Objetivo: avaliar os efeitos do tratamento com o Trifolium pratense nos sintomas menopausais em mulheres climatéricas utilizando o Índice Menopausal de Kupperman (IMK) e pelo Inventário de Satisfação Sexual Golombok e Rust versão feminina (GRISS) l. Metodologia: Este estudo foi prospectivo, randomizado, duplo cego e controlado com placebo, e realizado no setor de Ginecologia Endócrina e Climatério da Disciplina de Ginecologia do Departamento de Obstetrícia e Ginecologia do Hospital das Clínicas, da Faculdade de Medicina da Universidade de São Paulo. Foram selecionadas 100 mulheres na faixa etária de 45 a 65 anos com sintomas menopausais, com amenorréia superior há 1 ano e sem tratamento nos últimos 6 meses. Após a seleção, as mulheres foram divididas em dois grupos: Grupo I (n = 50) receberam Trifolium pratense na dose de 40 mg, 1 capsula/dia, por via oral; Grupo II (n = 50) receberam placebo (controle), contendo lactose, 1 cápsula/dia por via oral. A duração do tratamento foi de 12 meses e as mulheres foram avaliadas antes do tratamento com quatro, oito e 12 meses de tratamento, por exames clínico e laboratorial. Aplicaram-se o teste de t Student e o ANOVA para avaliar as diferenças entre os grupos. Resultados: Houve melhora significante dos sintomas após quatro meses de tratamento no IMK, principalmente, as ondas de calores, em relação aos dados antes do tratamento nos dois grupos. Não observamos melhora na avaliação da sexualidade (GRISS). Conclusão: Nossos dados sugerem que o efeito da ministração de 40mg ao dia de Trifolium pratense pode não ser superior ao do placebo, na redução dos sintomas da pós-menopausa durante um ano de estudo / Objective: to evaluate the effects of Trifolium pratense treatment on the climacteric symptoms and sexualiy in postmenopausal women through Kuppermann Menopausal Index (KMI) and the Golombok Rust Inventory of Sexual Satisfaction (GRISS), respectively. Methods: This study was prospective, randomized, double-blind and placebo-controlled study. Hundred women were selected, aged between 45 and 65 years with climacteric symptoms, with menstruation absence (amenorrhea) that was more then one year and without any treatment for last six months. After selection, women were divided into two groups: GI (n = 50) received 40 mg Trifolium pratense (one capsule per day); GII (n = 50) received placebo (control, one capsule of lactose per day). The length of treatment was 12 months and women were evaluated before and after four, eight and twelve months of treatment through clinical and laboratorial exams. The t Student test and ANOVA were applied for analyzing the differences between groups. Results: There was significant ameliorate in the symptoms after four months of treatment through the KMI, mainly in hot flashes, compared to baseline data of both groups. The sexuality evaluation did not found any difference before and after treatment in both groups. Conclusion: Our data suggested that the 40 mg Trifolium pratense effect may be not superior than placebo in relation to decrease the postmenopausal symptoms during one year of study

Introdução: Os estágios da transição menopausal e pós-menopausa fazem parte do processo de envelhecimento ovariano, se caracterizam por alterações hormonais, principalmente o hipoestrogenismo, e o aparecimento de sintomas desconfortáveis e agravos à saúde. Entre os sintomas, as alterações na qualidade do sono vêm ganhando destaque pelo grande número de morbidade relacionada a este quadro. Objetivo: Estimar a prevalência da qualidade de sono ruim e caracterizar os fatores associados em mulheres na transição menopausal e pós-menopausa. Método: Estudo observacional de corte transversal com utilização de dados secundários, que investigou a qualidade do sono por meio do Índice de Qualidade do Sono de Pittsburgh (PSQI) em 875 mulheres de 35 a 65 anos selecionadas aleatoriamente e atendidas pelo Programa de Saúde da Família de Pindamonhangaba-SP. Para pesquisa dos fatores associados foram questionadas informações sócio-demográficas, hábitos de vida, história ginecológica e de morbidade clínica, uso de medicamentos, e realizadas medidas de peso, altura e circunferência abdominal. Foram feitas análises bivariadas e multivariadas, bem como criado um modelo de regressão logística múltipla no programa Stata 8.0, utilizando um intervalo de confiança de 95%. Resultados: O sono ruim esteve presente em 45,13% das participantes e os fatores associados foram: depressão (IC95%:3,37-6,88), síndrome do ovário policístico (IC95%: 1,17-2,83), atividade física ocupacional acima da média da população estudada (IC95%:1,12-2,19), uso de medicamentos que alteram a qualidade do sono (IC95%: 1,34-22,76), e como fator protetor, consumir até 3 doses de qualquer bebida alcoólica (IC95%: 0,28-0,77).Conclusão: A prevalência de sono ruim foi alta entre as mulheres na transição menopausal e pós-menopausa, e esteve