Search

Detta var en kvalitativ studie där sex personer medverkade i intervjuer. Syftet var att undersöka chefer och medarbetares upplevelser av inre motivation och meningsfullhet såsom begreppen defineras enligt teorierna om Kasam och Self Determination Theory, kopplat till en välfungerande organisation. Tematisk analysmetod användes för att svara på studiens syfte och frågeställning. Resultatet visade att meningsfullhet, så som det förstås enligt Kasam och inre motivation från Self Determination Theory, tillsammans bidrar till arbetsengagemang utifrån ett arbets- och organisationsperspektiv. Studien visar även att gemenskap och socialt stöd är viktigt för att individer ska uppleva en hög känsla av inre motivation på arbetsplatsen. Likaså visade resultatet att individer som upplever inre motivation och meningsfullhet bidrar till en välfungerande organisation där individerna är engagerade i sina arbeten. Individer som upplever inre motivation samt meningsfullhet har goda förutsättningar för att uppnå en god psykologisk hälsa., This was a qualitative study with six people participated in interviews. The aim was to examine managers' and employees' experiences of intrinsic motivation and meaningfullness, as the concepts are defined according to the theories of Sense of Coherence and Self Determination Theory, linked to a well-functioning organization. Thematic analysis method was uused to answer the aim of the study and the study question. The result showed that meaningfullness, as understood within SOC and intrinsic motivation from Self Determination Theory, together contribute to work commitment based on a work and organizational perspective. The study also shows that kinship and social support are important for individuals to experience a high sense of intrinsic motivation in the workplace. Likewise, the results showed that individuals who experience intrinsic motivation and meaningfullness contribute to a well-functioning organization where the individuals feel strong work engagement. Individuals who experience intrinsic motivation and meaningfullness are prone to achieve good psychological health.

Background: Severe perineal lacerations (SPLs), common worldwide, are associated with short- and long-term complications: pelvic floor disorders, fecal incontinence, fistula, and profound psychological impacts. Limited research suggests that experiencing SPL may influence future reproductive intentions, but research on outcomes is lacking. Methods: We analyzed the effect of experiencing SPL during a first delivery among a large cohort of Swedish births between 1992 and 2013. We used linear and multinomial logistic regression to estimate the associations between SPL and four reproductive outcomes: subsequent total birth number, probability of a second birth, interpregnancy interval (IPI), and subsequent scheduled cesarean birth. Results: Among 947,035 singleton live-born first-births, we found that experiencing SPL was associated with slightly fewer overall births in fully adjusted models (a decrease of -0.020 births; 95% confidence interval [CI]: -0.028 to -0.012), but no difference in the probability of a second birth (risk ratio [RR]: 1.00; 95% CI: 0.99 to 1.00) or IPI. Scheduled cesarean was increased in births after SPL (adjusted RR: 4.57; 95% CI: 4.42 to 4.73). A secondary comparison of SPL to severe postpartum hemorrhage suggests that some of these observed differences may be related to experiencing any severe outcome, and some specifically to perineum disruption. Conclusion: This study provides a deeper understanding of the long-term impacts of SPL, which may be useful in informing best clinical practices for supporting women who have experienced SPL.

‘Doing science together’ collaborations are a more intense form of university–industry interactions and are characterized by a mutual involvement and active participation of academic and company scientists in scientific research. Here, we examine the successful approach that AstraZeneca and its internationally renowned academic partners, Karolinska Institutet and Uppsala University, implemented to fully unlock the potential of all parties in long-term, explorative, truly collaborative research programs. The underlying premises of these successful research programs are three collaborative governance mechanisms (3MCs) that are required that leverage the strengths of each organization: mutual collaboration; mutually beneficial science; and a mutual governance model with senior management involvement.

