The purpose of this study Has to determine attitudes toward the oral contraceptive as related to religious, regional, educational, age, sex, and marital status. The instrument utilized was a 30 item summated scale which was completed by 240 high school and college students from the Intermountain and Great Plains regions. The findings indicated a very large range or opinion regarding the pill. Attitudes were found to be related to religion, region, educational attainment, and marital status. Age and sex were not related to attitudes toward the pi11.

Women seem to be largely protected against certain ‘welfare disorders’ such as cardiovacular disease and osteoporosis, during their fertile years.The metabolic changes observed during women’s non-menstrual states, i.e. during pregnancy, after the menopause and during use of oral contraceptives, indicate the importance of sex steroids and an undisturbed biological rhythm. Treatment with monophasic, combined oral contraceptives constitutes a model for the non-cyclic state.Growth hormone (GH) is a pituitary hormone that has major metabolic effects. The pattern of GH exposure to the target organ is of vital importance for the effects and changes in rhythm could possibly induce metabolic changes.Growth hormome, cholecystokinin (CCK), osteocalcin and angiotensinogen were used as markers for metabolic effects and the concentrations in serum were recorded in women during non-menstrual states. The clinical material comprised a total of 60 women: 18 healthy non-pregnant, 25 pregnant, one lactating woman and 16 postmenopausal women. Using a portable pump and a non-thrombogenic venous catheter, blood samples could be collected at 30-min intervals during 24-h periods. Furthermore, the effects of estrogen and GH in the regulation of angiotensinogen were investigated in an experimental model in the rat.Oral contraceptives were found to alter the secretion of GH towards a pattern of lower and more frequent peaks, though the total amount secreted during 24 h was unchanged. Oral contraceptives seem to induce a suppression of the 24-h concentrations of CCK, which may be important with respect to weight gain in some women. Osteocalcin in serum display a significant circadian variation. This emphasizes the need for careful timing of single point measurements and the value of continuous blood sampling. Oral contraceptives may reduce osteocalcin serum concentrations. The long-term effects on bone are unknown. During late pregnancy osteocalcin levels are extremely low, which could indicate osteoblast inhibition and reduced bone turnover. The mode of GH administration is important for the plasma concentration of angiotensinogen in the non-pregnant rat. Estrogen effects on this protein may be mediated via a modification of GH secretion. Oral contraceptives not only increase angiotensinogen concentrations in serum but also markedly enhance their variability. Further studies are needed to elucidate the relation between the individual pattern of angiotensinogen and hypertension. / <p>S. 1-42: sammanfattning, s. 43-88: 6 uppsatser</p> / digitalisering@umu

Formål: Vurdere om etterutdanningen, som gir helsesøstre og jordmødre rekvireringsrett for p-piller til jenter i alderen16 til og med 19 år, har bidratt til økte kunnskaper om p-piller, endret holdning til ungdom og seksualitet og økt interesse for å tilby veiledning i samliv og seksualitet. Metode: Datamaterialet er fra en tidligere undersøkelse innhentet ved bruk av spørreskjemaer blant helsesøstre og jordmødre før og etter kvalifiserende etterutdanning. Resultater: Svarprosenten var 94. Studentene har tilegnet seg signifikant mer kunnskap om p-pillers virkning og fysiske og psykiske bivirkninger, men de har ikke tilegnet seg signifikant mer kunnskap om risiko for alvorlige sykdommer ved p-pillebruk. Etter kurset var det 58 og 50 % som svarte at tenåringsjenter trenger informasjon om faren for blodpropp i henholdsvis bein og lunger ved bruk av p-piller. Studentene var relativt liberale i sitt syn på ungdom og seksualitet før kurset og dette hadde ikke endret seg signifikant etter kurset. Etter kurset var studentene signifikant mer positive til å tilby veiledning i samliv og seksualitet. Konklusjon: Resultatene viser at målet om at kurset skulle gi studentene faglig oppdatering er bare delvis nådd. Studentene er blitt bedre kvalifisert til å informere om p-pillers virkning og fysiske og psykiske bivirkninger, mens deres kunnskap om risiko for alvorlige sykdommer ved p-pillebruk er uforandret etter kurset. Studentene viser etter kurset signifikant større interesse for å tilby veiledning i samliv og seksualitet / Purpose: To examine whether the qualifying postgraduate course, which authorizes public health nurses and midwives to prescribe oral contraceptives to teenage girls 16–19 years of age has increased the students’ knowledge of oral contraceptives, contributed to changing their attitude to adolescence and sexuality, and increased their motivation for offering teenage girls counselling in sexuality and sexual relationships.Method: The data set used for this study is a previously existing survey collected among public health nurses and midwives through questionnaires administered before and after they completed the course.Results: The response rate was 94 %. The students significantly increased their knowledge about effects and physical and psychological side effects of using oral contraceptives, but did not about the risk of serious diseases that accompanies oral contraceptive use. After the course, 58% and 50 % of the students found it necessary to inform teenage girls about the risk of blood clots in legs and lungs, respectively, when using oral contraceptives. The students’ attitudes towards youth and sexuality were quite liberal before the course and the course did not significantly change those attitudes. Moreover, students were significantly more positive about offering teenage girls counselling regarding sexual relationships and sexuality.Conclusion: The results demonstrate that the purpose of the course, i.e. upgrading students’ qualifications, is only partly successful. Although the students are significantly better qualified to inform teenage girls about oral contraceptives effects and their side effects, their knowledge about the risk of serious diseases did not increase significantly. The students show significantly more interest in offering counselling about sexual relationships and sexuality after completing the course. / <p>ISBN 978-91-85721-71-9</p>