associado a este quadro a presença de morbidade como depressão e síndrome do ovário policístico, o estilo de vida relacionado ao alto nível de atividade física ocupacional e o uso de medicamentos que alteram a qualidade do sono. / Introduction: The menopausal transition and postmenopause form part of the ovarian aging process and are characterized by hormonal alterations, principally hypoestrogenism, and the appearance of troublesome symptoms and deteriorations in health. Among the symptoms, changes in sleep quality are of particular note in view of the large number of morbidities related to this condition. Objective: To estimate the prevalence of poor sleep quality and characterize associated factors in women in the menopausal transition and postmenopause. Method: An observational, cross-sectional study carried out on secondary data using the Pittsburgh Sleep Quality Index (PSQI) to investigate sleep quality in 875 women of 35-65 years of age randomly selected among women receiving care in the Family Health Program in Pindamonhangaba, São Paulo. To evaluate associated factors, the sociodemographic data of the women were recorded and questions were asked regarding lifestyle habits, gynecological history, prior clinical morbidities and use of medication. Weight, height and abdominal circumference were measured. Bivariate and multivariate analyses were performed and a model of multiple logistic regression was created in the Stata software program, version 8.0, with a 95% confidence interval. Results: In 45.13% of participants, sleep quality was poor and other associated factors included depression (95%CI: 3.37-6.88), polycystic ovary syndrome (95%CI: 1.17-2.83), occupational physical activity above the average for the population studied (95%CI: 1.12-2.19), and use of medication that alters sleep quality (95%CI: 1.34-22.76). Consuming up to three doses of any alcoholic beverage per week was identified as a protective factor (95%CI: 0.28-0.77). Conclusion: The prevalence of poor quality sleep was high among women in the menopausal transition and postmenopause and was associated with the presence of morbidities such as depression and polycystic ovary syndrome, a lifestyle that includes a high level of occupational physical activity and the use of medication that alters sleep quality.

RESUME Introduction: Le cancer du sein (CS) est le cancer le plus fréquent chez la femme. Le risque de CS est influencé par de nombreux facteurs. Le traitement hormonal de la ménopause (THM) est l’un d’entre eux. Le risque de CS associé au THM varie probablement en fonction de la population traitée, du type de traitement utilisé, de la durée du traitement et du moment où il est instauré par rapport au début de la ménopause. Il existe des alternatives au THM pour soulager les symptômes de la ménopause. Quelques traitements ont montré une certaine efficacité mais présentent des effets secondaires. D’autres traitements doivent faire l’objet d’études plus approfondies. Objectifs: 1) Contribuer à l’analyse de l’influence du THM sur le CS. 2) Contribuer à l’amélioration de la qualité de vie des patientes ayant eu un CS. Résultats: 1) Nous avons analysé l’évolution de l’incidence du CS et des ventes de THM en Belgique et montré une corrélation entre ces deux paramètres. Nous avons réalisé une revue systématique des études analysant l’association entre l’incidence du CS et l’utilisation de THM. Toutes présentaient des limitations et leur hétérogénéité les rendait difficilement comparables. Nous avons analysé l’évolution des ventes de THM en Europe et montré une diminution importante au cours de la dernière décennie dans l’ensemble des pays étudiés. Nous avons analysé l’évolution de l’incidence du CS et de l’utilisation des THM dans différents pays européens et n’avons pas trouvé d’association entre ces deux paramètres. Nous avons réalisé une revue systématique des études évaluant l’influence du THM sur les caractéristiques du CS et montré que les CS développés sous THM n’étaient pas de meilleur pronostic. 2) Nous avons réalisé deux revues systématiques sur la sécurité d’emploi des THM et des traitements non hormonaux de la ménopause chez les femmes ayant eu un CS. Nous avons montré que le CS représentait une contre-indication au THM et que peu de données existaient concernant les traitements alternatifs. Nous avons mené deux études concernant l’utilisation de traitements de la ménopause chez les femmes ayant eu un CS et montré qu’une proportion importante des femmes ayant eu un CS présentait des symptômes de la ménopause mais que peu d’entre elles utilisaient un traitement. Certains de ces traitements pouvaient potentiellement réduire l’efficacité de leur traitement contre le CS. Conclusions: 1) L’influence exacte du THM sur l’incidence du CS reste difficile à déterminer. D’autres facteurs interviennent également. Nous avons montré l’importance du temps lorsqu’on observe l’évolution de deux paramètres. 