INTRODUCTION: Risk evaluation for preeclampsia in early pregnancy allows identification of women at high risk. Prediction models for preeclampsia often include circulating concentrations of placental growth factor (PlGF); however, the models are usually limited to a specific PlGF method of analysis. The aim of this study was to compare three different PlGF methods of analysis in a Swedish cohort to assess their convergent validity and appropriateness for use in preeclampsia risk prediction models in the first trimester of pregnancy. MATERIAL AND METHODS: First-trimester blood samples were collected in gestational week 11+0 to 13+6 from 150 pregnant women at Uppsala University Hospital during November 2018 until November 2020. These samples were analyzed using the different PlGF methods from Perkin Elmer, Roche Diagnostics, and Thermo Fisher Scientific. RESULTS: There were strong correlations between the PlGF results obtained with the three methods, but the slopes of the correlations clearly differed from 1.0: PlGFPerkinElmer = 0.553 (95% confidence interval [CI] 0.518-0.588) * PlGFRoche -1.112 (95% CI -2.773 to 0.550); r = 0.966, mean difference -24.6 (95% CI -26.4 to -22.8). PlGFPerkinElmer = 0.673 (95% CI 0.618-0.729) * PlGFThermoFisher -0.199 (95% CI -2.292 to 1.894); r = 0.945, mean difference -13.8 (95% CI -15.1 to -12.6). PlGFRoche = 1.809 (95% CI 1.694-1.923) * PlGFPerkinElmer +2.010 (95% CI -0.877 to 4.897); r = 0.966, mean difference 24.6 (95% CI 22.8-26.4). PlGFRoche = 1.237 (95% CI 1.113-1.361) * PlGFThermoFisher +0.840 (95% CI -3.684 to 5.363); r = 0.937, mean difference 10.8 (95% CI 9.4-12.1). PlGFThermoFisher = 1.485 (95% CI 1.363-1.607) * PlGFPerkinElmer +0.296 (95% CI -2.784 to 3.375); r = 0.945, mean difference 13.8 (95% CI 12.6-15.1). PlGFThermoFisher = 0.808 (95% CI 0.726-0.891) * PlGFRoche -0.679 (95% CI -4.456 to 3.099); r = 0.937, mean difference -10.8 (95% CI -12.1 to -9.4). CONCLUSION: The three PlGF methods have different calibrations.

Importance: Adverse pregnancy outcomes are recognized risk enhancers for cardiovascular disease, but the prevalence of subclinical coronary atherosclerosis after these conditions is unknown. Objective: To assess associations between history of adverse pregnancy outcomes and coronary artery disease assessed by coronary computed tomography angiography screening. Design, Setting, and Participants: Cross-sectional study of a population-based cohort of women in Sweden (n = 10 528) with 1 or more deliveries in 1973 or later, ascertained via the Swedish National Medical Birth Register, who subsequently participated in the Swedish Cardiopulmonary Bioimage Study at age 50 to 65 (median, 57.3) years in 2013-2018. Delivery data were prospectively collected. Exposures: Adverse pregnancy outcomes, including preeclampsia, gestational hypertension, preterm delivery, small-for-gestational-age infant, and gestational diabetes. The reference category included women with no history of these exposures. Main Outcomes and Measures: Coronary computed tomography angiography indexes, including any coronary atherosclerosis, significant stenosis, noncalcified plaque, segment involvement score of 4 or greater, and coronary artery calcium score greater than 100. Results: A median 29.6 (IQR, 25.0-34.9) years after first registered delivery, 18.9% of women had a history of adverse pregnancy outcomes, with specific pregnancy histories ranging from 1.4% (gestational diabetes) to 9.5% (preterm delivery). The prevalence of any coronary atherosclerosis in women with a history of any adverse pregnancy outcome was 32.1% (95% CI, 30.0%-34.2%), which was significantly higher (prevalence difference, 3.8% [95% CI, 1.6%-6.1%]; prevalence ratio, 1.14 [95% CI, 1.06-1.22]) compared with reference women. History of gestational hypertension and preeclampsia were both significantly associated with higher and similar prevalence of all outcome indexes. For preeclampsia, the highest prevalence difference was observed

