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In 8 heifers the ovaries were examined by ultrasonography every fourth hour during and after oestrus to determine the time of ovulation. Blood samples were taken every second hour during prooestrus and oestrus for determination of the LH-peak. Four animals were followed during one oestrus period and 4 animals during 2. The LH-peak occurred a few hours (mean 7.4 h) after the onset of oestrus. The intervals between onset of oestrus and ovulation and between LH-peak and ovulation were 32.3 and 24.9 h, respectively. There were only small differences in the interval between LH-peak and ovulation among animals (range 22-28 h) and also between the 2 observations on the same animal. On 4 occasions (3 heifers) 2 follicles ≥ 1.0 cm were seen in the ovaries during prooestrus and oestrus. This caused an increase in the length of the prooestrus period. Zusammenfassung Bestimmung der Ovulation mittels Ultraschall und ihre Beziehung zum LH-Gipfel bei Kalbinnen: Zur Bestimmung der Ovulation wurden bei 8 Kalbinnen die Ovarien während und nach dem Östrus in viertelstündigem Abstand mittels Ultraschall untersucht. Ferner wurden alle 2 Stunden während und nach dem Östrus Blutproben zur Ermittlung des LH-Gipfels gewonnen. Vier Tiere wurden während einer Brunstperiode und vier Tiere während zwei Brunstperioden entsprechend untersucht. Der LH-Gipfel trat einige Stunden (im Mittel 7,4 h) nach Beginn des Östrus auf. Der Abstand zwischen Östrusbeginn und Ovulation sowie Beginn des LH-Gipfels und Ovulation betrug 32,3 bzw. 24,9 h. Es ergaben sich bei den einzelnen Tieren nur geringe Unterschiede bezüglich des Abstandes zwischen LH-Gipfel und Ovulation. Analoges gilt für 2 Beobachtungen am gleichen Tier. In 4 Fällen (3 Tiere) wurden 2 Follikel ≥ 1,0 cm an den Ovarien während des Proöstrus und Östrus festgestellt. Dies war mit einer Zunahme der Länge des Proöstrus vergesellschaftet. [ABSTRACT FROM AUTHOR]

In 4 heifers the distal part of one oviduct was resected and the animals were inseminated with frozen-thawed semen in the body of the uterus during oestrus. The heifers were slaughtered 2 h after insemination and the uterus and oviducts were flushed. Spermatozoa were recovered from the flushing solution by microscopic investigation. Spermatozoa were recovered from the upper parts of the resected oviducts in all heifers. This indicates a transperitoneal migration of spermatozoa from one oviduct to the other. Zusammenfassung Transperitoneale Wanderung von Spermatozoen bei Kalbinnen Bei 4 Kalbinnen wurde der distale Teil eines Eileiters reseziert. Die Tiere wurden mit aufgetautem Gefriersamen während des Östrus intrauterin (Uteruskörper) besamt. Sie wurden 2h nach der Besamung geschlachtet. Der Uterus und die Eileiter wurden danach ausgespült. In der Spüllösung wurden die Spermatozoen mittels mikroskopischer Untersuchungen nachgewiesen. Bei alien Kalbinnen wurden Spermatozoen aus den oberen Abschnitten der resezierten Eileiter zurückgewonnen. Dies deutet auf eine transperitoneale Wanderung von Spermatozoen von einem Eileiter zum anderen hin. [ABSTRACT FROM AUTHOR]

• Excessive anxiety or worries can lead to fear and difficulty in managing pregnancy and childbirth. • There is sparse knowledge of worries in pregnant women living in sparsely populated areas with long distance to hospital. • Women were most worried about something being wrong with the baby, giving birth and the risk of miscarriage. • Fear of birth and depressive symptoms were strongly associated with higher worries. • Women reported high worries about giving birth on the road or in the car. Worries are common during pregnancy, but there is sparse knowledge of worries when the distance to hospital is long. To assess the extent and content of worries during pregnancy. Another aim was to evaluate the psychometric properties of the Swedish version of the Cambridge Worry Scale. Cross-sectional study of 280 women recruited to a continuity project and completed a questionnaire in mid pregnancy. Women were most worried about something being wrong with the baby, giving birth and the risk of miscarriage. Women also reported worries about giving birth on the road or in the car. Two domains of the Cambridge Worry scale were identified; Socio-medical and health aspects and Socio-economic and relationship aspects. Women with high fear and depressive symptoms were most at risk for major worries. Worries during pregnancy were mainly related to issues about pregnancy and birth, and specifically, to long distance to the labour ward. Women with depressive symptoms and fear of birth showed the highest levels of worries. When a woman expresses worries in connection to labour and birth, caregivers must be sensitive to the presence of underling fears or depressive symptoms and act to refer women to treatment or support. [ABSTRACT FROM AUTHOR]

