Submitted by Erika Demachki (erikademachki@gmail.com) on 2015-02-03T16:14:52Z No. of bitstreams: 2 Dissertação - Angela Bete Severino Pereira - 2014.pdf: 1691981 bytes, checksum: 26c135f52a948ba7451c03f77040dff7 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Erika Demachki (erikademachki@gmail.com) on 2015-02-03T16:55:54Z (GMT) No. of bitstreams: 2 Dissertação - Angela Bete Severino Pereira - 2014.pdf: 1691981 bytes, checksum: 26c135f52a948ba7451c03f77040dff7 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2015-02-03T16:55:54Z (GMT). No. of bitstreams: 2 Dissertação - Angela Bete Severino Pereira - 2014.pdf: 1691981 bytes, checksum: 26c135f52a948ba7451c03f77040dff7 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-07-11 / Introduction: The climacteric period is the transitional period between reproductive and non-reproductive life in women. Clinical evaluation of women during the climacteric period should be dictated by their health situation and possible difficulties endemic to this time, and involve a cross functional team. Healthcare includes both promotion of health and disease prevention. Objective: To evaluate the care provided to women during the climacteric period by health professionals using the Family Health Strategy. Methods: A descriptive, cross-sectional, exploratory study conducted among university educated health professionals using the Family Health Strategy (FHS) in the East Healthcare District of Goiania, Goias, Brazil. Data were collected through a questionnaire. This data collection instrument was previously assessed by experts and underwent pilot testing. All stages of the study were developed in accordance with the guidelines and regulations of Brazilian National Council on Health Resolution no. 466/2012. Data were processed using the Statistical Package for the Social Sciences using descriptive statistics and presented in tables and figures. Results: Participants included 57 (75.0%) university educated health professionals who work in the FHS. Many of the healthcare professionals reported that there are differences between the climacteric period and menopause, 57.9% could define these two phases accurately. The main reason that leads women in the climacteric period to seek care in the FHS is related to difficulties with understanding the signs and symptoms of the climacteric period, followed by questions related to new forms of hormone therapy. Concern with physical appearance presents itself as a common complaint during the climacteric period. Deficiencies and limitations in the qualifications of healthcare professionals related to knowledge of the topic of the climacteric period was the greatest difficulty. Cultural interference in the treatment of women during this phase featured prominently in reports. Conclusions: It is essential to create normative procedures and guidance for healthcare related activities for women in climacteric, especially when it comes to differences in the implementation of hormone replacement therapy. This will bring benefit to the professionals in terms of greater autonomy and safety in prescribing these and other types of treatment, ensuring completeness in service, with resolutions in a shorter timeframe. / Introdução: O climatério é a fase de transição entre o período reprodutivo e o não reprodutivo da mulher. A avaliação clínica da mulher no climatério deve ser direcionada à situação de saúde, às possíveis dificuldades dessa fase, envolvendo uma equipe multidisciplinar. A atenção à saúde abrange a promoção da saúde e a prevenção de doenças. Objetivo: Analisar a assistência prestada à mulher no climatério por profissionais de saúde que atuam na Estratégia Saúde da Família. Método: Estudo descritivo, transversal, exploratório, realizado com os profissionais de saúde do nível superior das Estratégias Saúde da Família (ESF) do Distrito Sanitário Leste de Goiânia, Goiás, Brasil. Os dados foram coletados por meio de um questionário. Esse instrumento foi previamente avaliado por especialistas e aplicado teste piloto. Todas as etapas do estudo foram desenvolvidas em consonância com as diretrizes e normas da Resolução do Conselho Nacional de Saúde n. 466/2012. Os dados foram processados no programa Statistical Package for the Social Sciences, utilizando-se estatística descritiva, e apresentados em tabelas e figura. Resultados: 57 (75,0%) profissionais de saúde de nível superior que atuam na ESF participaram do estudo. Grande parte dos profissionais referiram haver diferenças entre o climatério e a menopausa, 57,9% souberam definir essas duas fases com exatidão. O principal motivo que leva as mulheres climatéricas a buscar atendimento na ESF trata-se das dificuldades com os sinais e sintomas do climatério, seguidas por questionamentos relacionados às novas formas de tratamento hormonais. A preocupação com a aparência física configura-se como uma queixa frequente no climatério. Deficiências e limitações na qualificação dos profissionais de saúde, referentes à temática do climatério, foram as maiores dificuldades referidas. As interferências culturais no tratamento das mulheres, nessa fase, aparecem com destaque nos relatos. Conclusões: Considera-se fundamental a criação de protocolos normativos e orientadores para as atividades desenvolvidas na atenção à saúde da mulher no climatério, principalmente acerca dos aspectos relacionados às divergências em relação à implementação da terapia de reposição hormonal. Isso trará subsídio para os profissionais terem autonomia e segurança na prescrição desse e de outros tipos de tratamento, assegurando uma assistência integral, resolutiva e em menor tempo.