Background: Little is known about the latent phase of labor, including whether its duration influences subsequent labor processes or birth outcomes. Objective: This study aimed to describe the duration of the latent phase of labor from self-report of the onset of painful contractions to a cervical dilation of 5 cm in a large, Swedish population and evaluate the association between the duration of the latent phase of labor and perinatal processes and outcomes that occurred during the active phase of labor, second stage of labor, birth and immediately after delivery, stratified by parity. Study Design: This was a population-based cohort study of 67,267 pregnancies with deliveries between 2008 and 2020 in the Stockholm -Gotland Regions, Sweden. Nulliparous and parous women without a history of cesarean delivery in spontaneous labor with a term (>= 37 weeks of gestation), singleton, live, and vertex fetus without major malformations were included. Imputation was used if the notation of the end of the latent phase of labor (ie, cervical dilation of 5 cm) was missing in the partograph. Multivariable logistic regression was used to estimate the association with adjusted odds ratios and 95% confidence intervals, controlling for po-tential covariates. Results: Including the time from painful contraction onset to a cervical dilation of 5 cm, the median durations of the latent phase of labor were 16.0 (interquartile range, 10.0-26.6) hours for nulliparous women and 9.4 (interquartile range, 5.9-15.3) hours for multiparous women. The durations of the latent phase of labor beyond the median were associated with increased odds of labor dystocia diagnosis during the first stage active phase or second stage of labor and interventions commonly associated with dystocia (amniotomy, oxytocin augmentation, epidural, and cesarean delivery). The duration of the latent phase of labor of >90th percentile vs less than the median in nulliparous women demonstrated an increased risk of ad

Background: Physical activity is a useful means to improve symptoms and memory performance to some extent in individuals with stress-induced exhaustion disorder. Individuals in this group commonly do not need to reach the recommended levels of physical activity. Developing methods to support physical activity as a lasting behaviour is important. Objective: The aim of the study was to explore the processes involved when using physical activity prescription as part of rehabilitation in a group context for individuals with stress-induced exhaustion disorder. Method: A total of 27 individuals with stress-induced exhaustion disorder participated in six focus groups. The informants underwent a multimodal intervention including prescription of physical activity. The physical activity prescription had a cognitive behaviour approach and included information about physical activity, home assignments and goal setting. The data was analysed with grounded theory method using constant comparison. Results: The analysis of the data was developed into the core category ‘trying to integrate physical activity into daily life in a sustainable way’, and three categories: ‘acceptance of being good enough’, ‘learning physical activity by doing’ and ‘advocation for physical activity in rehabilitation’. The informants identified that during the physical activity prescription sessions they learned what physical activity was, what was ‘good enough’ in terms of dose and intensity of physical activity, and how to listen to the body’s signals. These insights, in combination with performing physical activity during home assignments and reflecting with peers, helped them incorporate physical activity in a new and sustainable way. A need for more customised physical activity with the ability to adjust to individual circumstances was requested. Conclusion: Prescription of physical activity in a group context may be a useful method of managing and adjusting physical activity in a sustainable way for

The aim of this study was to examine how women who have been in an alcohol addiction describe their experiences of being a woman who has an alcohol addiction and the possible shame and stigma related to it. We used Goffman's theory about stigma, narrative theory, and Judith Butler's theory of gender. The study was to be carried out based on their narrative in the form of autobiographies. Our selection criteria were women with alcohol addiction, the author had to be the person who had experienced it and the autobiographies had to take place in a Swedish context. The books also had to be available in Lund´s libraries. In this study, a qualitative research method was used in the form of narrative analysis. The most important results were that the authors had experienced shame and stigma linked to their addiction. This affected them in different ways, mostly negatively. Their experiences of being a woman with alcohol addiction were related to norms and ideals. It was clear to us that the women in the autobiographies have a hard time living up to the expectations that come with being a woman because of their alcohol addiction.