Objectifs et hypothèses :Cette thèse a pour objectif d'explorer les causes de la non observance en contraception orale qui se traduit par un nombre important d'IVG chez des femmes pourtant sous contraception. Nous avons formulé 3 hypothèses : il existe des différences significatives entre les femmes présentant des difficultés d'adhésion thérapeutique et celles qui n'en présentent pas. La 2ème hypothèse a trait à l'existence de relations significatives entre les causes de non observance et la motivation générale. La 3ème hypothèse énonce l'existence de différences significatives entre les moyennes des deux groupes concernant les causes de non observance, la motivation générale et ses différentes dimensions. Population : Elle est composée de 50 femmes âgées de 20 à 55 ans utilisatrices de la contraception orale, (soit deux groupes : 25 femmes présentant des difficultés d'observance et 25 femmes ne présentant pas des difficultés d'observance). Instruments : Deux questionnaires ont été mis au point et utilisés : 1) Un questionnaire sur l'observance en contraception orale et une échelle d'évaluation des causes de non observance en contraception orale. 2) Une échelle de Motivation Globale EMG-28 destinée à l’évaluation du degré de motivation à l'observance de la contraception orale en examinant les degrés d'auto-détermination de la motivation dans la vie en général. Résultats : Les résultats indiquent l'existence de causes de non observance liées à l'utilisatrice (oublis, fausses croyances, peur des effets indésirables, manque d'information), à la contraception orale (routine, lassitude, contrainte de la prise journalière) et à la relation entre le prescripteur et l'utilisatrice (qualité de l'information donnée, relation thérapeutique, écoute, logique de prescription). Conclusion : Le processus d'utilisation de la contraception orale se révèle très complexe. Une prise en charge motivationnelle s'avère nécessaire chez les femmes en situation d'échec de contraception, comme nous le montrons avec les deux cas cliniques présentés. / Objectives and assumptions : This thesis aims explore the causes of non adherence in oral contraception which lead to TOP among women however under contraception. We formulated 3 assumptions: there are significant differences between the women presenting adherence problems and those without problems. The 2nd assumption supposes the existence of significant relations between the causes of non adherence and the general motivation. The 3rd assumption states the existence of significant differences between the averages of the two groups concerning the causes in non adherence, the general motivation and its various components. Population : A survey was carried out based on a sample of 50 women users of oral contraception in Amiens, including a group of 25 women which exhibit adherence problems. Tools : Two questionnaires were developed within the framework of this thesis, 1) A questionnaire on adherence in oral contraception and a scale for the evaluation of the causes of non adherence in oral contraception. 2) A Scale of Global Motivation EMG28 intended to evaluate the degree of motivation for adherence to oral contraception by examining the self-determination degree of motivation in life in general. Results : Collected data confirm the assumptions posed. It reveals existence of causes of non observance related on the user (missing pills, beliefs, fear of undesirable effects, information lack, on the oral contraception (routine, lassitude, constraints …) and the relation between the prescriber and the user (therapeutic relation, quality of information given, model of prescription). Conclusion : The process of use of oral contraception appears very complex. A motivational therapy is necessary among women in situation of failure of contraception, as we show it with clinical cases presented.