Introdução: A depressão está entre as principais causas de incapacidade nas mulheres, sendo a idade fértil o período com maior prevalência de episódios depressivos. Os transtornos mentais do pós-parto afetam mulheres de forma ampliada e, nesse período, o que mais acontece são as: disforias (chamadas de melancolias), as depressões pós-parto e as psicoses puerperais. Apesar de sua importância e dos avanços instituídos na atenção à saúde da mulher no Brasil, ainda existem poucos estudos a respeito de sua prevalência. Objetivos: Caracterizar a prevalência da depressão pós-parto das mulheres do município de Itapecerica da Serra com o uso da escala de depressão pós-parto de Edimburgo (EPDS); Identificar fatores sociais, econômicos, familiares e de acesso ao serviço de saúde associados à ocorrência de DPP. Método: Trata-se de um estudo epidemiológico de caráter descritivo e transversal que analisou os fatores de risco associados a ocorrência do fenômeno, com o uso da EPDS, considerando-se a DPP se atingida a pontuação 12, e um formulário de caracterização socioeconômica e familiar da puérpera, elaborado pela própria pesquisadora. Participaram da pesquisa 168 puérperas (entre 10 e 60 dias, após o parto) entrevistadas nas UBS(s), em suas residências e em uma clínica privada no município do estudo. O cálculo amostral baseou-se na estimativa da prevalência de 30% de DPP, com nível de significância de 0,05 a 5% e erro absoluto de mais ou menos 7% ou 6%. Para a análise estatística, utilizou-se o programa Bio Estatístico 5.0, aplicando-se o Teste de Mann Whitney, para comparar as tendências centrais de duas amostras independentes (primíparas e multíparas) e o Teste do Qui-quadrado para estudar a dependência entre as duas variáveis, por meio de tabelas de contingência. O nível de significância foi fixado em 0,05 visando-se obter um resultado de relevância para o objeto do estudo. Resultados: A DPP teve uma prevalência de 43,4 % incidindo em 30 (17,8%) mulheres primíparas e 43 (25,6%) das multíparas com DPP. Na amostra, prevaleceram as seguintes características entre as puérperas com DPP: faixa etária entre 19 e 35 anos de idade, sendo (74,4%), na escolaridade salientou-se o ensino médio (48,8%), a renda familiar foi de 1 a 3 salários-mínimos com proporção de 55,9%, ocupação dona de casa (49,4%), cor da pele branca (48,2%), religião católica (47%), sexo do bebê oposto ao esperado (53,5%), com histórico de problemas hormonais (69,04%), cansaço físico no período puerperal (31,5%) e sem suporte familiar na volta da maternidade (22%). Conclusões: O estudo permitiu identificar as prevalências com possibilidades de aprimorar a assistência. Ao se pensar em uma assistência com qualidade, o suporte emocional e a identificação precoce de uma possível DPP tornam mais eficientes o trabalho. Com os dados obtidos, percebeu-se a necessidade de ampliar a dimensão do cuidado, sobretudo, na atuação direta do puerpério das mulheres que já realizaram o pré-natal, trazendo-lhes uma assistência mais segura, evitando, assim um aspecto da morbidade materna que interfere fortemente no desenvolvimento infantil / Introduction: Depression is among the leading causes of disability in women, the childbearing period with a higher prevalence of depressive episodes. Mental disorders affect postpartum women in a wider sense, and in that period what else happens are: disphorias calls (melancholy), postpartum depression and postpartum psychosis. Despite its importance and the advances introduced in the health care of women in Brazil, there are few studies about its prevalence. Objectives:To characterize the prevalence of postpartum depression women in the municipality of Serra Itapecerica using the scale of the Edinburgh postpartum (EPDS) depression; Identify social , economic , family, and access to health service factors associated with occurrence of PPD. Method: This was a descriptive cross-sectional epidemiological character study that examined the risk factors associated with the occurrence of the phenomenon , using the EPDS , considering the DPP is achieved scores 12 , and a form of socioeconomic characterization familial puerperal prepared by the researcher . The study gathered 168 women (between 10 and 60 days after birth) interviewed in UBS (s) in their homes and in a private clinic in the city of study. The sample size calculation was based on the estimated prevalence of 30 % of PPD , with a significance level of 0.05 to 5 % and absolute error of plus or minus (7% or 6%), thus estimating the following sample size. For statistical analysis, we used the Statistical Bio 5.0, applying the Mann Whitney test to compare the central tendencies of two independent samples (primiparous and multiparous) and Chi-square test to study the dependence between the two variables by means of contingency tables. The significance level was set at 0.05 aiming to obtain a result relevant to the object of study. Results: The DPP had a prevalence of 43.4% focusing on 30 (17.8%) and 43 primiparous women (25.6%) of multiparous with DPP. In the sample, the following characteristics prevailed among the mothers with PPD: age between 19 and 35 years of age, being (74.4%), in education stressed out high school (48.8%), family income was 1-3 minimum wages and ratio of 55.9%, ocupassion housewives (49.4%), were white (48.2), Catholics (47%), the sex opposite to that expected (53.5%) baby with hormonal problems (69.04%), physical fatigue in the postpartum period (31.5%) and no family support in the back maternity (22%). Conclusions: This study identified the prevalence with possibilities of improving care. When you think of quality care, emotional support and early identification of possible DPP become more efficient work. With the data obtained, we realized the need to expand the dimension of care, especially in the direct performance of postpartum women who have already performed prenatal bringing them safer care, thus avoiding an aspect of maternal morbidity interfering heavily on child development.