Pregnancy-related factors are important for short- and long-term health in mothers and offspring. The nationwide population-based Swedish Medical Birth Register (MBR) was established in 1973. The present study describes the content and quality of the MBR, using original MBR data, Swedish-language and international publications based on the MBR. The MBR includes around 98% of all births in Sweden. From 1982 onwards, the MBR is based on prospectively recorded information in standardized antenatal, obstetric, and neonatal records. When the mother and infant are discharged from hospital, this information is forwarded to the MBR, which is updated annually. Maternal data include information from first antenatal visit on self-reported obstetric history, infertility, diseases, medication use, cohabitation status, smoking and snuff use, self-reported height and measured weight, allowing calculation of body mass index. Birth and neonatal data include date and time of birth, mode of delivery, singleton or multiple birth, gestational age, stillbirth, birth weight, birth length, head circumference, infant sex, Apgar scores, and maternal and infant diagnoses/procedures, including neonatal care. The overall quality of the MBR is very high, owing to the semi-automated data extraction from the standardized regional electronic health records, Sweden's universal access to antenatal care, and the possibility to compare mothers and offspring to the Total Population Register in order to identify missing records. Through the unique personal identity numbers of mothers and live-born offspring, the MBR can be linked to other health registers. The Swedish MBR contains high-quality pregnancy-related information on more than 5 million births during five decades.

I och med nuvarande och kommande lagkrav för utsläpp från tunga lastbilar finns en efterfrågan på utvecklade strategier för utsläppsminskning. För att kontrollera utsläppen av kväveoxider (NOx) används katalytisk omvandling med AdBlue (vätskeblandning av urea och vatten). AdBlue-dropparna förångas av avgaserna eller på en förångningsyta där en väggfilm kan skapas som i sin tur kan öka risken för utfällningar av urea. Därför finns ett behov av ett reglersystem för att minimera risken för utfällning, Målet med detta examensarbete var att skapa en bättre förståelse för hur risken för utfällning av urea kan relateras till den nuvarande kalibreringen på Scania och föreslå hur det nuvarande reglersystemet kan förbättras. Tester uppdelat i två delar genomfördes i en provcell. Först testades ureadoseringen i pulser där doseringsmängden, förångningstiden och pulsfrekvensen varierades. Därefter testades varierat avgasflöde mellan två flöden genom att ändra ramptiden. Genom visuella inspektioner visade det sig att pulserna med urea behöver längre förångningstid än vad den aktuella kalibreringen anger. Detta för att minska risken av utfällningar. Vid dosering av urea över den stationära förångningskapaciteten skapades väggfilmen längre bort från doseringsenheten. Detta leder till mindre effektiv användning av den doserade urean. För varierat avgasflöde med de valda ramptidena förändrades inte risken för utfällning. Därför skulle det nuvarande styrsystemet kunna förbättras genom att inkludera en längre tid för förångning mellan ureadoseringspulserna., With current and upcoming emission legislation for heavy-duty transport, there is a demand for improved emission abatement strategies. To control nitrogen oxide (NOx) emissions, catalytic conversion with AdBlue (a liquid mixture of urea and water) is used. Droplets of AdBlue are evaporated by the exhaust gas or on an evaporation surface where a wall film can be created. A wall film increases the urea deposit risk which in turn causes problems. Consequently, there is a need for a control system to minimize the risk of urea deposits. The target of this thesis was to create a better understanding of how the urea deposit risk can be related to the current control calibration at Scania and to suggest how the current control system could be improved. Tests were performed in an engine testbed, in two parts. Firstly, varying of urea dosing was tested in pulses where the dosing amount, evaporation time and pulse frequency were varied. Secondly, the exhaust flow rate was varied between two flows by changing the ramp time. Through visual inspections, it was shown that the urea dosing pulses need longer evaporation time than the current control calibration states, to reduce the build-up of urea deposits. Furthermore, when dosing urea above the stationary evaporation capacity, the wall film was created further away from the dosing unit, thus, leading to less efficient use of the injected urea. For varying exhaust flow rate, the chosen ramp times did not change the urea deposit risk. Therefore, the current control system could be improved by including longer time for evaporation between the urea injection pulses.

