Dissertations / Theses on the topic 'Contraceptive pills'

Magister Pharmaceuticae - MPharm<br>Background: The effectiveness of the combined oral contraceptive pill as a family planning method is dependent on its quality. The quality of medicines on the healthcare market is established through postmarket quality studies. Methods: The quality of the combined oral contraceptive pill was established through the collection of samples from 17 (62%) private retail pharmacies in the Nyeri town of Kenya. Their quality was then determined through the assay of content of levonorgestrel and ethinylestradiol and the levonorgestrel dissolution test at the National Quality Control Laboratory. Findings: 13 of the 17 pharmacies were licensed with the Pharmacy and Poisons Board while 4 were unlicensed. Femiplan® was available in all the 17 pharmacies while Microgynon® was available in only 4 pharmacies. 17 samples of Femiplan® and 4 samples of Microgynon® were collected. None of the samples was counterfeit or falsely labeled. All the samples passed the assay of content of levonorgestrel and ethinylestradiol and the levonorgestrel dissolution test. Conclusion: Notwithstanding the fact this study provides a snapshot in time, it is reasonable to conclude that the combined oral contraceptive pill (0.15mg levonorgestrel and 0.03mg ethinylestradiol) in the Nyeri town of Kenya private retail pharmacies is of the right quality with respect to the quality tests of assay of content of levonorgestrel and ethinylestradiol and the levonorgestrel dissolution test.

The effect of a number of possible risk factors for stroke were examined in a nested case-control study of participants in the prospective Royal College of General Practitioners' Oral Contraception Study. The case were 253 women who had a first ever stroke or episode of amaurosis fugax between 1968 and 1990. Three age-matched controls were selected for each case. Current users of the pill had an increased risk of total and fatal stroke. Former users had a small elevated risk of total stroke and a stronger risk of fatal stroke. The effects in former users appeared to be restricted to women who smoked. The elevated risk of total stroke among former users appeared to diminish with time although a persisting risk of fatal or haemorrhagic stroke could not be excluded. Smoking increased the case fatality rates of pill users who had a stroke. The effects of the pill in women with other factors for stroke were explored, but were inconclusive. The newer oral contraceptives were associated with a lower risk of stroke than older preparations, a benefit which has occurred because of changes in pill formulation rather than more selective prescribing by doctors. Smoking enhanced the risk of cerebrovascular disease in hypertensive, and possibly diabetic, women. The largest population attributable proportions were associated with smoking (36%), ever use of oral contraceptives (23%), manual social class (21%) and hypertension (19%). The successful elimination of cigarette smoking must remain a public health priority.

Contraception is often a taken-for-granted element of actively heterosexual women’s lives. Yet while modern contraceptives have technically enhanced women’s ability to control their fertility, the history of women’s struggles to achieve this control shows the importance of understanding the social context within which women’s contraceptive decisions are situated. Previous feminist studies of contraception in the UK have tended to concentrate either on aspects of medicine or on heterosexuality. Whilst both areas have highlighted the need to understand how power relationships structure women’s contraceptive experiences, these two aspects have not been integrated adequately. There has also been a tendency to focus research on younger women, and mature women’s ongoing use of contraception has generally been overlooked. This thesis is based on qualitative interviews with twenty-two mid-life British women aged between 30 and 40, as well as observations at a family planning clinic. It demonstrates that only by giving full consideration to the extent and complexity of the power relationships surrounding contraception can an understanding of women’s decisions and everyday practices be achieved. The concept of ‘subjective power’ is developed to explore how these women make strategic and creative use of circulating discourses, interact with disciplinary regimes, and situate themselves within multi-faceted webs of power relationships, such as in relation to the institutions of medicine, the media, and heterosexuality. The embodied nature of both the risk of pregnancy and the use of contraceptive technologies is argued to lead the women to assert a right of bodily autonomy. Yet this assertion conflicts with their expectation of equitable coupledom within heterosexuality and their routine consideration of men’s preferences. In addition, this thesis will show that taking ‘proper’ responsibility for preventing pregnancy constructs women as respectable, yet may increase their risk of contracting sexually transmitted infections.

This is an ethnographic study of users of the oral contraceptive pill at a London specialist clinic. The pill was introduced in the United Kingdom in 1964 and is currently provided free of charge to twenty-five percent of British women. It has had a major impact on the sexual and reproductive lives of people in contemporary Britain. This ethnographic analysis of the pill contributes to our understanding of the cultural meanings and practices associated with the pill and shows some of the fundamental assumptions and expectations of pill users about their lives, including particularly ideas of femininity and nature. In this thesis, the central question of how the 'natural facts' of femininity are constantly negotiated in both private and public domains will be explored through the related examples of pregnancy, sex, and menstruation, as experienced and conceptualised by the women in this study. The ways in which these women use, think and talk about the pill demonstrate their efforts to balance the often contradictory demands made upon their bodies and persons in various social fields as they participate in social terrains once inhabited primarily by men. Therefore, a key argument will be that the social life of the pill is inseparable from the constitution of femininity and female bodies more broadly. This thesis contributes to the anthropological theory of "natural facts" by providing an example of how they are mobilised by women using the pill. It suggests that "natural facts" continue to provide a privileged ground for femininity. It adds to research on gender in the UK by illustrating the strategies employed by women at both symbolic and relational levels as they attempt to control their identities in the face of changing conventions and institutions. Finally, it is hoped that this ethnographic illustration of the experiences of pill users will provide insights relevant to the work of public health practitioners.

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<br>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