O Papilomavírus humano (HPV) é um vírus, sexualmente transmissível, com potencialidade carcinogênica para a cérvice uterina, o que torna a infecção de mulheres pelo HPV um problema de saúde pública. Conhecer as necessidades de cuidado de mulheres infectadas pelo HPV inclui também saber suas experiências vividas durante o processo de infecção. A prevenção de doenças e a promoção de saúde ainda estão determinadas por concepções tradicionais da prática médica. É necessário pensar em um cuidado que vá além das necessidades físicas, emocionais e sociais que considere o sujeito com base em seu modo de ser no mundo e que valorize suas experiências, juntamente com suas crenças e valores. O objetivo deste estudo foi compreender a vivência das mulheres infectadas pelo HPV e conhecer quais são suas necessidades de cuidado. Tratou-se de um estudo qualitativo, com referencial da Fenomenologia existencial de Martim Heidegger. Os sujeitos foram 14 mulheres que tinham recebido o diagnóstico de HPV. As questões norteadoras foram: Como é para você estar com HPV? Conte-me sua experiência desde que soube do diagnóstico até hoje. Como está sendo a assistência que você tem recebido? Como resultado, emergiram quatro unidades temáticas: ser-aí mulher com HPV; ser-com nas relações; buscando o cuidado como solicitude e o caminho de transcendência da mulher com HPV. O referencial utilizado possibilitou melhor apreensão dos significados de estar com HPV, assim como o compartilhamento da vivência dessas mulheres em seu cotidiano. Constatou-se a necessidade de implementar ações de promoção e prevenção à saúde, que devem ser executadas por profissionais capacitados e com um perfil adequado para atenção à mulher. As mulheres devem ser encorajadas a demonstrarem suas próprias necessidades de cuidado, e as questões culturais e de gênero devem ser consideradas. É preciso que os profissionais da área da saúde avancem no cuidado com as mulheres infectadas pelo HPV, superando o trabalho restrito à racionalidade das ciências biomédicas. A informação sobre o HPV deve ser compartilhada pelas mulheres, respeitando-se suas necessidades e seu nível de compreensão. É necessário um cuidado mais efetivo e afetivo, no qual as mulheres infectadas pelo HPV exerçam um papel ativo no processo do cuidado e as interações sejam verdadeiras. / The human Papillomavirus (HPV) is a virus, sexually transmittable, with potentiality carcinogenic for the uterine cervix, making women\'s infection by the HPV a problem for the public health. To know the necessities of care of women infected by the HPV includes also knowing their experiences during the process of infection. Diseases prevention and health promotion are still determined by traditional conceptions of medical practice. It is necessary to think about a care that goes besides the physical, emotional and social necessities, that considers the individual based on of her way of being in the world and considers her experiences, beliefs and values. The objective of this study was to understand the life experience of the women infected by the HPV and to know their necessities of care. This research have had a qualitative focus, with reference to the Existential Phenomenology by Martim Heidegger. Were subjected to this research 14 women HPV positive. The research was based on these questions: What does being HPV positive mean for you? Tell me the experience that you have had since you have known you were infected until today. How is the aid that you have been receiving? As result, four thematic topics surfaced: to be there a woman with HPV; to be a woman with HPV in relationships; looking for care as solicitude and the way of transcendence of the woman with HPV. The used referential made possible a better apprehension of the meanings of being with HPV, as well as the share of the existence of these women in their daily life. The necessity of implementing health promotion and prevention actions was noted, and these actions must be executed by enabled professionals with a profile adapted for attention to the woman. The women must be encouraged to demonstrating their necessities of care themselves and questions of culture and of gender must be considered. It is necessary that professionals of the health area keep advancing in the care of women infected by the HPV, surpassing the work limited to the rationality of biomedical sciences. The information on the HPV must be shared by the women, respecting their necessities and their level of understanding. It is necessary a more effective and affectionate care, in which the women infected by the HPV play an active part in the process of the care and the interactions are true.