2) Les traitements sûrs et efficaces des symptômes de la ménopause chez les femmes ayant eu un CS sont limités. La qualité de vie des patientes ménopausées, ayant souffert d’un CS, peut cependant être nettement améliorée. / ABSTRACT Introduction: Breast cancer (BC) is the most common cancer in women. BC risk is influenced by many factors. Menopausal hormone therapy (MHT) is one of them. BC risk associated with MHT may vary depending on the treated population, the type of MHT used, the treatment duration and the delay between the beginning of the treatment and the onset of the menopause. There are alternatives to MHT for the treatment of menopausal symptoms. Some of them have shown some efficacy but have side-effects. Others need further research. Objectives: (1) To contribute to the analysis of the influence of MHT on BC; (2) to contribute to the improvement of the quality of life of BC patients. Results: (1) We analysed changes in BC incidence and MHT sales in Belgium and showed a correlation between these two parameters. We made a systematic review of studies analysing the association between BC incidence and MHT use. All the studies had limitations and were heterogeneous, making them difficult to compare. We analysed changes in MHT sales in Europe and showed an important decrease during the last decade in all the studied countries. We analysed changes in BC incidence and MHT sales in several European countries and found no association between these two parameters. We made a systematic review of studies assessing the influence of MHT on BC characteristics and showed that cases of BC developed under MHT did not have a better prognosis. (2) We made two systematic reviews on the safety of MHT and non-hormonal treatments in BC patients. We showed that BC was a contra-indication to MHT and that few data on alternative treatments were available. We conducted two studies on the use of treatments to alleviate menopausal symptoms in BC patients and showed that an important proportion of these women suffered menopausal symptoms but that few of them were using a treatment. Some of these treatments could reduce the efficacy of their BC treatment. Conclusions: (1) The exact influence of MHT on BC incidence is difficult to evaluate. Other factors are also involved. We showed that long follow-ups are needed when analysing time trends. (2) Efficient and safe treatments for menopausal symptoms in BC patients are limited. However, the quality of life of BC patients may be improved. / Doctorat en Sciences biomédicales et pharmaceutiques (Médecine) / info:eu-repo/semantics/nonPublished

The percentage of obese adults in the U.S. has more than doubled since the late 1970.s. A large percentage of adults, especially women, are trying to lose weight at any given time. Although recommended weight-loss strategies combine reduced caloric intake with physical activity, the actual strategies used can vary. This dissertation uses a mixed-methods approach to investigate weight, weight loss, and body image in post-menopausal women ages 50 to 64. Quantitative data were analyzed from the National Health and Nutrition Examination Survey (NHANES) and semi-structured interviews with 81 women in Kentucky. Qualitative data was gathered from in-depth interviews with eight Kentucky women focusing on life-course factors that affect weight and perception of weight. Over 70% of the Kentucky subjects had attempted weight loss in the last year; 47% of the NHANES women had done so. The most common weight-loss strategies of the Kentucky sample were .ate less food. and .exercised.; in the NHANES samples, the most common choices were .ate less food. and .ate less fat.. In the Kentucky sample, feeling that one is in control of one.s own weight was associated with having joined a weight loss program. Exercise and restaurant frequency and were the most significant predictors of the weight outcomes investigated. Increased exercise was associated with an increased likelihood of being normal weight, gaining less than 10 pounds in the last 10 years, and gaining less than 30 pounds since age 25; decreased restaurant frequency was associated with all of these outcomes in the Kentucky sample. The in-depth interviews revealed that making good food choices, having others as role models, and the desire to be attractive were seen as positive influences on weight. The consumption of .bad. foods, stress, health problems that prevent exercise, menopause, and age were seen as negative influences. The qualitative data also strongly suggested that childhood weight, and past reactions of others to one.s weight, influence perception of current weight. It is the responsibility of women and the public health sector to make the most of these acknowledged motivators and minimize the perceived barriers to reverse the increasing obesity levels in the U.S.