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior<br>A contracepÃÃo de emergÃncia (CE) à um mÃtodo que evita a gravidez apÃs a relaÃÃo sexual. TambÃm conhecido por âpÃlula pÃs-coitoâ, esse mÃtodo utiliza progestogÃnio na forma concentrada e tem indicaÃÃo reservada Ãs situaÃÃes especiais ou de exceÃÃo, tais como falha conhecida ou presumida, uso inadequado e relaÃÃo sexual sem uso de mÃtodo contraceptivo, bem como em casos de violÃncia sexual. Descrever e analisar o nÃvel de conhecimento e a utilizaÃÃo da CE de usuÃrias do ServiÃo de Atendimento FarmacÃutico (SAC FARMA), de uma Rede de FarmÃcias ComunitÃrias em Fortaleza, CearÃ. Entre os meses de outubro de 2008 a maio de 2009, apÃs o esclarecimento de informaÃÃes sobre pÃlula pÃs-coito atravÃs do SAC FARMA, mulheres usuÃrias ou que tinham intenÃÃo de uso da CE, foram convidadas a participar da pesquisa sobre uso de CE. Para tanto, foi aplicado um questionÃrio e os dados foram incluÃdos no programa estatÃstico SPSS, versÃo 15.0. Das 54 entrevistas feitas, a maioria das mulheres estavam entre a faixa etÃria de 23 e 29 anos de idade (44,4%), solteiras (66,7%) e residentes no Estado do Cearà (66,7%). Tinham renda entre 1 e 3 salÃrios mÃnimos (48,1%) e cursavam ensino mÃdio (50,0%) e superior (42,6%). Pretendiam fazer uso ou utilizaram CE sem orientaÃÃo/prescriÃÃo mÃdica (92,6%) e a maioria (54%) obteve alguma informaÃÃo sobre CE atravÃs de amigos e familiares. Mais da metade (64,8%) afirmou que nÃo era a primeira vez de uso, sendo que 82% relataram utilizar uma ou duas vezes. Com relaÃÃo ao conhecimento sobre o risco de diminuiÃÃo de eficÃcia caso houvesse repetiÃÃo do uso, a maioria (64%) relatou desconhecer essa informaÃÃo. Relataram nenhuma reaÃÃo ou queixa (72%) e 98,1% conheciam outro mÃtodo contraceptivo, sendo o preservativo o mais conhecido (92,6%) e utilizado (84%). Um dos principais motivos para justificar a utilizaÃÃo da CE foi o sexo desprotegido (53,7%). Quando perguntadas atà quanto tempo apÃs a relaÃÃo sexual o mÃtodo pode ser utilizado, a maioria respondeu que pode ser atà 72 horas (56,3%), 25% nÃo souberam responder e 65,6% relataram que a âPÃlula do Dia Seguinteâ nÃo possui efeito abortivo. A maioria das mulheres avaliadas pretendia fazer uso ou utilizar a CE sem orientaÃÃo/prescriÃÃo mÃdica, obteve informaÃÃes sobre a pÃlula atravÃs de amigos e familiares e, alÃm disso, nÃo tinha conhecimento sobre o risco de diminuiÃÃo de eficÃcia se o uso for repetitivo. Estes fatos alertam para que se tenha uma maior preocupaÃÃo em relaÃÃo à possibilidade de uso indevido do medicamento e seu fÃcil acesso nas farmÃcias comerciais.<br>The emergency contraceptive pill (EC) is a method of the emergency contraception that prevents pregnancy after sexual intercourse. It is also known as the âpost coital pillâ and contains high dose progestin-hormone. The EC can be taken immediately or up to five days after sex if the woman did not use birth control, in cases of suspected birth control failure, or if she was forced to have sex. To describe the level of knowledge and use of EC by users of the Medicine Attendance Service (SAC FARMA) in a network of community pharmacies placed in Fortaleza, CearÃ. In the months October (2008) to May (2009), after each enquiry about the âpost coital pillâ, women who were using or intended to use this pill were invited to participate in a survey on the use of emergency contraception by the application of a structured questionnaire. The data were analyzed with the statistical program SPSS, version 15.0. Of the 54 women interviewed, the majority were aged between 23 and 29 years (44.4%), were single (66.7%) and resident in the State of Cearà (66.7%). (48.1%) had income between 1 and 3 minimum wages, 50,0% higher secondary education and 42.6% had higher education.). Almost all (92,6%) wished to use or have used EC without guidance/prescription and of these the majority (54%) obtained some information about EC through friends and family. More than half (64.8%) said it was not their first time of use, and 82% reported using EC once or twice previously. With respect to knowledge about the risk of loss of effectiveness if the use is repetitive, the majority (64%) were unaware of this information. Most (72%) reported no adverse reaction or other complaints. Also, 98.1% of interviewed reported that they knew other method of contraception, being the condom the most widely known (92.6%) and used (84%). One of the main reasons to justify the use of EC was unprotected sex (53.7%). When asked for how long after intercourse the method can be used, most answered within 72 hours (56.3%), 25% did not respond and 65.6% reported that "post coital pill" has no abortive effect. Most of the women studied wanted to use the EC without prescription and obtained information about EC pill from friends and family. Moreover most women had no knowledge about the risk of reduced effectiveness if the use is repetitive. These findings are of concern as they indicate the possibility of misuse of the EC given its easy access in pharmacies.

<p>The overall aim of this thesis was to study knowledge, attitudes and experience of emergency contraceptive pills among women and providers.</p><p>Both quantitative and qualitative methods were used. Focus-group interviews were conducted with teenage-girls (I) and with women who had purchased ECP without prescription (IV). Self-administered waiting-room questionnaires were administered to women presenting for induced abortion in three large hospitals (II, III), and after the deregulation of ECP, a postal questionnaire was sent to pharmacy staff and nurse-midwives in three counties in mid-Sweden (V). </p><p>Overall, women showed high basic awareness of ECP although specific knowledge such as the level of effectiveness, time-frames and how the method works was lacking. Approval of the method was high and most women were positive to use the method if they needed. Contradictory views as to whether ECP undermines contraceptive behavior were expressed. As many as 43% of women requesting induced abortion had a history of one or more previous abortions. Among the abortion applicants, one out of five, 22%, had previously used ECP and 3% had used it to prevent the current pregnancy. Media and friends were the two most common sources of information on ECP. Half of the women, 52%, were positive to having ECP prescription-free. Those women who had purchased ECP in a pharmacy without prescription, appreciated this possibility, and the major benefits expressed were time saving aspects. No severe side-effects were reported. The women's experiences of interaction with pharmacy staff were both positive and negative. The importance of up-to-date information about ECP and the OTC-availability from the health care providers was emphasized. Both pharmacy staff and nurse-midwives had positive attitudes towards ECP and the OTC availability. Of pharmacy staff, 38% reported that they referred women to nurse-midwives/gynecologists for further counseling and follow-ups. The need for increased communication and collaboration between pharmacies and local family planning clinics was reported by both study groups with suggestions of regular meetings for information and discussions.</p><p>The results suggest that ECP is still underused and that more factual information is needed before the method is becoming a known, accepted and integrated back-up method to the existing family planning repertoire. Longitudinal research to assess the long-term effects of ECP is needed. </p>