Diese Dissertation bietet eine Darstellung und Analyse der Handlungsfelder serbischer Frauen. Dabei werden die Frauenbildung, das Engagement von Frauen in sozialkaritativen und patriotischen Frauenvereinen, sowie ihre Teilnahme an den zwischen 1876 und 1918 geführten „Befreiungskriegen“ thematisiert. Das Problemfeld von Nation und Geschlecht ist für Serbien fast völlig unbearbeitet. Die vorliegende Untersuchung geht den folgenden Fragen nach: Wie partizipierten Serbinnen am Prozess der Nations- und Nationalstaatsbildung? Welche Weiblichkeits- und Männlichkeitsbilder wurden im Nationsbildungsprozess verwendet? Auf welche Art und Weise partizipierten sie an den Kriegen und unterstützten das Militär? Wie wirkte sich der „Große Krieg“ auf die Geschlechterordnung in Serbien bzw. Jugoslawien aus? Da die für Frauen zentralen politischen, kulturellen und ökonomischen Wandlungsprozesse im 19. und 20. Jahrhundert in der bürgerlichen Gesellschaft der Städte stattgefunden haben, konzentriert sich auch diese Darstellung auf den städtischen Raum und seine Bewohnerinnen. Das bäuerlich-ländliche Frauenleben wird nur kurz angerissen. Die Arbeit nimmt den weiblichen Gruppenbildungsprozess in den Blick, der innerhalb einer schmalen bürgerlichen Schicht stattfand. In den westeuropäischen Ländern entstanden die ersten Frauenvereinigungen am Ende des 18. bzw. zu Beginn des 19. Jahrhunderts. Serbien, dessen Bevölkerung mehrheitlich lese- und schreibunkundig war und von einer ländlichen Subsistenzwirtschaft lebte, folgte mit einer zeitlichen Verzögerung von mehreren Jahrzehnten. Um 1900 war in allen diesen Ländern ein dichtes Netz unterschiedlichster Frauenvereine anzutreffen. Anfang des 20. Jahrhunderts stieg auch in Serbien die Zahl der Frauenvereine, die sich in einem Dachverband zusammenschlossen. Dieser Bund trat den internationalen Frauenorganisationen bei.:Inhaltsverzeichnis Vorwort 5 Einleitung 7 Ziel der Arbeit 13 Die Gliederung der Arbeit 16 Forschungsstand 17 Zur Quellenlage 20 Teil A Nation und Geschlecht in Serbien von der Mitte des 19. Jahrhunderts bis zum Ende des Ersten Weltkrieges 24 I. Grundlagen 25 I. 1. Historischer Hintergrund: Von den serbischen Aufständen bis zum Ende des Ersten Weltkrieges (1804–1918) 26 I. 2. Demographischer und sozialer Wandel 42 I. 2. 1. Territorium und Bevölkerungsentwicklung 42 I. 2. 2. Sozialer Wandel 49 II. Die Lage der Frauen in der serbischen Gesellschaft 54 II. 1. Die Bauernfamilie 55 II. 2. Die Rechtsstellung der Frauen nach dem Serbischen Bürgerlichen Gesetzbuch (1844) und dem Strafgesetzbuch (1860) 60 III. Die Anfänge des weiblichen Engagements (ca. 1850–1870er Jahre) 67 III. 1. Der Hintergrund: Die Anfänge des Vereinswesens 68 III. 2. Die „Vereinigte Serbische Jugend“ 72 III. 2. 1. Die Frauen in der „Omladina“ 75 III. 2. 2. „Liebe Schwestern! nicht nur die Söhne, sondern im gleichen Maße auch die Töchter, gehören zu unserem Volk“: Die erste serbische Frauenrechtlerin „Schwester Draga“ 85 III. 2. 3. Svetozar Marković und die Frauenfrage 89 III. 3. Die Geschichte des serbischen Frauenvereinswesens in Südungarn 95 IV. Handlungsfelder der serbischen Frauenbewegung 105 IV. 1. Bildung (1846–1914/18) 106 IV. 1. 1. Grundschulen für Mädchen 106 IV. 1. 2. Die höhere Frauenbildung 109 IV. 1. 3. Die Frauenfachschule (Radnička škola) des Belgrader Frauenvereins 118 IV. 1. 4. Der Universitätszugang 122 IV. 1. 5. Weibliche Schul- und Berufserfahrungen 128 IV. 2. Sozialkaritatives Engagement und wirtschaftliche Förderung (1875–1914/18) 139 IV. 2. 1. Der Belgrader Frauenverein 139 IV. 2. 1. 1. Die Heimindustrie 143 IV. 2. 1. 2. Die Förderung der Heimindustrie: Der Pazar 145 IV. 2. 2. Mutterschaft – eine soziale Funktion 152 IV. 3. Frauen in der städtischen Gesellschaft 157 IV. 3. 1. Frauen und urbane Geselligkeit: Der Salon (Poselo) 157 IV. 3. 2. Frauen und Öffentlichkeit: Domaćica 165 IV. 3. 3. „Gott beglücke mein Volk, dem ich sechs Kinder geschenkt habe“: Frauen in der Ehe 172 IV. 4. Frauen und nationale Mobilisierung (1875–1914/18) 188 IV. 4. 1. Patriotische Wohltätigkeit: Der Belgrader Frauenverein 188 IV. 4. 1. 1. Die erste Schirmherrin des Belgrader Frauenvereins: Die Königin Natalija Obrenović 191 IV. 4. 1. 2. Die Kriege von 1877/78 und 1885/86 195 IV. 4. 2. Arbeit an der Nation: Das Engagement des Damenausschusses „Fürstin Ljubica“ in „Altserbien“ und Makedonien 199 IV. 4. 