The objective was to evaluate the sequentially updated predictive capacity for preeclampsia during pregnancy, using multivariable longitudinal models including data from antenatal care. This population-based cohort study in the Stockholm-Gotland Counties, Sweden, included 58,899 pregnancies of nulliparous women 2008-2013. Prospectively collected data from each antenatal care visit was used, including maternal characteristics, reproductive and medical history, and repeated measurements of blood pressure, weight, symphysis-fundal height, proteinuria, hemoglobin and blood glucose levels. We used a shared-effects joint longitudinal model including all available information up until a given gestational length (week 24, 28, 32, 34 and 36), to update preeclampsia prediction sequentially. Outcome measures were prediction of preeclampsia, preeclampsia with delivery < 37, and preeclampsia with delivery >= 37 weeks' gestation. The area under the curve (AUC) increased with gestational length. AUC for preeclampsia with delivery < 37 weeks' gestation was 0.73 (95% CI 0.68-0.79) at week 24, and increased to 0.87 (95% CI 0.84-0.90) in week 34. For preeclampsia with delivery >= 37 weeks' gestation, the AUC in week 24 was 0.65 (95% CI 0.63-0.68), but increased to 0.79 (95% CI 0.78-0.80) in week 36. The addition of routinely collected clinical measurements throughout pregnancy improve preeclampsia prediction and may be useful to individualize antenatal care.

Introduction There is limited knowledge on how the SARS-CoV-2 affects pregnancy outcomes. Studies investigating the impact of COVID-19 in early pregnancy are scarce and information on long-term follow-up is lacking. The purpose of this project is to study the impact of COVID-19 on pregnancy outcomes and long-term maternal and child health by: (1) establishing a database and biobank from pregnant women with COVID-19 and presumably non-infected women and their infants and (2) examining how women and their partners experience pregnancy, childbirth and early parenthood in the COVID-19 pandemic. Methods and analysis This is a national, multicentre, prospective cohort study involving 27 Swedish maternity units accounting for over 86 000 deliveries/year. Pregnant women are included when they: (1) test positive for SARS-CoV-2 (COVID-19 group) or (2) are non-infected and seek healthcare at one of their routine antenatal visits (screening group). Blood, as well as other biological samples, are collected at different time points during and after pregnancy. Child health up to 4 years of age and parent experience of pregnancy, delivery, early parenthood, healthcare and society in general will be examined using web-based questionnaires based on validated instruments. Short- and long-term health outcomes will be collected from Swedish health registers and the parents experiences will be studied by performing qualitative interviews. Ethics and dissemination Confidentiality aspects such as data encryption and storage comply with the General Data Protection Regulation and with ethical committee requirements. This study has been granted national ethical approval by the Swedish Ethical Review Authority (dnr 2020-02189 and amendments 2020-02848, 2020-05016, 2020-06696 and 2021-00870) and national biobank approval by the Biobank Vast (dnr B2000526:970). Results from the project will be published in peer-reviewed journals., Funding Agencies|Swedish government [ALFGBG-77860, 2020-YF0016]; Swedish county councils, the ALF agreement [ALFGBG-77860, 2020-YF0016]; Department of Obstetrics and Gynaecology, Sahlgrenska Academy, Gothenburg University Sweden; Western health care region [VGFOUREG-938771]; Swedish Research CouncilSwedish Research CouncilEuropean Commission [2018-00470, 2016-00526, 2019-02082]

BACKGROUND: Aspirin is offered to pregnant women to prevent preeclampsia, a severe obstetrical complication. Large studies of nonpregnant populations have consistently shown that aspirin prophylaxis increases the risk of hemorrhagic complications. However, there have not been any population-based studies investigating this in a pregnant population. OBJECTIVE: This study aimed to investigate whether aspirin use during pregnancy is associated with an increased risk of bleeding complications. STUDY DESIGN: We performed a register-based cohort study using the Swedish Pregnancy Register wherein we examined 313,624 women giving birth between January 2013 and July 2017. Logistic regression was used to assess the risk of antepartum, intrapartum, and postpartum hemorrhage. A propensity score and inverse probability treatment weighting was used to generate an odds ratio that corrects for differences in baseline characteristics. RESULTS: Aspirin use was registered in 4088 (1.3%) women during pregnancy. Compared with women who did not take aspirin, aspirin use was not associated with bleeding complications during the antepartum period (adjusted odds ratio, 1.22; 95% confidence interval, 0.97-1.54). However, aspirin users had a higher incidence of intrapartum bleeding (2.9% aspirin users vs 1.5% nonusers; adjusted odds ratio, 1.63; 95% confidence interval, 1.30-2.05), postpartum hemorrhage (10.2% vs 7.8%; adjusted odds ratio, 1.23; 95% confidence interval, 1.08-1.39), and postpartum hematoma (0.4% vs 0.1%; adjusted odds ratio, 2.21; 95% confidence interval, 1.13-4.34). The risk of a neonatal intracranial hemorrhage was also increased (0.07% vs 0.01%; adjusted odds ratio, 9.66; 95% confidence interval, 1.88-49.48). After stratifying by mode of birth, a higher incidence of bleeding among aspirin users was present for those who had a vaginal birth but not those who had a cesarean delivery. CONCLUSION: Using aspirin during pregnancy is associated with increased postpartum bleeding a