The first study investigates the effect of daily low-dose mifepristone on proliferation markers [phospho-histone H3 (pH3) mitosis marker] and steroid receptors [oestrogen receptor, progesterone receptor, androgen receptor (AR)] in the endometrium. There was a significant down-regulation in pH3 and PR expression following mifepristone treatment whereas AR expression was up-regulated. Since androgens antagonize oestrogen-effects on the endometrium, mifepristone-induced AR up-regulation could play a role in its anti-proliferative effects. The second study investigates the effects of daily low-dose mifepristone on endometrial parameters [microvasculature, vascular endothelial growth factor (VEGF) and glucocorticoid receptor (GR)]. The majority (15/16) of subjects were amenorrhoeic, mean oestradiol concentrations remained in the mid-proliferative range and most (9/16 subjects) endometrial samples showed proliferative histology. GR expression was induced in the nuclei of glands and surface (luminal) epithelium and there was a significant increase in micro-vessel density and decrease in stromal VEGF following treatment. Glucocorticoids can modulate angiogenesis and the high incidence of mifepristone-induced amenorrhoea may be related to change in the regulation of vascular function. The third study investigates the effects of daily low-dose mifepristone on vaginal morphology, histology, steroid receptor and Serine Leukocyte Protease Inhibitor (SLPI) content. There was no change in vaginal thickness, steroid receptor and SLPI content and distribution following mifepristone treatment. The absence of changes, in contrast to other oestrogen-free hormonal contraception, is reassuring. The fourth study investigates the effect of three single doses of mifepristone on menstrual cycle and the feasibility of timing administration as a once-month-contraceptive pill based on the length of previous menstrual cycles (calendar). It is not possible to use the calendar approach to identify the correct time of administration of mifepristone and mifepristone disrupts menstruation in a dose-dependent manner.

Introdução: A prescrição da pílula anticoncepcional passa a ser realizada no Brasil a partir de 1962. Sua prática trouxe transformações políticas e sociais ao país: a pílula passa a ter grande aceitabilidade das mulheres e permanece como o método anticoncepcional mais utilizado por elas até a atualidade. Seu uso influenciou na queda da taxa de fecundidade e compõe, atrelada a uma série de outros fatores, um conjunto de transformações que modifica a formulação de políticas públicas referentes à saúde reprodutiva e à saúde sexual feminina. Objetivo: Compreender como a prescrição da pílula anticoncepcional por médicos ginecologistas era realizada no Brasil na época em que começa a ser utilizada no país. Metodologia: Trata-se de uma pesquisa qualitativa, tendo como material empírico as narrativas de seis médicos ginecologistas que atuaram na década de 1960, no estado de São Paulo. Resultados e Discussão: A partir das entrevistas, foram identificados quatro eixos temáticos de análise, que contemplaram a descrição Introdução: A prescrição da pílula anticoncepcional passa a ser realizada no Brasil a partir de 1962. Sua prática trouxe transformações políticas e sociais ao país: a pílula passa a ter grande aceitabilidade das mulheres e permanece como o método anticoncepcional mais utilizado por elas até a atualidade. Seu uso influenciou na queda da taxa de fecundidade e compõe, atrelada a uma série de outros fatores, um conjunto de transformações que modifica a formulação de políticas públicas referentes à saúde reprodutiva e à saúde sexual feminina. Objetivo: Compreender como a prescrição da pílula anticoncepcional por médicos ginecologistas era realizada no Brasil na época em que começa a ser utilizada no país. Metodologia: Trata-se de uma pesquisa qualitativa, tendo como material empírico as narrativas de seis médicos ginecologistas que atuaram na década de 1960, no estado de São Paulo. Resultados e Discussão: A partir das entrevistas, foram identificados quatro eixos temáticos de análise, que contemplaram a descrição sobre o primeiro contato dos médicos com a pílula, seguido das diferentes formas de utilização da pílula anticoncepcional como uma nova tecnologia. Também foi identificada a relação entre a prescrição médica e a indústria farmacêutica, assim como o uso da pílula anticoncepcional e a construção do discurso médico sobre o corpo feminino. Esses achados foram analisados à luz dos estudos sobre medicalização do corpo feminino, e como a sua prescrição foi sendo incluída na clínica médica a partir da década de 1960. Considerações Finais: O uso da pílula anticoncepcional apresentou-se como uma nova tecnologia de controle da reprodução e dos corpos femininos. Compreender a história da prescrição da pílula é levar em consideração os múltiplos agentes, interesses e práticas que ainda se inscrevem sobre os corpos das mulheres<br>Introduction: The prescription of the contraceptive pill began in Brazil in 1962. This practice brought political and social changes to the country: the pill becomes highly accepting of women and remains the contraceptive method most used by them until nowadays. The pill use has influenced the fall in fertility rate and, based on a series of other factors, is a set of transformations that modifies the formulation of public policies regarding reproductive health and female sexual health. Goal: To understand how the prescription of the contraceptive pill happened in Brazil, carried by gynecologists at the time when it begins to be used in the country. Methodology: This is a qualitative research, having as empirical material the narratives of six gynecologists who worked in the 1960s, at São Paulo state. Results and Discussion: From the interviews, four thematic axes of analysis were identified, which included the description of the first contact of the doctors with the pill, followed by different ways of using the contraceptive pill as a new technology. Also, were identified the relationship between medical prescription and the pharmaceutical industry, as well as the use of the contraceptive pill and the construction of the medical discourse about the female body. These findings were analyzed in light of the studies on medicalization of the female body, and how the contraceptive pill prescription was included in the medical clinic from the 1960s. Final Considerations: The use of the contraceptive pill was presented as a new technology for the control of Reproduction and of female bodies. Understanding the history of pill prescription is to take into account the multiple agents, interests, and practices that are still inscribed on women\'s bodies

Since the introduction of the combined oral contraceptive the dosage of both the oestrogen and progestogen components have been reduced to try to eliminate unwanted effects. Preparations with 20μg ethinyl oestradiol doses appear to inhibit ovulation effectively but allow appreciable ovarian activity. There have been problems also with unscheduled vaginal bleeding. Three ovulation inhibition studies were performed in which women were monitored over a pre treatment control cycle, three treatment cycles and a further cycle post treatment. Ovarian activity was monitored by ovarian ultrasound and hormone assays. Data on bleeding patterns and side effects also were recorded. The first study was a randomised double blind trial of the effect of 23 and 21 day administration of 20μg ethinyl oestradiol and 75μg gestodene. 20 women were allocated to 21 days active treatment and 22 women to receive 23 days active treatment. The women with the shorter pill free interval, had less ovarian activity in terms of serum oestradiol and follicle development. In addition there was less breakthrough bleeding. The 21 day preparation was launched in Europe in 1996.

The first oral contraceptive was introduced in the United States during the 1960s, and, subsequently, there was an increase in women’s labor force participation rates. Although the economic role of oral contraceptives is still highly debated by scholars, previous studies have found that the pill had a statistically significant impact on women’s labor force participation rates. Using the National Longitudinal Survey of Young Women, I will analyze how hours worked, hourly wages, weekly earnings and occupations for women were affected by oral contraceptives. By controlling for various governing statutes that affected the availability of the use and distribution of oral contraceptives in different states, I am able to provide evidence highlighting the extent of the pill’s significance. I find that early legal access (ELA) to oral contraceptives that resulted from residential states legalizing abortion before others positively and significantly affects women’s hours worked, hourly wages, weekly earnings and whether or not women entered into professional occupations.