acase@tulane.edu

There is an increasing awareness in the food industry about the role that proper nutrition plays in maintaining health and preventing disease. Women especially have always been interested in nutrition and its impact on their well-being. This awareness has placed more pressure on the food industry to provide a greater variety of nutritious and wholesome products which has led to the development of a new field in the food industry, called functional foods. These are food products that apart from the micro- and macronutrients that it already provides have additional important physiologically active functions that enhance health. These active components, called phytochemicals (from plant sources) and zoochemicals (from animal sources) have changed the role of diet in health. Functional foods can, by nature or design, bridge the traditional gap between food and medicine and thereby provide consumers with the opportunity to become involved in their own health care. One of these functional foods that have been receiving increased attention and research is soy. Apart from other health benefits of soy, such as cholesterol reduction and bone strengthening, scientific evidence has shown that soy can be used as an alternative for hormone replacement therapy (HRT). The increased interest in the latter can be ascribed to the changed attitude of women, as well as evidence of the side effects of conventional hormone replacement therapies. Consumer research in the nutraceutical area is, however, still in its infancy stage. Objective: The main objective of this study was thus to assess South African consumers' opinion of the potential health benefits of soy and soy products as an alternative for HRT. To attain this main objective, the following specific objectives were stated: To determine, by means of a consumer questionnaire, the percentage of South African consumers who are aware of soy. To determine, by means of an attitude scale, the attitudinal disposition of South African consumers towards the potential health benefits of soy and soy products as an alternative for HRT. To determine South African consumers' opinions regarding the menopausal related health benefits of soy. To determine whether there is a relation between respondents who Eat/drink soy and their opinion of the potential health benefits of soy. To determine whether there is a relation between respondents who never use soy and their opinion of the bone strengthening benefit of soy. To determine whether there is a relation between respondents' opinion of the health benefits of soy and their opinions of soy as an alternative for HRT and reliever of menopausal symptoms, respectively. Methods: In this study, consumers' opinion regarding the health benefits of soy was evaluated using a questionnaire. Respondents were randomly selected from nine metropolitan, as well as rural areas in South Africa, representing the four main race groups, namely whites, blacks, coloureds and Indians. The total sample size of the metropolitan and rural subjects was 3001. A sub-dataset was created which included female respondents that have heard of soy before and were premenopausal (35-44 years) and post-menopausal (50-59 years) of age. Thus, the total number of respondents used for further statistical analyses was 825. The respondents expressed their opinions of the health benefits of soy on a five-point hedonic (Likert) scale which was adapted to a three-point scale for easier interpretation of the tables. Results: 1. Of the 3 001 respondents, 2 437 (80%) were aware of soy. 2. A mean attitudinal disposition score of 2.47 on a three-point scale indicated a neutral to positive attitudinal disposition of the South African consumer population towards the potential health benefits of soy and soy products as alternative for HRT. No practically significant differences were found between the mean values of each statement, which indicated that no specifically strong opinions were expressed between different races or between different age groups. 3. Of all the consumers surveyed and those who did express a specific opinion, 72% agreed that soy has many health benefits compared to only 7% who disagreed. Although 34% of South Africans expressed a positive opinion when asked if soy can be used as alternative for HRT, the majority (46%) of the population had a neutral opinion. Forty-two percent of the consumers who held an opinion regarding soy as reliever of menopausal symptoms were positive, 35% had a neutral opinion and 23% of South Africans did not agree that soy can relieve menopausal symptoms. 4. A relation, although not of practical significance, was found between respondents who eat/drink soy and their opinion of the health benefits of soy. Of the respondents who indicated that they eat/drink soy, the majority agreed that soy has many health benefits. The respondents who disagreed when asked if they eat/drink soy, still expressed an overall positive opinion when asked whether soy has many health benefits. 5. A relation, although not of practical significance, was found between respondents who never use soy and their opinion of the bone strengthening benefit of soy. Of those who indicated that they use soy, the majority agreed that soy has a bone strengthening benefit. On the contrary, only 43% of those who agreed that they never use soy were positive about the bone strengthening benefit of soy, whereas 37% held a neutral opinion and 20% expressed a negative opinion. 