Multiple factors contribute to gestational duration variability. Understanding the sources of variability allows to design better association studies and assess public health measures. Here, we aimed to assess geographical and temporal changes in the determination of gestational duration and its reporting in Sweden between 1973 and 2012. Singleton live births between 1973 and 2012 were retrieved from the Swedish Medical Birth Register. Gestational duration trends in percentiles and rates of pre- and post-term deliveries were analyzed by plotting the values over time. Temporal changes in gestational duration based on ultrasound and last menstrual period (LMP) estimation methods were compared. Intervals between LMP date and LMP-based due date were analyzed to assess changes in expected gestational duration. In total, 3 940 577 pregnancies were included. From 1973 until 1985, the median of gestational duration estimated based on LMP or ultrasound decreased from 283 to 278 days, and remained stable until 2012. The distribution was relatively stable when ultrasound-based estimates were used. Until the mid-1990s, there was a higher incidence than expected of births occurring on every seventh gestational day from day 157 onward. On an average, these gestational durations were reported 1.8 times more often than adjacent durations. Until 1989, the most common expected gestational duration was 280 days, and thereafter, it was 279 days. The expected gestational duration varied from 279 to 281 days across different Swedish counties. During leap years, the expected gestational duration was one day longer. Consequently, leap years were also associated with significantly higher preterm and lower post-term delivery rates than non-leap years. Changes in data handling and obstetrical practices over the years contribute to gestational duration variation. The resulting increase in variability might reduce precision in association studies and hamper the assessment of public health measu

INTRODUCTION: Some studies have shown that women with a previous cesarean section, compared with women with a previous vaginal delivery, have an increased risk of retained placenta during a subsequent vaginal delivery. It is unknown whether this is mediated by anterior placental location, when the placenta might cover the uterine scar. The aim of this study was to evaluate whether the increased risk of retained placenta in women with a previous cesarean section is mediated by anterior placental location. MATERIAL AND METHODS: This is a population-based cohort study, with data from the regional population-based Stockholm-Gotland Obstetric Cohort, Sweden, from 2008 to 2014. The overall study population included 49 598 women with a vaginal second delivery, where adequate information about placental location from the second-trimester ultrasound scan was available. For the main analysis, including the 3921 women with a previous cesarean section, we calculated the relative risk of retained placenta in women with an anterior placental location, using women with non-anterior placental locations as reference. Relative risks were calculated as odds ratios (OR) with 95% CI. In a second model, adjustments were made for maternal age, height, country of birth, smoking in early pregnancy, infant sex, and in vitro fertilization. RESULTS: In the overall study population, the rate of retained placenta at the second delivery was 2.0%. The proportion of women with a retained placenta was higher among women with a previous cesarean compared with those with a previous vaginal delivery (3.4% vs 1.9%; P < .0001). In the main analysis, including women with a previous cesarean section, the risk for retained placenta was not increased with anterior compared with non-anterior placental location (OR 0.84, 95% CI 0.60-1.20). Adjustments did not affect the estimates in a significant way. CONCLUSIONS: The increased risk of retained placenta in women with a previous cesarean section is not media