3. An der Seite von Nation und Armee: Der „Kranz der serbischen Schwestern“ 208 IV. 4. 4. Jüdische Frauen und Nation 226 IV. 4. 5. Intellektuelle Frauen und nationale Agitation: Das Beispiel Isidora Sekulić 232 IV. 4. 6. Wird jeder Serbe als Soldat geboren? – Patriotisch-wehrhafte Männlichkeitskonstruktionen 241 IV. 4. 7. Kämpfende Frauen: „Amazonen“ 254 IV. 4. 8. Zwischen national-patriotischen und frauenspezifischen Anliegen: Der Serbisch-nationale Frauenbund 261 V. Zwischenfazit 279 Teil B Nation und Geschlecht im Zwischenkriegsjugoslawien 282 I. Grundlagen 283 I. 1. Entstehung und Entwicklung Jugoslawiens (1918–1941) 284 I. 2. Demographischer und sozialer Wandel 293 I. 2. 1. Territorium und Bevölkerungsentwicklung 293 I. 2. 2. Sozialer Wandel 297 II. Die Lage der Frauen in der jugoslawischen Gesellschaft 304 II. 1. Die Bauernfamilie 305 II. 2. Die Rechtsstellung der Frauen 313 III. Die jugoslawische Frauenbewegung 322 III. 1. Akademische Bildung, Berufsleben, Berufsverbände 323 III. 2. Politische Partizipationsforderungen: Kampf um das Wahlrecht 335 III. 3. Zwischen traditionellem Patriotismus und Jugoslawismus, zwischen Feminismus und Sozialismus 354 III. 3. 1. Nationaler Unitarismus 355 III. 3. 2. Die Emanzipation der patriarchalen Gesellschaft 366 IV. Zwischenfazit 384 Zusammenfassung 390 Abkürzungsverzeichnis 393 Quellen und Literatur 394 Quellen 394 Literatur 399 Verzeichnis der Karten, Tabellen und Graphiken 410 Verzeichnis der Abbildungen 412

Bakgrund: Kejsarsnitt är ett ingrepp som blir allt vanligare världen över vilket resulterar till att fler kvinnor drabbas av komplikationer. I takt med att kejsarsnitt blivit säkrare har vårdtiden för kvinnorna blivit kortare, vilket gör att det uppstår en osäkerhet och rädsla kring komplikationer efter utskrivning för dessa kvinnor. Syfte: Syftet var att belysa kvinnors upplevelse kring komplikationer vid panerat kejsarsnitt efter utskrivning. Metod: Studien är en litteraturstudie med induktiv ansats där sju kvalitativa resultatartiklar ligger till grund för resultatet. Resultat: Utefter syftet identifierades fyra teman: att leva med långvarig smärta orsakad av genomgånget planerat kejsarsnitt, upplevelse av information, upplevelse av postnatal infektion samt skam och ångest kring planerat kejsarsnitt. Kvinnor upplever sin egen kunskap otillräcklig för att identifiera komplikationer samt vart kvinnan skall vända sig när komplikationer uppstår. Informationen som kvinnan får postoperativt kring infektion och smärtans utveckling vid planerat kejsarsnitt efter utskrivning, ansåg kvinnan bristfällig med avsaknad av personcentrerat förhållningssätt. Kvinnor upplever även en stigmatisering kring planerat kejsarsnitt från hälso- och sjukvårdspersonal samt samhället. Konklusion: Hälso- och sjukvården behöver få en större förståelse för kvinnans upplevelse kring komplikationer vid planerat kejsarsnitt efter utskrivning samt förbättra vården med ett personcentrerat förhållningssätt i form av stöd och information. / Background: Cesarean section is a procedure that is becoming more common around the world, which means that more women are suffering from complications. As the operation has become safer, the care time for the women has become shorter, which indicates that there is an uncertainty about complications after discharge. Aim: The aim was to illustrate women's experience of complications during elective cesarean section after discharge. Method: The study is a literature study with an inductive approach where seven qualitative articles formed the result. Result: According to the purpose, four themes were identified: living with long-term pain caused by elective cesarean section, experience of information, experience of postnatal infection and shame and anxiety around a planned cesarean section. Women experience insufficient knowledge to identify complications and where the woman should turn once it occurs. Postoperative information is not designed to be easily absorbed, as well as a stigma surrounding the woman's elective cesarean section in meetings with health and medical profession and society. Conclusion: The health care needs to gain a greater understanding of the woman's experience of complications after elective caesarean section at discharge and improve care with a person-centered approach in the form of support and information.