Objective: To study midwives management, practice and reasoning regarding contraceptive counseling for women who are experiencing "mild" side effects of the pill Methods: Four focus groups, made up of three to five midwives per group, participated in focus group discussions. Qualitative design with the method “Think-Aloud” has been used to collect data and the material was analyzed using content analysis. Results: The study identified three categories, the first "How midwives practice regarding the side effects of the pill," shows that midwives have a systematic approach when meeting with women who are experiencing side effects of the pill. The next category "Using a holistic and professional approach for women" highlights that the midwives take women's side effects seriously and that midwives respect individual woman’s autonomy. Finally in the third category "Lack of evidence about side effects becomes a women's dilemma" here midwives describe varying ways of interpreting side effects as well as attitudes and socio-economic conditions in society that affect women's choice of contraception. Conclusion: The midwives express that side effects such as loss of libido, depression and weight gain are complex and often difficult to attribute solely to the pill. The midwives' work is characterized by a holistic approach. We see the benefits of sharing information in groups, therefor we suggest that midwives create mediums where they can learn from each other by sharing their valuable experience and knowledge.

Many biological systems vary rhythmically in response to changes in both the external and internal environment. Some rhythms, such as the menstrual cycle in women, are built into the organism and repeat themselves over time without any support from external factors. It has been acknowledged for a long time that in addition to the predictable changes in steroid hormones that occur over the menstrual cycle, many women also experience concomitant changes in their physical and emotional well being. Most of the literature concentrates on the fact that negative moods and physical changes seem to occur predominantly before and during menstruation. Given the close temporal relationship of these changes to the timing of the steroid cycle, causal mechanisms have traditionally been sought in the hormonal changes themselves. Yet the literature reveals that no causal role has consistently been found for any of a large number of hormonal parameters that change over the menstrual cycle. Further, there is good evidence that variations in well being of a similar magnitude, and with similar timing occur during the combined oral contraceptive pill cycle. This thesis is concerned with exploring the aetiology of cycle-related change in emotional and physical well being during oral contraceptive use. Its two fundamental objectives are 1) to clarify why women taking the pill have similar experiences to women with hormonally distinct, menstrual cycles, and 2) to test a novel aetiological hypothesis with women taking the pill that there exists an endogenous rhythm of well being that is coupled to, but not caused by cyclical hormones. This knowledge may help us to understand better the phenomenology of the 'normal' cycle. The role of social factors in the expression of cycle-related change is just as poorly understood as the complex influence of biological factors. Thus a third portion of this thesis is devoted to exploring the nature of women's beliefs about their cycles, and investigating how they may 'translate' in their experience and reporting.

Introduction: Exercise-induced muscle damage (EIMD) is an accepted consequence of eccentric exercise. Sex differences in EIMD are attributed to tendon properties, fascicle lengthening and direct hormonal influences, however these remain unreported in vivo. Furthermore, the classical definition of eccentric contractions omits the role of the elastic tendon in determining eccentric fascicle lengthening and subsequent EIMD. Aim: The overall aims of the current thesis were, to investigate the role of the patella tendon during eccentric contractions, to investigate whether muscle and tendon properties are determinants of EIMD and investigate group differences (sex and oral contraceptive (OCP)use) in EIMD. Materials and method: In brief, vastus lateralis (VL) and patella tendon properties were measured in males, females and female OCP users, using a combination of ultrasonography, electromyography and dynamometry. During maximal voluntary eccentric knee extensions ((MVEKE) 12 reps × 6 sets), VL fascicle lengthening and MVEKE torque was recorded every 10 of knee joint angle (20 - 90). Maximal isometric voluntary knee extensor (MVCKE) torque loss, creatine kinase (CK) and muscle soreness were measured pre, post, 48, 96 and 168 hours post damage as markers of EIMD. Main findings: Patella tendon properties appear to act as a mechanical buffer on VL fascicle lengthening during MVEKE in vivo. Furthermore, due to significantly higher patella tendon stiffness, VL fascicle lengthening was significantly greater in males compared to females. Despite evidencing an attenuating role of the patella tendon on VL fascicle lengthening, patella tendon properties did not correlate with any indirect markers of EIMD, nor did they explain group differences in EIMD. Furthermore, MVEKE torque, MVEKE torque made relative to estimated total quadriceps anatomical cross-sectional area and VL fascicle lengthening did not correlate with any functional indirect marker of EIMD, nor did they explain group differences in EIMD. Within the current thesis CK was the only indirect marker of EIMD to be significantly different between the groups (males > females < OCP users). Creatine kinase was consistently lower in the groups with lower circulating oestrogen levels. Therefore, it was concluded that the antioxidant and membrane stabilising role of oestrogen might explain the group differences in CK reported in the current thesis. Conclusion: In agreement with the historical definition, VL fascicles lengthen during MVEKE. Furthermore, it is evident from the current thesis that patella tendon properties determine the magnitude of VL fascicle lengthening during MVEKE, but do not appear to explain the variability or group differences in EIMD.

Some high-profile media stories called panics appear to result in various changes - legislative and behavioural. The word panic here refers both to the emotive quality of the story as event and to the behaviour that it is assumed to trigger. Conceptually, panics can tie related to moral panics, first described analytically by Cohen (1972) and elaborated by Goode and Ben-Yehuda (1994). The moral panic concept has been critiqued extensively and there have been attempts to integrate it with recent theoretical work on risk. Some of the media stories with the most extensive coverage appear to have caused little impact, as measured using alternative sources. How can this paradox be explained? The present work is a comparative study using content analysis of the presentation of four panics in the United Kingdom national press (1989-2007): the contraceptive pill scare of 1995, drug facilitated sexual assault, dangerous dogs, and road rage. In each case, the media presentation is contrasted with an alternative construction obtained using official statistics, interviews, reports and academic studies. The analysis leads to four main conclusions. The first describes the limitations of assumption of the effects of media coverage, and the importance of checking media conclusions about effects using other sources. The second is that the results of panics depend not only on their media depiction but on their underlying nature. I Third, localized risks are integral to understanding the emergence, depiction and effects oft panics. Finally, existing models of panics are inadequate for dealing with longer-term perspectives and processes of moralization.