Made available in DSpace on 2016-04-28T14:16:24Z (GMT). No. of bitstreams: 1 Joelma Ramos Santana.pdf: 1423651 bytes, checksum: 8780200329c93a76a016c2383c8ba409 (MD5) Previous issue date: 2016-03-11 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The present study sought to analyze contextual and historiographical aspects related with the diffusion of oral contraception, particularly among women, along the period of its introduction and initial commercialization in Brazil (1962-1972). Therefore we analyzed how the information on the mode of action of the pill on the female body, related implications and alleged risks and benefits was divulgated. For that purpose the sources used were magazines and journals commonly read at that time and the biology textbooks used in secondary schools. The result was a mapping of the contemporary scientific ideas on oral contraception and the socio-historical framework that circumscribed its divulgation. Our study shows that while the arrival of the pill in Brazil was a cause of heated debate, it dealt less with scientific than with moral, political and religious issues. The school textbooks, in turn, continued to convey information on reproductive anatomy and physiology outdated in more than 50 years. If mentioned at all, the possibility to control fertility was discussed within the context of eugenic, hygienist or religious ideas / O objetivo do presente trabalho foi explorar aspectos contextuais e historiográficos relacionados à difusão da pílula anticoncepcional, sobretudo entre as mulheres, no período de sua introdução e comercialização, que abrange de 1962 a 1972. Dessa forma, buscou-se analisar como se deu o processo de divulgação da informação sobre o modo de ação do contraceptivo hormonal no organismo feminino, quais eram as implicações associadas e seus supostos riscos e benefícios. A fonte desta pesquisa foram revistas e jornais grande circulação na época e os livros didáticos de biologia destinados ao ensino colegial, resultando num mapeamento das ideias ou argumentos científicos sobre o uso da contracepção oral, assim como do marco sócio-histórico que contornou a divulgação desta. Nosso estudo permitiu conferir que a chegada da pílula causou um intenso debate, menos acerca de questões científicas, que de problemas morais, políticos e religiosas. Quanto aos livros didáticos, continuaram a transmitir conhecimentos sobre anatomia e fisiologia reprodutivas ultrapassados em mais de meio século. O controle da reprodução, quando citado, estava ao serviço de ideias eugenistas e higienistas ou religiosas

This thesis describes a methodology for expressing the consumption of drugs, a system of ATC/DDD, ATC classification and DDD recommended daily dose assigment. It also describes the data source which are relevant for this expression. In this thesis I will focuse on combined oral contraception and its consumption which I will express in DDD/1000inhab/day, number of packages and in financial expression in czech krones. At the end of this thesis I will evaluate the results of the consumption according State institute for drug control and my own survey.

This diploma thesis is oriented to analysis of physiological effect of synthetic estrogen ethinylestradiol (EE), which represents the main component of steroid-based substance used in hormonal contraception. From wide range of physiologically important protein molecules, which might be effected by this steroid, thesis focuses to the study of the sodium plus potassium activated, magnesium dependent adenosinetriphosphatase (Na+, K+ - ATPase), which is selectively inhibited by cardiac glycosides such as ouabain (g strophantine). Na+, K+ - ATPase represents an important plasma membrane bound enzyme, which catalyzes the active transport of sodium and potassium across plasma membrane. In the first part of this work, Na+, K+ - ATPase was determined by binding of radioactively labeled selective inhibitor of this enzyme [3H]ouabain, used for this purpose. In the second part of this work, plasma membrane fluidity was analyzed by steady-state fluorescence anisotropy of DPH. The effect of EE on [3H]ouabain binding was studied first under in vitro conditions by using human embryonic kidney cells (HEK293) which were cultivated for 24 hours in the presence of EE in tissue culture medium. Second, the effect of EE was also studied under in vivo conditions, by subcutaneous application of EE to the female rats of Wistar...