This thesis will investigate to what extent the midwifery programme atselected Swedish universities is including the issue of female genitalmutilation (FGM) into their education and curriculum. This is an importantsubject to do research on since a lot of existing literature on the topic showsthat midwives in Sweden are seriously lacking in knowledge regarding thepractice of FGM. According to a study done by Tamaddon et al. (2006) lessthan 30% of the Swedish midwives believed that they had adequateknowledge of FGM. Another study of the issue of FGM showed thatSwedish midwives felt that their knowledge of FGM was lacking and that itwas a marginalized issue on their place of work (Widmark et al. 2002).The reason to why the focus of my research will be on midwifery studentsand teachers within the midwifery program is because the healthprofessionals who is most likely to meet circumcised women are midwives.According to Dawson et al. (2015) “Midwives are often the first providerswomen will see for their maternal health needs and therefore play a criticalrole in providing quality care and preventing the practice” (Dawson et al.2015 p 230).The chosen research topic fits smoothly into the broader peace anddevelopment area due to what has been mentioned earlier, the increase inpeople movement in the world today makes some issues a global challenge.Which has been the case of the practice of FGM, it is now time to understandthat this is no longer an issue only in the countries were FGM is traditionallypracticed, it is an issue and especially a challenge even in high incomecountries.The method to be used in this research is semi-structured interviews with acareful sampling process of participants, done by a purposive sampling. Itwill be a qualitative study based on a cross-sectional design.

Bakgrund: Graviditetsrelaterad bäcken- och/eller ländryggssmärta drabbar många kvinnor och ett stort antal har kvarstående besvär postpartum. Många kvinnor tenderar dessutom att bli fysiskt inaktiva under och efter graviditet. Fysioterapeutiska åtgärder som avser att minska besvär och optimera rörelseförmåga hos denna patientgrupp ges främst ur ett biomedicinskt perspektiv. Nya studier har dock indikerat att fysioterapeutiska åtgärder som beaktar bio-psyko-sociala faktorer är värdefullt. Syfte: Syftet med studien är att undersöka hur kvinnor med graviditetsrelaterad bäcken- och/eller ländryggssmärta postpartum upplever att deras fysiska aktivitetsnivå påverkats av fysioterapeutiska åtgärder. Metod: Studien genomfördes med en kvalitativ, deskriptiv design och data samlades in under sju semistrukturerade intervjuer. Data analyserades genom en kvalitativ innehållsanalys med induktiv ansats. Resultat: Analysen resulterade i fem kategorier: Åtgärder som minskar fysiska besvär ökar förmågan till aktivitet, Individanpassade åtgärder betydelsefullt för ökad aktivitet, Fysioterapeutens kompetens avgörande för aktivitet, Fysioterapeutens bemötande och attityd påverkar behandlingsupplevelsen samt Förståelse för hur aktivitet påverkar besvär främjar rörelse. Slutsats: Resultatet i studien indikerar att fysioterapeutiska åtgärder som integrerar ett bio-psyko-socialt förhållningssätt gynnar ökad fysisk aktivitet hos kvinnor med bäcken- och/eller ländryggssmärta postpartum. Kvinnorna uppgav vidare att fysioterapeutens kompetens samt bemötande och attityd påverkar aktivitetsnivå och huruvida besvären förbättras eller inte. / Background: Pregnancy-related pelvic and/or low back pain affects many women, and a significant number of women have persistent pain postpartum. A lot of women tend to become physically inactive during and after pregnancy. Physiotherapeutic interventions that aim to decrease discomfort and optimize mobility are given foremost from a biomedical approach for this patient group. However, recent studies have indicated that physical therapy interventions that consider a bio-psycho-social approach are valuable. Objective: The purpose of this study is to investigate how women with pregnancy-related pelvic and/or low back pain postpartum experience that their level of physical activity is affected by physiotherapeutic interventions. Method: The study was conducted with a qualitative, descriptive design and data was collected through seven semi-structured interviews. Data were analyzed through a qualitative content analysis with an inductive approach. Results: The analysis resulted in five categories: Interventions to decrease physical discomfort increase the ability to become more active, Individual constructed interventions important for increased activity, The physiotherapist competence is decisive for activity, The physiotherapist approach and attitude affects treatment experience and Understanding how activity affect discomfort promotes movement. Conclusion: This study indicates that physiotherapeutic interventions that integrate a biopsychosocial approach promote increased level of physical activity in women with pregnancy-related pelvic and/or low back pain postpartum. The women further stated that the physiotherapist's competence as well as approach and attitude affect the level of activity and if the discomfort improves or not.