<p>Background: In Namibia, studies showed that HIV/AIDS affects youth, especially the under 24 years age group. At the same time the pregnancy rate is also high by age 19. Interestingly, in&nbsp<br>Andara district several reports from staff working in the reproductive services have indicated that adolescent girls, who would seem to be taking responsibility in one sphere of their sexual lives&nbsp<br>by protecting themselves against unwanted pregnancy, were however not using condoms to protect themselves from HIV infection. Study Aim and Objectives: To describe the knowledge, attitude and behaviour related to HIV/AIDS amongst female adolescents who are accessing the primary health care (PHC) services for contraception. Specific objectives were to describe the&nbsp<br>knowledge of female adolescents who are accessing the PHC services for contraception about the modes of transmission and prevention of HIV/AIDS, to assess their attitude with regards to&nbsp<br>condom use, abstinence and being faithful to one uninfected partner, also to determine the significance of association between age and knowledge, attitudes and behaviour, between their&nbsp<br>education level and knowledge, attitudes and behaviour and the significance of association between knowledge of HIV prevention strategies and&nbsp<br>behaviour of female adolescents accessing&nbsp<br>&nbsp<br>PHC services for contraception in the district. Setting: The study was conducted in Andara district, North East of Namibia. Methods: Descriptive cross-sectional KAB study. Sample: All female&nbsp<br>adolescents who are accessing PHC services for contraception selected from multistage simple random sampling in 5 facilities and systematic sampling at facility level in Andara. All married&nbsp<br>women within this age range were excluded in the study. Data collection tool: An interviewer-administered standardised questionnaire was used to collect the data. Data analysis and&nbsp<br>Interpretations: Epi Info software 2002 was used for data analysis. The results were presented using descriptive statistics including means, 95% confidence intervals and percentages and&nbsp<br>this information was shown in tables, bar and pie charts. Cross-tabulations of knowledge, attitude and behaviour scores against demographic variables were performed. P-values &lt<br>0.05 were&nbsp<br>&nbsp<br>considered statistically significant. Results: 76.5% knew that unprotected sexual intercourse was the main way of getting HIV/AIDS, 77.3% knew that people could protect themselves by&nbsp<br>abstaining from sexual intercourse and 64.5% knew that people could protect themselves by having one uninfected faithful sexual partner. Out of 192 respondents who stated that unprotected&nbsp<br>sexual intercourse was the main way of HIV/AIDS transmission, 25.5% used condom every time they had sexual intercourse, 10.9% used condom almost every time they had sex, 41.1% used&nbsp<br>condom sometimes and 22.4% never used condom. Older girls and those who were in higher grades at school had more knowledge that could protect them from HIV infection. Later sexual&nbsp<br>debut is associated with increased&nbsp<br>condom usage at sexual debut. Conclusions: The general HIV knowledge of respondents and their knowledge of how to&nbsp<br>protect themselves from HIV infection were disappointing given that this&nbsp<br>study was conducted in health facilities. In this study we also see that knowledge does not always translate into the appropriate behaviour. The health services need to evaluate the targeting and&nbsp<br>effectiveness of their HIV educational messages and develop skills that will support behaviour change.&nbsp<br></p>

A Síndrome dos Ovários Policísticos (PCOS) é a endocrinopatia mais frequente em mulheres na idade reprodutiva, além de ser a causa mais comum de hiperandrogenismo e anovulação crônica. Diferentes fenótipos da PCOS foram identificados, e um melhor entendimento dessas diferentes apresentações clínicas se faz necessário para o reconhecimento de riscos, medidas preventivas e terapêuticas específicas para cada fenótipo. Associações entre polimorfismos de substituição de um único nucleotídeo (SNPs) em genes que codificam enzimas responsáveis pelo metabolismo androgênico e PCOS foram descritos. O anticoncepcional oral (ACO) é utilizado para o tratamento de mulheres com PCOS por seu efeito supressivo na secreção de androgênios ovarianos e melhora do hirsutismo. Entretanto, os dados na literatura são conflitantes quanto aos efeitos do ACO nos parâmetros metabólicos de mulheres com PCOS. Além disso, não está bem estabelecido se a presença de alelos polimórficos está associada com diferenças nos fenótipos da PCOS e se pode influenciar na resposta ao tratamento com ACO. Os objetivos desta tese foram investigar a influência dos SNPs -71 AG no gene AKR1C3 e SNP50 no gene CYP19 gene (substituição de G por A) na resposta de mulheres com PCOS ao tratamento com ACO e verificar se o SNP50 está associado com fenótipos da PCOS. Cento e sessenta e duas mulheres com PCOS foram estratificadas em PCOS clássicas (hiperandrogenismo e disfunção ovulatória, c-PCOS) e PCOS ovulatórias (hiperandrogenismo, ciclos ovulatórios, aparência policística dos ovários, ov-PCOS) e uma subamostra de 51 mulheres (que não apresentavam resistência insulínica evidente) completaram 6 meses de tratamento com ACO (20 ug etinilestradiol e 75 ug gestodeno, 21/28 dias por ciclo). A presença ou ausência dos alelos polimórficos foram consideradas para expressar os resultados que avaliaram os SNPs -71 AG e SNP50. O escore de hirsutismo foi similar em c-PCOS e ov-PCOS, e as diferenças nos parâmetros hormonais e metabólicos observadas foram independentes da presença do alelo A do SNP50. Após os 6 meses de tratamento com ACO, como era esperado, os níveis de testosterona total e o escore clínico de hirsutismo diminuíram, enquanto os níveis da globulina carreadora de hormônios sexuais aumentaram. Houve uma pequena redução da pressão arterial sistólica e do hormônio luteinizante. As medidas de insulina e do índice HOMA permaneceram inalteradas após o tratamento. Houve um aumento dos níveis de lipídios, mas os valores permaneceram dentro dos limites da normalidade. Nenhuma das alterações observadas esteve associada com a presença dos alelos polimórficos dos SNPs -71 AG ou SNP50. As conclusões são de que o ACO é uma alternativa eficaz para o tratamento dos sintomas do hiperandrogenismo, sem comprometimento dos parâmetros metabólicos, pelo menos naquelas mulheres sem resistência insulínica prévia ao tratamento. Os SNPs -71AG no gene AKR1C3 e SNP50 no gene CYP19 não contribuem para as melhoras observadas com o uso do ACO. Além disso, o SNP50 parece não estar associado com as diferenças existentes entre os fenótipos clássico e ovulatório da PCOS.<br>Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder in women at reproductive age, and also the most common cause of hyperandrogenism and chronic anovulation. Different phenotypes of PCOS have been identified, and a better knowledge of these clinical symptoms is necessary to recognize risks, prevention, and treatment strategies for each phenotype. Associations between single nucleotide polymorphisms (SNPs) in genes that codify enzymes responsible for the androgenic metabolism and PCOS have been described. The oral contraceptive pill (OCP) is used to treat women with PCOS due to the suppressive effect on ovarian androgen secretion, with consequent amelioration of hirsutism. However, data are conflicting in literature regarding the effects of OCP on metabolic variables in PCOS. Besides that, it is not well established whether the presence of polymorphic alleles is associated with PCOS phenotypes and whether can influence on the response to OCP treatment. The aims of this thesis were to investigate the influence of the SNPs -71 AG at AKR1C3 gene and SNP50 of CYP19 gene (G to A substitution) on the response of PCOS to treatment with oral contraceptive pills and to assess whether the SNP50 is associated with PCOS phenotypes. A hundred sixty two hirsute women were stratified into a classic PCOS group (hyperandrogenism and ovulatory dysfunction, c-PCOS) and an ovulatory PCOS group (hyperandrogenism, ovulatory cycles, polycystic ovaries, ov-PCOS), and a subsample of 51 women (without evidences of insulin resistance) completed a 6-month OCP trial (20 ug ethinylestradiol plus 75 ug gestodene, 21/28 days per cycle). We considered the presence or absence of the polymorphic alleles to express results and to perform the comparisons regarding the SNPs -71 AG and SNP50. Hirsutism score was similar in c-PCOS and ov-PCOS, and the differences in hormone and metabolic variables between phenotypes were independent of the presence of allele A for SNP50. After 6 months of OCP treatment, as expected, total testosterone and hirsutism score declined, while sex hormone binding globulin increased. There was a slight reduction in systolic blood pressure and luteinizing hormone levels. Insulin and homeostasis model assessment remained unchanged after treatment. There was an increase in lipids, but the values remained at the normal range. None of these changes were associated with the presence of polymorphic alleles for -71 AG or SNP50 polymorphisms. We conclude that OCP is an alternative to ameliorate androgenic symptoms without compromising metabolic parameters, at least in women without insulin resistance before treatment. The -71AG SNP of AKR1C3 gene and the SNP50 of CYP19 gene did not contribute to the improvements observed. Besides that, SNP50 may not be associated to the existing differences between classic and ovulatory PCOS phenotypes.

