer ranks as the 10th most frequent cancer among women between 15-44 years of age, with about 291 new cervical cancer cases diagnosed annually. Cervical cancer can be prevented in two ways: primary prevention aimed at preventing HPV infection through prophylactic HPV vaccinations; and secondary prevention aimed at preventing precancerous lesions from progressing into invasive lesions through screening. Cervical cancer screening is under researched in Iraq. It is clear that Iraq’s years of isolation and disorder has resulted in a loss of research capacity. Aim: To provide evidence–based strategies to establish population based cervical cancer screening services in Iraq. Methods: A mixed methods sequential exploratory design was used; an iterative mixed method approach which included the triangulation of qualitative, quantitative and systematic review methods. Results of all phases were used to develop an emergent theory around the barriers for establishing cervical screening programme and to provide evidence to enhance cervical cancer screening services to be established in Iraq. Findings: The findings from the systematic review indicated significant health inequalities for Arab Muslim women, in that no population-based cervical cancer screening programmes have been implemented in most of Western Asian and Middle Eastern Arab countries. Findings from the qualitative phase revealed gap in theoretical and practical knowledge among the health care professionals regarding cervical cancer screening programmes with a lack of the capacity and infrastructure to establish population based cervical screening programme in Kirkuk, Iraq. Also, results suggest that the health behaviour of women living in Kirkuk is influenced by cultural ‘stigma’ around the word ‘cancer’, in addition to women’s lack of awareness in relation to smear test and cervical screening. Conclusion: Women in Iraq are more likely to be diagnosed at an advanced, rather than early stage of cervical cancer. These women should be targeted by cervical cancer screening and health education programmes. Policy makers need to improve the cervical screening infrastructure and make the cervical screening service more accessible to women. The current opportunistic cervical screening services are insufficient; there is an urgent need to developing cervical cancer intervention programmes.

Orientadores: Paulo César Giraldo, Rose Luce Gomes do Amaral / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-24T16:38:40Z (GMT). No. of bitstreams: 1 Ruiz_Camila_M.pdf: 754661 bytes, checksum: 0af2005c32494829a282f4331f1aabb5 (MD5) Previous issue date: 2014 / Resumo: Os cuidados com a genitália feminina quanto à higiene pessoal é assunto de interesse de todas as mulheres. Milhares de dólares são gastos por ano com higiene, vestimentas, uso de produtos para depilação, adornos sem que se determine a eficiência, eficácia, necessidade, consequências ou resultados das mesmas. A forma, frequência e ocasiões não são claras, necessitando de fundamentação científica. Objetivo Avaliar a prática cotidiana do cuidado com a genitália feminina em médicas ginecologistas, incluindo os cuidados diários de higiene, uso de tatuagens e piercings genitais, depilação, vestimentas e uso de absorventes sanitários e hábitos sexuais.Desenho do Estudo: Estudo analítico descritivo. Questionário auto-respondido com 60 perguntas relacionadas aos cuidados diários dos genitais femininos e hábitos de vestimenta, uso de adornos e comportamento sexual foi aplicado em 220 médicas ginecologistas, no período de junho à setembro de 2013 durante congressos da especialidade. O registro e armazenamento dos dados utilizou o programa Microsoft Office Excel. Os resultados foram analisados através de estatísticas descritivas (frequências, média e desvio padrão). Resultados: A média de idade das entrevistadas era de 37,3 anos (DP±12,9), 71,3% eram brancas.A taxa de aceitação foi de 94, 6%. Quase metade (46, 8%) estava formada entre 1 e 10 anos e permaneciam fora de suas casas por períodos acima de 10 horas consecutivas (53,6%). Apesar disto,mais da metade, referiram que tomam 2 banhos por dia (55,9%), A maioria usava apenas papel para secar a vulva após as micções (66,3%).Somente 21,5% lava a região anal com água e sabão após a evacuar, e 48,6% usam desodorantes íntimos com frequentemente. A higiene genital é feita com sabonete líquido por apenas 39% das entrevistadas e 6,8% usam sabonetes bactericidas. Um quinto faz duchas vaginais, 52,7% higienizam-se antes da relação sexual e 78,5% lavam a área genital após o coito apenas com água. O protetor diário (absorventes higiênicos) é usado no período intermenstrual por 41%. Mais de 85% usam roupas íntimas de algodão apesar de que 62,7% usam calças Jeans apertadas. A maioria faz depilação genital (89,15%) e menos da metade destas (48,6%) não usam produtos de hidratação ou para evitar complicações na região. O perfil sexual mostrou que mais da metade das entrevistadas tinham frequência de relações sexuais de 1 a 3 vezes por semana, praticavam sexo oral e anal em 47,2% e 22,2% respectivamente. Mais de 29% delas relataram dor nas relações em intensidades variadas e 24,5% usam condom. / Abstract: The care of the female genitalia as personal hygiene and sexual practice are matters of interest to all women. Thousands of dollars are spent every year on hygiene, clothing, use of products for depilation, ornaments, use of erotic products, without which determine the efficiency, effectiveness, necessity, consequences or results thereof. The form, frequency and timing are unclear and require scientific foundation. Objective: To evaluate the daily practice of care for female genitalia in medical gynecologists, including higyene habits, genital tattoos ands piercings, use of sanitary pads and clothing. Study Way: A descriptive analytical study. A questionnaire was administered to 220 medical gynecologists with 60 questions self-administred , in congress of specialty in the period from june to september related to the daily care of the female genitals and habits of dress, use of ornaments and sexual behavior. The recording and storage of data used Microsoft Office Excel program. The results were analyzed using descriptive statistics (frequencies, means and standard deviations) to identify the interrelationships among the most significant variables. Results: The mean age of respondents was 37.3 years (SD ± 12.9) and 71.3% of them are white. The acceptance rate was 94,6%. Almost half (46, 8%) of the gynecologists were between 1 and 10 years of graduation, and 53.6% remain out of their homes for periods over 10 consecutive hours. Nevertheless 55.9% reported taking 2 showers a day, and 52%, washing genitals 2 times per day, in counter point to the fact that only 66.3% use paper to dry the vulva after urination. Only 21.5% wash the anal area with soap and water after bowel movements and 48.6% of them frequently use intimate deodorants. The genital hygiene with liquid soap is made by only 39% of respondents and 6.8% use antibacterial soaps. About 20% make vaginal douches on frequency and time variables, 52.7% sanitize yourself before sex and 78.5% wash the genital area after intercourse, with just water. Daily Protector (sanitary napkins) is used in the intermenstrual period by 41%. The sexual profile found that 50.9% of respondents had frequency of sexual intercourse 1-3 times a week, engaged in oral and anal sex in 47.2% and 22.2% respectively. Over 29% reported pain in varying intensities intercourse and 24.5% them use condom / Mestrado / Fisiopatologia Ginecológica / Mestra em Ciências da Saúde