INTRODUCTION: First-trimester pregnancy risk evaluation facilitates individualised antenatal care, as well as application of preventive strategies for pre-eclampsia or birth of a small for gestational age infant. A range of early intervention strategies in pregnancies identified as high risk at the end of the first trimester has been shown to decrease the risk of preterm pre-eclampsia (<37 gestational weeks). The aim of this project is to create the Improving Maternal Pregnancy And Child ouTcomes (IMPACT) database; a nationwide database with individual patient data, including predictors recorded at the end of the first trimester and later pregnancy outcomes, to identify women at high risk of pre-eclampsia. A second aim is to link the IMPACT database to a biobank with first-trimester blood samples. METHODS AND ANALYSIS: This is a Swedish prospective multicentre cohort study. Women are included between the 11th and 14th weeks of pregnancy. At inclusion, pre-identified predictors are retrieved by interviews and medical examinations. Blood samples are collected and stored in a biobank. Additional predictors and pregnancy outcomes are retrieved from the Swedish Pregnancy Register. Inclusion in the study began in November 2018 with a targeted sample size of 45 000 pregnancies by end of 2021. Creation of a new risk prediction model will then be developed, validated and implemented. The database and biobank will enable future research on prediction of various pregnancy-related complications. ETHICS AND DISSEMINATION: Confidentiality aspects such as data encryption and storage comply with the General Data Protection Regulation and with ethical committee requirements. This study has been granted national ethical approval by the Swedish Ethical Review Authority (Uppsala 2018-231) and national biobank approval at Uppsala Biobank (18237 2 2018 231). Results from the current as well as future studies using information from the IMPACT database will be published in peer-reviewed

Objective: To describe the duration, progression and patterns of first stage of labor among Swedish women. Design: Population-based cohort study. Population: Data from Stockholm-Gotland Obstetric Cohort 2008–2014 including ¼ of all births in Sweden, the final sample involved a total of 85,408 women with term, singleton, vertex, live fetuses experiencing spontaneous labor onset and vaginal delivery with normal neonatal outcomes. Main outcome measures: Time to progress during first stage of labor using three approaches: 1) Traverse time in hours to progress centimeter to centimeter, 5th, 50th (and 95th percentile); 2) Dilation curves for different percentiles, and; 3) Cumulative duration for the 95th percentile by parity and dilation at admission. Results: Variation in both the total duration and the trajectory of cervical change over time is large. Similar to the general held view, the rate of cervical dilation accelerates at 5–6 centimeters. Among nulliparous women, the median time found in our population was faster than their counterparts in studies conducted on American and African cohorts. Among nulliparous and multiparous women our data suggest that the median cervical change over time is faster than 1 cm per hour during the first stage of labor. However, traverse time of cervical change at and beyond the 95th percentile is longer than 1 cm per hour. Conclusions: Labor progression varies widely and labors experiencing a prolonged first stage can still result in normal outcomes. The assumption of 1 cm per hour cervical dilation rate for the first stage of labor may not be universally meaningful. There are differences in progression for women during first stage of labor in different populations. For prolonged labor progression to be more clinically meaningful, the association with adverse birth outcomes needs to be further investigated in specific populations.

Objective: Preeclampsia is a severe obstetric complication affecting 2-8% of pregnancies. There is a common belief that women with preeclampsia experience a shorter duration of labor, where it is thought that increased inflammation that occurs with the disease facilitates labor. However, little evidence exists to support or refute this. Thus, we undertook a register-based cohort study investigating the association between hypertensive disorders of pregnancy and labor duration. Study design: This was a Swedish register-based cohort study of nulliparous women with spontaneous or induced onset of labor at >34 weeks of gestation with a singleton fetus in cephalic presentation. Information of duration of labor was retrieved from electronic birth records and compared between women with hypertensive disorders and normotensives pregnancies. Data was represented as mean adjusted difference in hours (adjusted for pre-gestational disorders, maternal characteristics and mode of delivery) and adjusted hazard ratios (aHR), with an event defined as vaginal birth and women with intrapartum caesarean section censored. An aHR >1 indicated shorter duration of labor. Results: Among 101,531 women, 5548 (5.5%) developed a hypertensive disorder of pregnancy. The overall mean duration of labor was 9.43 (SD 5.32) hours. Women with hypertensive disorders experienced a shorter duration of labor compared to normotensive women, with an adjusted mean difference of-0.68 h (95% CI-0.90,-0.47) for gestational hypertension and-1.53 h (95% CI-1.72,-1.35) for preeclampsia. This corresponded to an aHR of 1.05 (95% CI 1.01, 1.10) and 1.12 (95% CI 1.08, 1.17), respectively. However, when we confined the analysis to those who labored spontaneously, the presence of hypertensive disorders did not alter duration of labor (aHR 0.98, 95% CI 0.95,1.01). Only women who were induced and also had hypertensive disorders experienced a shorter duration of labor (aHR 1.07, 95% CI 1.04,1.09). Conclusions: Hyperte