Orientador: Maria Helena Baena de Moraes Lopes<br>Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas<br>Made available in DSpace on 2018-08-20T23:10:47Z (GMT). No. of bitstreams: 1 Alves_AngelaFerreiraSilvaMiranda_M.pdf: 8133917 bytes, checksum: 2ddba523f4ac0561b3078da05e510508 (MD5) Previous issue date: 2012<br>Resumo: A gravidez na adolescência é um problema de saúde pública, que traz complicações não somente aos adolescentes, mas à criança, à família e a toda a sociedade. De acordo com a Organização Mundial de Saúde (OMS) a adolescência corresponde como sendo a segunda fase da vida e varia as idades entre 10 e 19 anos. Pesquisadores demógrafos desenvolveram um modelo especial conhecido como estudo CAP (Conhecimento, Atitude e Prática), que pretende medir o conhecimento, atitude e prática de uma população, permitindo fazer um diagnóstico e mostrar o que as pessoas sabem, sentem e como elas se comportam perante determinado tema. Determinadas características de personalidade contribuem para a adesão ou não da anticoncepção na adolescência, e isso é o que a escala de lócus de controle pretende avaliar, ou seja, quem ou o quê é responsável pelo controle de sua própria vida. Pode ser interna, no caso do indivíduo acreditar que mantém o controle sobre sua vida; ou externa, no caso do sujeito atribuir o controle da sua vida a outras pessoas, entidades ou até mesmo sorte ou destino. O presente estudo visa avaliar a relação entre o lócus de controle; conhecimento, atitude e prática na anticoncepção em um grupo de adolescentes do ensino médio de escolas públicas no interior de Minas Gerais, a fim de melhor subsidiar o desenvolvimento de intervenções específicas para esse público alvo. Tratou-se de um estudo descritivo e transversal, com abordagem quantitativa. A amostra foi composta por 1193 adolescentes. Iniciaram as relações sexuais 494 (41,4%) adolescentes, e dentre os que haviam iniciado, 424 (87%) relatou ter usado algum método contraceptivo na primeira relação sexual. Os métodos mais utilizados foram o preservativo masculino e a pílula anticoncepcional. Observou-se que 282 (74,7%) dos adolescentes buscam informações por meio de sugestões da família, do companheiro e de informações dadas pelos profissionais de saúde. Analisando o conhecimento em relação à prática, observou-se uma correlação positiva fraca (p<0,0001 e r=0,361), indicando que quanto maior os índices de conhecimento, maiores os de prática. Considerando-se a relação entre atitude e conhecimento, o adolescente que tem uma atitude positiva apresentou maior conhecimento sobre os métodos (p=0,0002). Em relação à prática, a atitude positiva também estava relacionada a uma prática mais adequada (p<0,0001), indicada pelos índices mais elevados de acerto das questões relacionadas. Comparando a pílula e o preservativo, há um maior conhecimento e prática em relação ao preservativo. Quanto ao lócus de controle, as adolescentes do sexo feminino tiveram maior Externalidade Outros Poderosos quando comparados com os adolescentes masculinos (p=0,0015). Na correlação do lócus de controle com a idade, os adolescentes com idade acima de 17 anos tem maior Externalidade Acaso (p=<0,0001) que os de menor idade. Os estudantes que fizeram uso de algum método anticoncepcional na primeira relação sexual apresentaram maior Externalidade Outros Poderosos (p=0,0107) e o uso de coito interrompido, como uso de contraceptivo, relacionou-se com maior Externalidade Acaso (p=0,0013). Os que faziam uso atual de algum método apresentavam maior Externalidade Outros Poderosos (p=0,0217) e Externalidade Acaso (p=0,0077), o uso atual de preservativo masculino também esteve associado a maior Externalidade Acaso (p=0,0001). A Internalidade foi inversamente proporcional à prática (p=< 0,05 e r= -0,075), porém a correlação foi ínfima. Não houve associação entre a atitude e as dimensões do lócus de controle. Conclui-se que os adolescentes iniciam atividade sexual precocemente, mas buscam informações sobre anticoncepção. Apesar do conhecimento dos adolescentes sobre anticoncepção, existe uma necessidade de ampliar o acesso a serviços especializados, como também, enfocar sobre a importância do processo educativo referente à sexualidade, promoção da saúde e a inclusão da família e da comunidade nesse processo. As dimensões do lócus de controle influenciam a prática contraceptiva nesse grupo de adolescentes, assim, elas podem ser consideradas nas intervenções relacionadas à anticoncepção<br>Abstract: Teenage pregnancy is a public health problem, which brings complications not just for adolescents but to the child, family and society as a whole. According to World Health Organization (WHO), the adolescence corresponds as the second phase of life and ages ranging between 10 to 19 years old. Researches demographers have developed a special study known as KAP (Knowledge, Attitudes and Practices), which aims to measure knowledge, attitude and practice of a population, allowing a diagnosis and to show what people know, feel and how they behave towards certain theme. Certain traits of personality contribute to the membership or not of contraception in adolescence, and this is what the scale of lócus of control to evaluate, and, who or what is responsible for controlling their own lives. It can be internal, in the case that the individual believe that he maintains the control over his life, or external, in the case of the subject to assign control over his life to other people, entities or even luck or fate. The present study evaluates the relation between lócus of control, knowledge, attitude and practice on contraception in a group of high school adolescents from public schools in the interior of Minas Gerais state, in order to better inform the development of specific interventions for this public target. This was a descriptive and transversal study with a quantitative approach. The sample comprised 1,193 adolescents. Of all these adolescents, 494 (41.4%) had already the first intercourse, and among those who had started, 424 (87%) reported having use a contraceptive method at first intercourse. The methods used were the condom and the birth control pill, observed that 282 (74,7%) of the teenagers seek information through suggestions from family, partner and information given by health professionals. Analyzing knowledge regarding the practice, there was a weak positive correlation (p <0.0001 and r = 0.361), indicating that the higher rates of knowledge, the largest of practice. Considering the relationship between attitude and knowledge, the teenager who has a positive attitude showed greater knowledge about methods (p = 0.0002). Regarding practice, positive attitude was also related to a more appropriate practice (p <0.0001), indicated by higher rates of correct questions. Comparing the birth control pill and condoms, there is a greater knowledge and practice about condom use. Regarding the lócus of control, female adolescents were more Powerful than Others Externality compared to male adolescents (p=0.0015). In the correlation of lócus of control with age, adolescents aged of 17 years have more chance externality (p=<0.0001) than those of younger age. Students who used a contraceptive method at first intercourse had higher Powerful Others Externality (p=0.0107) and the use of coitus interruptus, and contraceptive use, was related to greater Externality by Chance (p=0.0013). Those who were currently using some method had higher Powerful Others Externality (p=0.0217) and Chance Externality (p=0.0077), current use of condoms was also associated with greater externality Chance (p=0.0001). The Internality was inversely proportional to the practice (p=<0.05 and r=-0.075), but the correlation was insignificant. There was no association between the attitude and the dimensions of lócus of control. It is concluded that adolescents initiate sexual activity early, but seek information about contraception. Despite the knowledge of adolescents about contraception, there is a need to expand that access to specialized services, but also focus on the importance of the educational process about sexuality, health promotion and inclusion of the family and community in this process. The dimensions of lócus of control influence contraceptive practice in this group of adolescents, so they can be considered in interventions related to contraception<br>Mestrado<br>Enfermagem e Trabalho<br>Mestra em Ciências da Saúde