6. The relation between respondents' opinion of the overall health benefits of soy and their opinion of soy as alternative for HRT and reliever of menopausal symptoms was of practical significance. Of the respondents who did not agree that soy has many health benefits, the majority expressed a negative opinion of soy as an alternative for HRT. Of those who agreed that soy has many health benefits, 45% expressed a neutral opinion and 44% a positive opinion of soy as alternative for HRT. Almost half (47%) of the respondents who agreed that soy does have many health benefits, expressed a neutral opinion when asked if soy can relieve menopausal symptoms, whereas only 30% had a positive opinion in this regard. The majority (86%) of the respondents who disagreed that soy has many health benefits, also expressed a negative opinion of soy as reliever for menopausal symptoms Conclusion: The results of this study indicate that 80% of the South African consumer population are aware of soy and that South African consumers have a neutral to positive attitudinal disposition towards the potential health benefits of soy. Respondents did not express a particularly strong opinion regarding several health benefits of soy. It may be hypothesized that they are not informed well enough on the health benefits of soy as to take a stand and to form a definite opinion. Neither different race groups, nor pre- or post-menopausal women differ significantly in the frequency of their opinions, indicating that in this study, race and age did not have a practical significant influence on opinion of the health benefits of soy. Of all those surveyed and who did express a specific opinion, 72% agreed that soy has many health benefits, which is almost the same percentage (74%) as American consumers who perceive soy products as healthy as according to the United Soybean Board (USB) National Report (2003-2004:4). A survey by Adams (2001:433) reported that 71% of American consumers believed that plant-derived HRT have fewer risks and can thus be used as a safe alterative for conventional HRT. According to the results of the present study only 34% of South African consumers expressed a positive opinion when asked if soy can be used as an alternative for HRT. Insufficient evidence on the safety and efficacy of the potential health benefits of soy, as well as a lack of consumer education in South Africa, could be the reason for this uncertainty among XIV South African consumers. While only 26% of American consumers are aware that soy might relieve menopausal symptoms (USB National Report, 2003- 2004:4), results of the current study found that 42% of South Africans were of opinion that soy can relieve menopausal symptoms. A relation, although not of practical significance, was found between respondents who eat/drink soy and their opinion of the health benefits of soy. This can be an indication that whether or not the South African consumer population consume soy doesn't have an influence on their opinion of soy's health benefits in practice. The relation found between respondents who never use soy and their opinion of the bone strengthening benefit of soy were not of practical significance. This can be an indication that whether or not South Africans use soy does not influence their opinion of the bone strengthening benefit of soy in practice. Furthermore, a practically significant relation was found between respondents' opinion of the overall health benefits of soy and their opinion of soy as alternative for HRT and reliever of menopausal symptoms, respectively. Interestingly, respondents who expressed a positive opinion regarding the health benefits of soy did not have a convincingly positive opinion of soy as alternative for HRT and as reliever of menopausal symptoms. They expressed a more neutral opinion. As expected, consumers that were not of opinion that soy has certain health benefits, also disagreed when asked if soy can be used as an alternative for HRT or as reliever of menopausal symptoms. Although the causes for the respondents' opinion or uncertainty were not determined in this study, it can be hypothesised that it may be due to lack of standardisation of evidence on the safety and efficacy of alternative hormone replacement therapies. Further studies are still needed to determine the contributing factors which influence consumers' opinion or lack of opinion on soy. If consumers are not educated about the benefits and disadvantages of soy as alternative for HRT, they cannot make intelligent decisions and choices as to whether or not to use soy as alternative for HRT. / Thesis (M. Consumer Science)--North-West University, Potchefstroom Campus, 2004.

There is an increasing awareness in the food industry about the role that proper nutrition plays in maintaining health and preventing disease. Women especially have always been interested in nutrition and its impact on their well-being. This awareness has placed more pressure on the food industry to provide a greater variety of nutritious and wholesome products which has led to the development of a new field in the food industry, called functional foods. These are food products that apart from the micro- and macronutrients that it already provides have additional important physiologically active functions that enhance health. These active components, called phytochemicals (from plant sources) and zoochemicals (from animal sources) have changed the role of diet in health. Functional foods can, by nature or design, bridge the traditional gap between food and medicine and thereby provide consumers with the opportunity to become involved in their own health care. One of these functional foods that have been