Die Studie untersuchte die geschlechtsspezifischen Unterschiede im Umgang mit alkohol- und psychisch kranken Patienten Ende des 19. und Anfang des 20. Jahrhunderts am Beispiel der Psychiatrischen und Nervenklinik der Universität Würzburg. 2014 wurden die Patientenakten und Standbücher der Universitätsklinik der Jahre 1888 bis 1944 erstmalig zu Studienzwecken freigegeben, die Ergebnisse dieser Studie wurden vor dem Hintergrund der Forschungsliteratur diskutiert. Die Studie betrachtete die unterschiedlichen Epochen- Industrialisierung, Kaiserreich, Erster Weltkrieg, Weimarer Republik, Nationalsozialismus und Zweiter Weltkrieg - und insbesondere die Trinkerfürsorge sowie die Geschlechtergeschichte der Psychiatrie jener Epochen. Ebenso wurde auf die spezielle Rolle der Universitätspsychiatrie eingegangen. Die Analysen ergaben, dass Alkoholismus bei Frauen verurteilt, bei Männern beschönigt und entschuldigt wurde. Frauen wurden stark nach ihrem Lebenswandel und etwaigen“ moralischen Verfehlungen“ beurteilt, bei Männern wurde dies kaum berücksichtigt. Psychische Leiden bei Frauen wurden häufig mit hormonellen oder sexuellen Ursachen in Verbindung gebracht, bei Männern gab es kein analoges Erklärungsmuster. Es bestand eine sehr hohe Toleranzschwelle für häusliche Gewalt gegenüber alkoholkranken Patientinnen. Gutachten ärztlicherseits befürworteten meist Ehescheidung und Entmündigungen von alkoholkranken Patienteninnen, bei männlichen Alkoholkranken erfolgte dies nur bei massiver Beweislast. Die Analysen ergaben einen oft herablassenden und teils respektlosen Umgang mit allen psychiatrischen Patienten, jedoch mit standes- und geschlechtsspezifischen Unterschieden. Patientinnen wurden insgesamt respektloser behandelt als männliche Patienten, speziell wenn sie den „unteren Ständen“ angehörten und ihr Lebenswandel nicht den gesellschaftlichen Erwartungen entsprach. Alkoholkranke waren niemals primäres Ziel der nationalsozialistischen Rassen- und Vernichtungspolitik. Da Alkoholkranke meist arbeitsfähig waren, waren sie selten Opfer von Zwangsterilisationen, und soweit arbeitsfähig, auch nicht Opfer von dem gezielten Hungersterben in den Anstalten oder der „Aktion T4“. Die Psychiatrische und Nervenklinik der Universität Würzburg nahm als Universitätsklinik im Lichte der Öffentlichkeit eine besondere Rolle ein. Sie war von wirtschaftlichen Zwängen kaum betroffen, Arbeitstherapie war zwar Teil des klinischen Alltags, jedoch weit weniger intensiv als in den Anstalten und Arbeitshäusern. Es ergab sich kein Hinweis auf „Hungerkost“ während der beiden Kriege, es gab keine direkten Transporte in die Tötungsanstalten im Rahmen der „Aktion T4“ und es ergaben sich keine Hinweise auf Experimente an psychiatrisch erkrankten Patienten an der Würzburger Lehrklinik. / This study analyzes gender specific differences in the treatment of alcoholics and mentally ill patients at the Psychiatric Hospital of the University of Wuerzburg during the period of the late 19th and early 20th century. Patient and admission records from the Psychiatric University Hospital from the years 1888 through 1944 were first released in 2014 for study purposes, the results of this study were being discussed in the background of corresponding literature. The study discusses the different eras- industrialisation, German Empire, First World War, Weimar Republic, Nationalsocialism, and Second World War- in particular the treatment of alcoholics as well as psychiatric gender history of of those eras. Consideration was also given to the special role of University Psychiatry in the field of mental health care. Female alcoholism was judged heavily while male alcoholism was excused. Women were judged by their lifestyle. "Moral transgressions“ were weighed heavily, with men the same were hardly considered. Mental illness in women was put in close correlation with hormonal or biological causes, with men no analogue model existed. There was high tolerance for domestic violence against female alcoholics. Forensic testimonies of psychiatrists usually supported the divorce or incapacitation of female alcoholics, cases with male alcoholics however required massive evidence. The study showed a humiliating and degrading behavior toward mentally ill patients from the hospital staff, however there were some differences based on gender and class. Female patients were treated worse than male patients, especially if they belonged to lower socioeconomic classes and their lifestyles did not meet societal expectations. Alcoholics were not the target of the Nazi racial and annhiliation policies. Because alcoholics were usually able to work they were not the target of forced sterilisations, nor the mass starvations in mental asylums during World War II, nor the „Aktion T4“- the organised mass murder of the mentally ill. The Psychiatric Hospital of the University of Wuerzburg as a teaching hospital remained steadily in the public eye and therefore had special conditions. It was barely affected by economic pressures, forced labor was part of psychiatric therapy in Wuerzburg, yet by far not to the extent it was common at the mental asylums and the „Arbeitshäuser“. There were no reports of starvation deaths in Wuerzburg nor the transport of patients to one of the killing facilities in connection with the „Aktion T4“. Furthermore there was no indication that experiments were carried out on any of the psychiatric patients.

Civic engagement is a fundamental component of a healthy democracy, contributing to higher government accountability and overall improvement in "good governance". Civic engagement is particularly critical to subgroups which are under-represented in formal political structures, such as women, as it affords these groups the opportunity to voice their unique concerns. However, women participate less in many important forms of civic engagement. The United Nations and other international organizations have emphasized the importance of increasing women's voice and empowerment in an attempt to improve women's overall well-being, particularly in the developing world. Individual and contextual factors have demonstrated contributions toward influencing levels of civic engagement, but these effects only serve in partially explaining why women are less engaged. This study adds to this discussion by examining gender differences in the development and contribution of social capital (measured by networks and trust) to civic engagement within two young and developing democracies; Ecuador and Peru. The study finds that gender differences exist in how social capital is formed, but these differences don't explain women's decreased likelihood for engagement. Thus, social capital can be used to build civic engagement among both genders.