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária<br>O reconhecimento da presença de recetores específicos para as hormonas sexuais, estrogénio e progesterona, na gengiva humana, fez com que o tecido periodontal passasse a ser considerado alvo potencial para as variações hormonais as quais, por sua vez, passaram a constituir possíveis fatores modificadores da resposta inflamatória inerente ao hospedeiro quando do estabelecimento da doença periodontal. Para tanto, evidencia-se o papel das hormonas sexuais na vascularização tecidual, na resposta imunitária, no perfil funcional das células próprias do periodonto, assim como, no reparo tecidual e no metabolismo ósseo. Diante desses aspectos, em razão da vasta utilização de contracetivos orais como método hormonal preferencial das mulheres no planeamento familiar, realizou-se revista na literatura para que fossem coligidos os dados mais relevantes acerca do impacto que a administração de produtos sintéticos, a base de estrogénio e progesterona, podem ter sobre o tecido periodontal. Foi realizada, assim, pesquisa na base de dados PUBMED, Sciene Direct, Bireme, Scielo, B-on e Google Académico, sem que limite temporal fosse estabelecido. Na pesquisa também foram utilizadas algumas obras literárias. Do referido trabalho, concluiu-se que as mulheres que utilizam contraceptivos orais, apresentam um aumento de perda de inserção clínica e rápida progressão da doença periodontal, decorrente do aumento da concentrações hormonais nos tecidos subgengivais, da existência de placa bacteriana, bem como, da sua utilização prolongada. The recognition of the existence of specific hormone receptors, estrogen and progesterone, in the human gingiva, has placed the periodontal tissue as a potencial target to hormonal variations, which became possible modifier factors inherent to the host’s inflammatory response when periodontal disease sets. Accordingly, the role of sex hormones in vascular tissue, the immune response, the functional profile of the periodontum’s own cells as well as in tissue repair and bone metabolism, are highlighted. Considering these aspects and due to the widespread use of oral contraceptives as a preferential method used by women in family planning, a literary review was held in order to collect the most relevant data about the impact that the administration of syntethic products, the basis of estrogen and progesterone may have on periodontal tissue. Hereby, a research was made in PUBMED, Science Direct, Bireme, Scielo, B-on and Google Académico, without any time limits. In addition, some literary works were also used in this research. In this study it has been concluded that, women who use oral contraceptives have an increased loss attachment and quick progression of the periodontal disease, due to the increase of hormonal concentrations in subgengival tissues,, the existence of bacterial plaque as well as its prolonged use.

The aim of this study was to explore a broad range of high risk behaviours amongst the Muslim community in Australia. Social supports, decision making and lifestyle factors were also investigated. Previous studies have found religiosity to be a protective factor for risk behaviours. However few studies have examined a broad variety of risk behaviours, particularly in the Muslim community. Respondents for this study included 149 adults who identified as Muslims and participated in an online survey adapted from that used by (Abbott-Chapman & Denholm, 2001; Abbott-Chapman, Denholm, & Wyld, 2008a, 2008b). The Risk Activity by Personal Risk Assessment (RAPRA) index was used to combine risk perception and risk involvement scores of 24 risk behaviours to determine risk propensity from the perspective of the participants. Weighted averages of the 24 risk behaviours were correlated with demographic data using Pearson’s correlations and one way Analysis of Variance (ANOVA) tests to determine factors associated with each risk behaviour. The religiosity index which combined religious beliefs, place of worship attendance and religious importance was also correlated with weighted averages to determine if religiosity was a protective factor. Relationships between risk activities were also explored. Data on social support networks, decision making and lifestyle values were also collected. On average, behaviours involving manufactured illegal drug use were of least concern and sex without self/partner being on the pill, watching R or X rated movies, sex without a condom and speeding in a car were of highest concern. However risk propensity ranged from low to moderate across all 24 behaviours. Characteristics related to the most risks were being a male, being a parent and low religiosity which were all related to alcohol, smoking marijuana/hash and smoking cigarettes. All risk activities had significant relationships with other risk activities in the study. High religiosity was found to be protective for binge drinking, alcohol use, cigarettes, gambling, smoking marijuana/hash, snorting cocaine and taking speed/ecstasy. Muslims would seek support from their close family members and same gender friends for personal and career issues and parents were most trusted. Doctors were most relied on for health problems and teachers/educators were most relied on for study problems. When making decisions about risk, Muslims concern for safety, morality, legality and family were found to be important. Lifestyle values considered important by Muslims included self-respect, being responsible for one’s own actions, perceptions of right and wrong and respecting others. Muslims considered following rules set by religion, sharing experience with someone more experienced, seeking advice from parents and seeking advice from members of their religious community all as important when making decisions about their lifestyle. These findings provide significant data for future research in specific areas of concern in the Muslim community particularly with men and parents. This study also supports research that implies that high religiosity is effective in preventing involvement in risk activities. Religion, family and community were found to important values in the lives of Muslims and in their decision making processes.