receiving increased attention and research is soy. Apart from other health benefits of soy, such as cholesterol reduction and bone strengthening, scientific evidence has shown that soy can be used as an alternative for hormone replacement therapy (HRT). The increased interest in the latter can be ascribed to the changed attitude of women, as well as evidence of the side effects of conventional hormone replacement therapies. Consumer research in the nutraceutical area is, however, still in its infancy stage. Objective: The main objective of this study was thus to assess South African consumers' opinion of the potential health benefits of soy and soy products as an alternative for HRT. To attain this main objective, the following specific objectives were stated: To determine, by means of a consumer questionnaire, the percentage of South African consumers who are aware of soy. To determine, by means of an attitude scale, the attitudinal disposition of South African consumers towards the potential health benefits of soy and soy products as an alternative for HRT. To determine South African consumers' opinions regarding the menopausal related health benefits of soy. To determine whether there is a relation between respondents who Eat/drink soy and their opinion of the potential health benefits of soy. To determine whether there is a relation between respondents who never use soy and their opinion of the bone strengthening benefit of soy. To determine whether there is a relation between respondents' opinion of the health benefits of soy and their opinions of soy as an alternative for HRT and reliever of menopausal symptoms, respectively. Methods: In this study, consumers' opinion regarding the health benefits of soy was evaluated using a questionnaire. Respondents were randomly selected from nine metropolitan, as well as rural areas in South Africa, representing the four main race groups, namely whites, blacks, coloureds and Indians. The total sample size of the metropolitan and rural subjects was 3001. A sub-dataset was created which included female respondents that have heard of soy before and were premenopausal (35-44 years) and post-menopausal (50-59 years) of age. Thus, the total number of respondents used for further statistical analyses was 825. The respondents expressed their opinions of the health benefits of soy on a five-point hedonic (Likert) scale which was adapted to a three-point scale for easier interpretation of the tables. Results: 1. Of the 3 001 respondents, 2 437 (80%) were aware of soy. 2. A mean attitudinal disposition score of 2.47 on a three-point scale indicated a neutral to positive attitudinal disposition of the South African consumer population towards the potential health benefits of soy and soy products as alternative for HRT. No practically significant differences were found between the mean values of each statement, which indicated that no specifically strong opinions were expressed between different races or between different age groups. 3. Of all the consumers surveyed and those who did express a specific opinion, 72% agreed that soy has many health benefits compared to only 7% who disagreed. Although 34% of South Africans expressed a positive opinion when asked if soy can be used as alternative for HRT, the majority (46%) of the population had a neutral opinion. Forty-two percent of the consumers who held an opinion regarding soy as reliever of menopausal symptoms were positive, 35% had a neutral opinion and 23% of South Africans did not agree that soy can relieve menopausal symptoms. 4. A relation, although not of practical significance, was found between respondents who eat/drink soy and their opinion of the health benefits of soy. Of the respondents who indicated that they eat/drink soy, the majority agreed that soy has many health benefits. The respondents who disagreed when asked if they eat/drink soy, still expressed an overall positive opinion when asked whether soy has many health benefits. 5. A relation, although not of practical significance, was found between respondents who never use soy and their opinion of the bone strengthening benefit of soy. Of those who indicated that they use soy, the majority agreed that soy has a bone strengthening benefit. On the contrary, only 43% of those who agreed that they never use soy were positive about the bone strengthening benefit of soy, whereas 37% held a neutral opinion and 20% expressed a negative opinion. 6. The relation between respondents' opinion of the overall health benefits of soy and their opinion of soy as alternative for HRT and reliever of menopausal symptoms was of practical significance. Of the respondents who did not agree that soy has many health benefits, the majority expressed a negative opinion of soy as an alternative for HRT. Of those who agreed that soy has many health benefits, 45% expressed a neutral opinion and 44% a positive opinion of soy as alternative for HRT. Almost half (47%) of the respondents who agreed that soy does have many health benefits, expressed a neutral opinion when asked if soy can relieve menopausal symptoms, whereas only 30% had a positive opinion in this regard. The majority (86%) of the respondents who disagreed that soy has many health benefits, also expressed a negative opinion of soy as reliever for menopausal symptoms Conclusion: The results of this study indicate that 80% of the South African consumer population are aware of soy and that South African consumers have a neutral to positive attitudinal disposition towards the potential health benefits of soy. Respondents did not