Abstract Cardiovascular diseases are the leading cause of death worldwide and type 2 diabetes is reaching a global epidemic. Epidemiological studies have identified numerous risk factors and pharmacotherapies in relation to these cardiometabolic diseases. However, the detailed molecular mechanisms of these risk factors and drug therapies generally remain incompletely understood. Elucidating the underlying molecular effects would be essential for better understanding of the disease pathogenesis and also for discovering new therapeutic targets. Quantitative serum metabolomics, which allows for simultaneous quantification of multiple circulating metabolic measures, provides a hypothesis-free approach to systematically inspect the metabolic changes in response to endogenous and exogenous stimuli. Metabolomics thus presents a valuable tool to study the detailed molecular effects of disease risk factors and drug therapies. However, current metabolomics studies are mostly conducted in small cross-sectional studies and the causal relations of the risk factors on the metabolic measures are generally unclear, providing limited public health impact. The present thesis serves as a proof-of-concept to illustrate that well-designed observational studies can be used to infer causality. With the exemplars of assessing molecular effects of two risk factors (body mass index and sex hormone-binding globulin) and two drug therapies (statins and oral contraceptives), the thesis demonstrates that an improved causal inference can be achieved in observational studies via the combination of multiple study designs, including cross-sectional, longitudinal and Mendelian randomization analysis. This robust study design approach together with metabolomics data can be also extended to study the molecular effects of other risk factors and drug therapies. With an improved molecular understanding of a wide range of risk factors and therapies, better understanding of disease pathogenesis is ensured. / Tiivistelmä Sydän- ja verisuonitaudit ovat johtava kuolinsyy maailmassa ja tyypin 2 diabetes on saavuttamassa globaalin epidemian mittasuhteet. Epidemiologiset tutkimukset ovat löytäneet useita riskitekijöitä ja lääkehoitoja edellä mainituille yleisille taudeille. Tyypin 2 diabetekseen ja sydän- ja verisuonitauteihin liittyvät yksityiskohtaiset molekylaariset mekanismit ymmärretään kuitenkin puutteellisesti. Molekylaaristen yksityiskohtien tarkempi ymmärtäminen olisi siten erittäin merkittävää sekä tautiprosessien ymmärtämiseksi että lääkehoitojen kehittämiseksi. Seerumin kvantitatiivinen metabolomiikka mahdollistaa useiden metabolisten suureiden samanaikaisen määrittämisen verenkierrosta ja tarjoaa siten hypoteesittoman lähestymistavan sekä sisäisten että ulkoisten ärsykkeiden aiheuttamien metabolisten muutosten systemaattiseen tutkimukseen. Metabolomiikka on siten arvokas työkalu yksityiskohtaisten molekylaaristen mekanismien tutkimuksessa, olipa kyseessä taudin riskitekijät tai lääkehoito. Metabolomiikkatutkimuksia on kuitenkin pääasiassa tehty pienissä poikittaistutkimuksissa ja riskitekijöihin liittyvien metabolisten suureiden syy- ja seuraussuhteet ovat yleisesti epäselviä, josta johtuen metabolisten suureiden kansanterveydellinen sovellettavuus on ollut heikkoa. Tämä väitöskirja esittelee tutkimuskonseptin hyvin suunniteltujen havaintotutkimuksien soveltamiseksi syy- ja seuraussuhteiden arvioinnissa. Työ sisältää esimerkit kahden riskitekijän (painoindeksi ja sukupuolihormoneja sitova globuliini) ja kahden lääkehoidon (statiinit ja ehkäisypillerit) molekylaaristen vaikutusten kausaalisista tutkimuksista. Tulokset havainnollistavat, että kausaalisten johtopäätösten luotettavuutta voidaan parantaa yhdistämällä useita tutkimusasetelmia, kuten poikittais- ja pitkittäistutkimuksia sekä Mendelististä satunnaistamista. Esitettyjä luotettavia tutkimusasetelmia, yhdessä metabolomiikkadatan kanssa, voidaan laajentaa muiden riskitekijöiden ja lääkehoitojen molekylaaristen vaikutusten tutkimuksiin. Parantunut molekyylitason ymmärrys useista riskitekijöistä ja lääkehoidoista johtaa myös parempaan tautiprosessien ymmärtämiseen.