Enligt skollagen har alla elever rätt till en likvärdig undervisning där skolan ska kompensera för de eventuella hinder som individen kan möta i skolans kontext. Forskningen visar tydligt hur viktigt det är att ta hänsyn till elevens språkliga nivå i skolan. För elever med annat modersmål än svenska innebär det språkliga hindret ofta att skolspråket inte är individens starkaste språk. När språket blir ett hinder kan det i sin tur innebära svårigheter att uppfylla skolans kunskapskrav. För att stötta elever med annat modersmål än svenska beskriver forskningen betydelsen av att dessa elever får möjlighetatt använda sitt modersmål parallellt med svenska för att på bästa sätt utvecklas i skolan. Syftet med studien var att skapa kunskap om hur arbetet med extra anpassningar och särskilt stöd till elever med annat modersmål än svenska kan se ut på gymnasiets nationella program. För att besvara studiens forskningsfrågor användes en kvalitativ metodansats och fem semistrukturerade intervjuer genomfördes. Den insamlade empirin transkriberades och tematiserades utifrån analysmetoden meningskoncentrering. Resultatet analyserades i relation till tidigare forskning och med hjälp av studiens teoretiska perspektiv, KASAM och relationellt perspektiv, skapades förståelse för den insamlade empirin. Att skapa tid till undervisning i mindre grupp beskrivs av informanterna som framgångsfaktorer för arbetet med elever med annat modersmål än svenska. I en mindre grupp ökar tryggheten och det finns möjlighet för eleverna att ställa frågor i lugn och ro. För lärarna innebär den mindre gruppen en ökad möjlighet att bedöma elevens kunskapsnivå och vilket eventuellt stödbehov som finns. När det gäller hinder i undervisningen för elever med annat modersmål än svenska beskriver informanterna svårigheter att både bedöma kunskapsnivå och anpassa stödinsats när lärare och elever saknar gemensamt, starkt, skolspråk. Studiens slutsats är att det är svårt att lyckas med extra anpassningar och särskilt

Volatile Fatty Acids (VFAs) are a by-product when producing methane through anaerobic digestion (AD). Due to their many uses as building block chemicals, it is of interest to look into ways to optimize anaerobic digestion toward VFA production instead of methane generation. This report will focus on different parameters to produce VFA from food waste (FW), primary sludge (PS), and digested sludge (DS) in different ratios. In this project, three different experimental sets were run over a period of 25 days. The three different sets were 100 % FW, 100 % PS, and 50/50 % FW and PS mixture. Reactors were adjusted to an initial pH-value of 10 and then sparged with nitrogen to create an anaerobic environment. Measurements of the pH were done by sampling at each retention time. Gas chromatography (GC) was used at the end of the project to determine the concentrations of the VFA in the samples. The results showed that, with pH 10, a retention time of 15 days and using only FW, was optimal for VFA production as it gave the highest total concentration of 14.03 g VFA/L. Acetic acid was found in the highest concentration in all ratios. A mixture of FW and PS had an optimal retention time of 12 days, but did not generate as high concentrations of VFAs as only using FW, with a maximum concentration of 9.34 g VFA/L. Using only PS generated even lower concentrations, with a maximum of 5.33 g VFA/L, but did not start decreasing during the experimental run, and no clear conclusion can, therefore, be drawn.