express a particularly strong opinion regarding several health benefits of soy. It may be hypothesized that they are not informed well enough on the health benefits of soy as to take a stand and to form a definite opinion. Neither different race groups, nor pre- or post-menopausal women differ significantly in the frequency of their opinions, indicating that in this study, race and age did not have a practical significant influence on opinion of the health benefits of soy. Of all those surveyed and who did express a specific opinion, 72% agreed that soy has many health benefits, which is almost the same percentage (74%) as American consumers who perceive soy products as healthy as according to the United Soybean Board (USB) National Report (2003-2004:4). A survey by Adams (2001:433) reported that 71% of American consumers believed that plant-derived HRT have fewer risks and can thus be used as a safe alterative for conventional HRT. According to the results of the present study only 34% of South African consumers expressed a positive opinion when asked if soy can be used as an alternative for HRT. Insufficient evidence on the safety and efficacy of the potential health benefits of soy, as well as a lack of consumer education in South Africa, could be the reason for this uncertainty among XIV South African consumers. While only 26% of American consumers are aware that soy might relieve menopausal symptoms (USB National Report, 2003- 2004:4), results of the current study found that 42% of South Africans were of opinion that soy can relieve menopausal symptoms. A relation, although not of practical significance, was found between respondents who eat/drink soy and their opinion of the health benefits of soy. This can be an indication that whether or not the South African consumer population consume soy doesn't have an influence on their opinion of soy's health benefits in practice. The relation found between respondents who never use soy and their opinion of the bone strengthening benefit of soy were not of practical significance. This can be an indication that whether or not South Africans use soy does not influence their opinion of the bone strengthening benefit of soy in practice. Furthermore, a practically significant relation was found between respondents' opinion of the overall health benefits of soy and their opinion of soy as alternative for HRT and reliever of menopausal symptoms, respectively. Interestingly, respondents who expressed a positive opinion regarding the health benefits of soy did not have a convincingly positive opinion of soy as alternative for HRT and as reliever of menopausal symptoms. They expressed a more neutral opinion. As expected, consumers that were not of opinion that soy has certain health benefits, also disagreed when asked if soy can be used as an alternative for HRT or as reliever of menopausal symptoms. Although the causes for the respondents' opinion or uncertainty were not determined in this study, it can be hypothesised that it may be due to lack of standardisation of evidence on the safety and efficacy of alternative hormone replacement therapies. Further studies are still needed to determine the contributing factors which influence consumers' opinion or lack of opinion on soy. If consumers are not educated about the benefits and disadvantages of soy as alternative for HRT, they cannot make intelligent decisions and choices as to whether or not to use soy as alternative for HRT. / Thesis (M. Consumer Science)--North-West University, Potchefstroom Campus, 2004.

Made available in DSpace on 2015-07-22T20:50:22Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-04-30. Added 1 bitstream(s) on 2015-08-11T03:25:43Z : No. of bitstreams: 1 Publico-10758.pdf: 1690333 bytes, checksum: d7a29a28113d0d3356c99f9cd179cc12 (MD5) / Objetivo: Analisar as diferenças na aferição da pressão arterial de mulheres na transição-menopausal e na pós-menopausa, levando-se em conta o índice de massa corpórea (IMC), categorizado em normal quando se apresenta entre 18 e 25 Kg/m², e obesa quando maior ou igual a 30Kg/m². Utilizamos, para tanto, esfigmomanômetros com manguitos com duas diferentes medidas, adaptados ao biotipo físico de cada mulher. Métodos: Avaliamos 203 mulheres na transição menopausal e na pós-menopausa. Os dados clínicos foram obtidos por meio de entrevistas, sendo aferidas as pressões arteriais em uma única visita, as quais foram registradas em planilhas. Calcularam-se a média e o desvio-padrão das variáveis epidemiológicas e clínicas, bem como da pressão arterial sistólica e diastólica. Material: Foram utilizados aparelhos da Marca Missouri aneróide, modelo de parede, para as mulheres selecionadas com peso normal e obesas. O aparelho de pressão para as com peso normal apresenta bolsa interna de látex medindo 22 por 15cm e manguito de 54 por 15cm (aparelho de pressão convencional). O aparelho usado para as pacientes obesas apresenta bolsa interna de látex medindo 30 por 15cm e manguito de 70 por 15cm (aparelho de pressão não convencional). Ambos os aparelhos têm desvio de circunferência, sendo convencional com 22 a 28cm e, o não convencional, com 31 a 39cm. Todos foram calibrados pelo INMETRO, conforme norma da ABNT. Resultados: A idade média foi de 54,6 anos; a estatura média foi de 1,5m e o peso médio de 72,3Kg. Dentre os biotipos avaliados e as diversas medidas encontradas, deparamo-nos com pressão arterial sistólica média de 122,9mmHg em mulheres com peso normal e de 141,4mmHg em as mulheres obesas. A média das medidas da pressão arterial diastólica variou de 79,5mmHg a 83,7mmHg para as mulheres com peso normal e de 84,6mmHg a 90,4mmHg para as obesas. Conclusões: 1- Para as mulheres obesas, não houve diferença significante quanto às medidas da pressão arterial sistólica e diastólica em relação ao diâmetro do braço utilizado para a medida (esquerdo ou direito) e a posição (sentada ou deitada). Utilizando o aparelho não convencional, houve diminuição significante da pressão arterial, tanto sistólica quanto diastólica, em comparação às medidas realizadas com o aparelho convencional. 