[pt] O objeto desta tese consiste na análise das diferentes dimensões do acesso de refugiadas congolesas à atenção integral à saúde da mulher no município do Rio de Janeiro. Compreendeu-se que com o princípio da universalidade estabelecido no Sistema Único de Saúde (SUS) tanto os brasileiros quanto os migrantes e refugiados que estão no país podem acessar os serviços de saúde sem que sejam impostas barreiras de acessibilidade, legais, econômicas, físicas ou culturais. A tese traz um tema ainda pouco explorado nos estudos no que diz respeito as mulheres refugiadas e migrantes, principalmente em relação aos estudos de: gênero e refúgio, violência de gênero e a interseccionalidade. Assim, entende-se que as mulheres já vivenciam várias formas de violações de direitos e são mais afetadas pelas desigualdades sociais, entretanto isso se agrava com fatores como raça e classe e neste estudo, acrescenta-se a nacionalidade e sua condição de migrante e refugiada. A pesquisa foi realizada na Atenção Primária do Rio de Janeiro. A metodologia utilizada é a abordagem qualitativa. Foram realizadas 12 entrevistas semiestruturadas com gestores (4), profissionais da Clínica da Família (5) e mulheres refugiadas congolesas (3). Para analisar os dados coletados foi utilizada a análise de conteúdo na modalidade temática. A partir da pesquisa identificou-se que no município do Rio de Janeiro ainda não existe uma política voltada para atendimento à saúde de mulheres refugiadas, ela segue sendo desenhada, porém, os profissionais realizam o atendimento nas unidades de saúde. A cultura e a falta de tradutores nas unidades de saúde são desafios para os profissionais e gestores de saúde, isso aparece atrelados a outros problemas como a violência contra mulheres e a ausência de uma política pública para tradutores nas unidades. O contexto de desmonte da Atenção Primária no governo Crivella interferiu no trabalho que vinha sendo desenvolvido no município do Rio de Janeiro em relação à saúde de refugiados, atualmente há uma reconstrução ainda em curso. A Atenção Primária é a principal porta de entrada para as mulheres refugiadas que buscam os serviços principalmente para realizar pré-natal, a gravidez aparece como uma busca pelo direito de cidadania no Brasil a partir da visão dos profissionais e também é importante apontar a busca dos profissionais em fazer com que as mulheres refugiadas compreendam e acessem seus direitos sexuais e reprodutivos. Cabe apontar que as congolesas utilizam os serviços de saúde e afirmam que o atendimento foi bom, demostram que no Brasil a saúde é melhor que na RDC, e embora sejam gratas, elas questionam a demora no atendimento, o mau atendimento médico e precarização nos serviços. Por fim, nota-se que o contexto de desmonte do SUS também afeta as mulheres refugiadas que buscam atendimentos de saúde da mesma forma que afeta as brasileiras e outras migrantes, todavia, é nesse contexto que a política de saúde para refugiados vem sendo desenhada, já que ainda não foi legitimada e trata-se de um processo de luta com significativas conquistas nos últimos anos. / [en] The aim of this thesis is to analyze the different dimensions of access by Congolese refugees to comprehensive women s health care in the municipality of Rio de Janeiro. It was understood that with the principle of universality established in the Unified Health System (SUS), both Brazilians and migrants and refugees who are in the country can access health services without the imposition of legal, economic, physical or cultural accessibility barriers. The thesis deals with a topic that has not yet been explored in studies on refugee and migrant women, especially in relation to studies on: gender and refuge, gender violence and intersectionality. Thus, it is understood that women already experience various forms of rights violations and are more affected by social inequalities, however this is aggravated by factors such as race and class and in this study, nationality and their status as migrants and refugees are added. The study was carried out in Primary Care in Rio de Janeiro. The methodology used is a qualitative approach. Twelve semi-structured interviews were conducted with managers (4), Family Clinic professionals (5) and Congolese refugee women (3). Thematic content analysis was used to analyze the data collected. The research revealed that in the municipality of Rio de Janeiro, there is still no policy on health care for refugee women; it is still being drawn up, but the professionals provide care in the health units. The culture and lack of translators in health units are challenges for health professionals and managers, and this appears to be linked to other problems such as violence against women and the absence of a public policy for translators in units. The context of the dismantling of PrimaryCare under the Crivella government interfered with the work that was being carried out in the municipality of Rio de Janeiro in relation to refugee health. Primary Care is the main gateway for refugee women who seek services mainly for prenatal care, pregnancy appears to be a search for the right to citizenship in Brazil from the point of view of the professionals and it is also important to point out the professionals search to make refugee women understand and access their sexual and reproductive rights. It is worth noting that the Congolese women use the health services and say that the service was good, demonstrating that health in Brazil is better than in the DRC, and although they are grateful, they question the delay in service, the poor medical care and the precariousness of the services. Finally, it can be seen that the context of the dismantling of the SUS also affects refugee women who seek health care in the same way that it affects Brazilians and other migrants. However, it is in this context that the health policy for refugees is being designed, since it has not yet been legitimized and it is a process of struggle with significant achievements in recent years.