Since its release onto the market in 1960, the oral contraceptive pill (OCP) has become one of the most widely used medications for women. During the ensuing 60 years, most countries have made the OCP available-over-the counter (OTC), due to its safety profile and public health policies of making access to contraception a right for women. Australia is becoming anomalous by its continued prescription-only status for the OCP. This study aimed to explore contemporary Australian women’s experiences of accessing the OCP, as well as to understand these women’s uses of the OCP with one-to-one semi-structured interviews (n=25). Within a feminist post-structuralist framework, Thematic Discourse Analysis was employed to produce five discursive themes: Auxiliary Uses of the OCP - the ‘Lifestyle Drug’; Barriers to Obtaining the OCP for Women under 25; Barriers to Obtaining the OCP for Women 25 and Over; The Impact of Gender on the Clinical Experience; and The Medical Expertise of the General Practitioner. In the study it was found that women aged 25 or over primarily encountered structural barriers to obtaining the OCP, while women under 25 years described experiencing a range of social and cultural barriers to access. The study also demonstrated that the OCP is often used not as a contraceptive, but as medication for acne, and heavy and/or painful periods. The results of this study may inform further research and Australian public health policy makers on women’s barriers to contraception which may be removed by scheduling the OCP to OTC to be in line with analogous countries.

Relatório de Estágio do Mestrado Integrado em Ciências Farmacêuticas apresentado à Faculdade de Farmácia<br>Since the beginning of humanity, the human being has shown interest and, mainly, concern with contraceptive methods. The concern for controlling the household and, later, obtaining sexual pleasure, has always been the basis of the evolution of contraceptives and contraception methods, which have improved throughout history. However, its evolution was marked by ideals and values in force at certain times and which were decisive for what we now call contraceptive methods.In this study, several methods of contraception will be described, some older, others more recent; some more comfortable, others less so; its origin and evolution, and we will see how they all aimed to avoid a high number of pregnancies that could lead women to suffer countless diseases and control the number of children in each family.This monograph aims to understand how in the most ancient times, times when there was not an abundance of information that exists today, proceeded in relation to contraceptive methods, and how the evolution of these same methods were influenced by values ​​and ideals defended by society at certain times in human history.After almost five years of theoretical training, students of the Integrated Master's Degree in Pharmaceutical Sciences (MICF) will have to do an internship in community pharmacy. This internship proves to be of great importance at the culmination of a university education cycle, as it is where students will be able to put into practice all the theoretical knowledge acquired during the course, and confront the reality of the labor market.This internship report will be described in SWOT format of the internship that was carried out at Pharmacy Adriana (FA) in Coimbra between January 6, 2020 and July 24, 2020 under the guidance of Dr. João Pimentel, together with the pharmacy team composed by Dr. Ângela Mota and the Technique Adélia Guerra, who supported me throughout my path and in applying theoretical knowledge to professional practice.<br>Desde do início da humanidade que o ser humano tem mostrado interesse e,principalmente, preocupação com métodos contracetivos. A preocupação pelo controlo doagregado familiar e, mais tarde, obtenção do prazer sexual, esteve sempre na base da evoluçãodos contracetivos e métodos de contraceção, que foram melhorando ao longo da história.Porém, a sua evolução foi marcada por ideais e valores vigentes em determinadas épocas eque foram determinantes para o que hoje chamamos de métodos contracetivos.Neste estudo serão descritos vários métodos de contraceção, uns mais antigos, outrosmais recentes; uns mais cómodos, outros nem tanto; sua origem e evolução, e veremos comotodos tiveram como objetivo evitar um elevado número de gestações que poderiam levar asmulheres a sofrer inúmeras doenças e controlar o número de filhos de cada família.Esta monografia tem como objetivo compreender como nos tempos mais antigos, tempos esses dos quais não havia a abundância de informação que existe hoje, se procedia em relação a métodos contracetivos, e como a evolução destes mesmos métodos foram influenciados por valores e ideais defendidas pela sociedade em determinadas épocas da história da humanidade.Após quase cinco anos de formação teórica, os estudantes do curso do mestrado integrado em ciências farmacêuticas (MICF) terão que realizar um estágio em farmácia comunitária. Este estágio revela-se de enorme importância no culminar de um ciclo de formação universitária, pois é nele que os estudantes vão poder colocar em prática todos os conhecimentos teóricos adquiridos durante o curso, e confrontar-se com a realidade do mercado de trabalho.Este relatório de estágio será descrito em formato SWOT do estágio que foi realizado na Farmácia Adriana (FA) em Coimbra entre 6 de janeiro de 2020 e 24 de julho de 2020 sob orientação do Dr. João Pimentel, juntamente com a equipa da farmácia composta pela Dra. Ângela Mota e a Técnica Adélia Guerra, que me apoiaram em todo o meu percurso e na aplicação do conhecimento teórico à prática profissional.

The diploma thesis is focused on the social aspects of women's oral hormonal contraception in the lives of two generations of women - daughters and their mothers. The theoretical part introduces the fundamental concepts of contraception research based on gender perspective. It also highlights the important historical milestones related to so-called birth control pill. Furthermore, the development of the contraceptive behavior of the Czech population since the 50s of the 20th century is analyzed. The empirical part of this thesis includes the description of methodology and the analysis of semi-structured interviews with ten women - mothers who were born in the 1960s and their daughters born around the turn of the 80s and 90s. The aim of the analysis is to discover how a generally accepted theory about contraception as the emancipation mechanism that helps women to control their own body and decide about their own reproduction is expressed in the lives of interviewed women. I ask the reason why, when and under what conditions these women decided to use birth control pills and the role of other circumstances in their decision-making. Moreover, I focus on the way how the birth control pills affect the relationship to own body and self-esteem of my respondents. And also, how birth control pills affect...