2 - Nas mulheres com peso normal houve diferença significante quanto à posição sentada ou deitada e ao tipo de aparelho utilizado, convencional e não convencional, porém não houve diferença significante quanto ao braço utilizado, direito ou esquerdo. / Objective: The aim of this study was the measurement of the arterial blood pressure of perimenopausal or menopausal women compared to the body mass index (BMI). We studied two groups of women: normal weight 18-25 Kg/m2 and obese having . 30 Kg/m2 of BMI. Methods: We analyzed 203 women of the Climacteric outpatient clinic. The interviewer obtained the clinical data and measured the arterial pressure using the sphygmomanometer (Missouri, wall model). The measure the blood pressure was realized through the use of sphygmomanometer with different cuff width being specific for the each women biotype and following the Who-Working Group on the use and interpretation of anthropometric indicator of nutrition status. We used the cuff width with 22 x 15cm for normal weight and 70X15cm for obese women. Results: The women presented as media valor: Age = 54.6; height = 1.50 m, weight = 72.3 Kg. The normal weight women had media diastolic blood pressure of 122.9 and the obese group had 144.4 mmHg. The systolic pressure of the normal weight group and obese was respectively 84.6 and 90.4 mmHg. Conclusion: There were no differences on the normal weight group in relation to the blood pressure results. There was a decrease of the blood pressure results on the obese group when we used the sphygmomanometer with adequate cuff in comparison to blood pressure obtained with sphygmomanometer for normal weight. / TEDE / BV UNIFESP: Teses e dissertações

Abstract The effectiveness of intrauterine insemination (IUI) combined with controlled ovarian hyperstimulation (COH) in the treatment of subfertility was investigated in the present study. For this purpose the prognostic factors associated with success of clomiphene citrate (CC)/human menopausal gonadotrophin (HMG)/IUI were identified in 811 treatment cycles. Furthermore, a long gonadotrophin-releasing hormone agonist (GnRHa)/HMG stimulation protocol was compared with a standard CC/HMG protocol. In addition, the usefulness of alternative insemination techniques including fallopian tube sperm perfusion (FSP) and intrafollicular insemination (IFI) was investigated. Finally, the obstetric and perinatal outcome of pregnancies after COH/IUI was examined and compared with those of matched spontaneous and in vitro fertilization(IVF) pregnancies. Female age, duration of infertility, aetiology of infertility, number of large preovulatory follicles and number of the treatment cycle were predictive as regards pregnancy after CC/HMG/IUI. The highest pregnancy rate (PR) was obtained in women of < 40 years of age with infertility duration ≤ 6 years, who did not suffer from endometriosis. A multifollicular ovarian response to CC/HMG resulted in better treatment success than a monofollicular response, indicating the necessity of COH combined with IUI. A significantly higher PR was achieved in the first treatment cycles compared with the others, and 97% of the pregnancies were obtained in the first four treatment cycles. The PR per cycle did not differ significantly between a long GnRHa/HMG and a standard CC/HMG protocol, but the average medication expense of GnRHa/HMG stimulation was four times the cost of CC/HMG stimulation. Therefore, the routine use of a long GnRHa/HMG protocol in IUI treatment remains questionable. The FSP procedure was easy to perform by using a paediatric Foley catheter. The success rate in couples with either FSP or standard IUI did not differ significantly, although there was a trend towards a lower PR in the FSP group. The FSP technique should not replace the simpler and less time-consuming IUI technique in routine use. The IFI technique was also simple to perform and convenient for patients. However, only one normal singleton intrauterine pregnancy resulted in 50 IFI-treated women, indicating that IFI is inefficacious for treating subfertility. The IUI parturients differed from average Finnish parturients in respect to higher maternal age, more frequent primiparity and a higher incidence of multiple pregnancies. The use of antenatal care services was significantly lower in IUI singleton pregnancies compared with IVF singletons, although there were no more complications in IVF pregnancies. The hospitalization and Caesarean section rates were generally high in all pregnancies. The mean birthweight of IUI singletons was significantly lower than that in spontaneous pregnancies, but comparable to that in IVF pregnancies. However, the incidence of preterm birth, low birth weight and other variables describing the outcome of infants were similar in IUI, IVF and spontaneous pregnancies. In summary, the IUI procedure itself does not seem to affect adversely the obstetric and perinatal outcome of pregnancy, and patient characteristics and multiplicity may be more important in this respect.

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