• Continuity models of midwifery are growing internationally and the organisation of such models could impact on the level of continuity. • Developing and implementing a continuity model of midwifery care in a rural area with long distance to hospital is challenging. • The models of care resulted in different levels of continuity. Women who received continuity were more satisfied with the medical and the emotional aspects of intrapartum care. In many countries, various continuity models of midwifery care arrangements have been developed to benefit women and babies. In Sweden, such models are rare. To evaluate two on-call schedules for enabling continuity of midwifery care during labour and birth, in a rural area of Sweden. A participatory action research project where the project was discussed, planned and implemented in collaboration between researchers, midwives and the project leader, and refined during the project period. Questionnaires were collected from participating women, in mid pregnancy and two months after birth. One of the models resulted in a higher degree of continuity, especially for women with fear of birth. Having a known midwife was associated with higher satisfaction in the medical (aOR 2.02 (95% CI 1.14–4.22) and the emotional (aOR 2.05; 1.09–3.86) aspects of intrapartum care, regardless of the model. This study presented and evaluated two models of continuity with different on-call schedules and different possibilities for women to have access to a known midwife during labour and birth. Women were satisfied with the intrapartum care, and those who had had a known midwife were the most satisfied. Introducing a new model of care in a rural area where the labour ward recently closed challenged both the midwives' working conditions and women's access to evidence-based care. [ABSTRACT FROM AUTHOR]

• Previous studies show that continuity models of midwifery care are best practice that should be offered to most women. • Models that provide midwifery continuity of care are rare in Sweden. • Women self-recruited to a caseload model of care and provided with a modified form of midwifery continuity of care in a rural area of Sweden needed less augmentation during labour, had more normal vaginal births, fewer perineal lacerations and were more likely to breastfeed. Continuity models of midwifery care are rare in Sweden, despite its well-known positive effects. The aim was to describe pregnancy and birth outcome in women participating in a continuity of care project in a rural area of Sweden. A register-based study of 266 women recruited to the project and a control group of 125 women from the same catchment area. Midwives provided antenatal care and were on-call 7 a.m. to 11 p.m. for birth. Data were collected from the antenatal and birth records. Crude and adjusted odds ratios with 95% confidence intervals were calculated between women in the project and the control group. There were more primiparous women and highly educated women recruited to the project, and fewer foreign-born and single women, compared to the control group. Women in the project met more midwives and were less likely to have a pregnancy complication. During intrapartum care, women recruited to the project were less likely to need labour augmentation and less likely to have an instrumental vaginal birth and elective caesarean section. They had fewer second degree perineal tears and were more likely to fully breastfeed at discharge. No differences were found in neonatal outcome. The continuity of a known midwife at birth was quite low. This study shows that women self-recruited to a continuity of care project in a rural area of Sweden had a higher rate of normal births. There were few differences if having a known midwife or not. Long distances to hospital and lack of staff affected the level of continuity. [ABSTRACT FROM AUTHOR]

• The midwives' availability during pregnancy made the women feel safe and calm. • Trustful woman–midwife relationships increased women's confidence and reduced their fear. • The midwives felt better equipped to address women's needs during childbirth. • A caseload midwifery model could be an option to support women with fear of birth. Although fear of birth is common during pregnancy and childbirth, the best treatment for fear of birth in clinical care remain unclear. Strong evidence suggests that continuity models of midwifery care can benefit women and birth outcomes, though such models are rare in Sweden. Because women with fear of birth could benefit from such models, the aim of this qualitative study was to examine how women with fear of birth and their midwives experienced care in a modified caseload midwifery model. A qualitative interview study using thematic analysis. Participants were recruited from a pilot study in which women assessed to have fear of birth received antenatal and intrapartum care, from a midwife whom they knew. Eight women and four midwives were interviewed. An overarching theme—"A mutual relationship instilled a sense of peace and security"—and three themes—"Closeness, continuity, and trust," "Preparation and counselling," and "Security, confidence, and reduced fear"—reflect the views and experiences of women with fear of birth and their midwives after participating in a modified caseload midwifery model. For both women with fear of birth and their midwives, the caseload midwifery model generated trustful woman–midwife relationships, which increased women's confidence, reduced their fear, and contributed to their positive birth experiences. Moreover, the midwives felt better equipped to address women's needs, and their way of working with the women became more holistic. Altogether, offering a continuity model of midwifery care could be an option to support women with fear of birth. [ABSTRACT FROM AUTHOR]

Background: Up to 85% of people with motor neuron disease (MND) report pain, but whether pain has negative impact on quality of life is unclear. The aim was to study associations between pain, disease severity and individual quality of life (IQOL) in patients with MND. Methods: In this cross sectional study, 61 patients were recruited from four multidisciplinary teams in Sweden, whereof 55 responded to the pain measure (The Brief Pain Inventory – Short form) and were included in the main analyses. Disease severity was measured with the Amyotrophic Lateral Sclerosis Functional Rating Scale - Revised Version, and individual quality of life was measured with a study-specific version of the Schedule for the Evaluation of Individual Quality of Life - Direct Weighting. Results: Forty-one (74%) of the participants who answered BPI-SF (n = 55) reported pain. Thirty-nine (71%) of those reported pain during the past 24 h. The severity of pain was on average moderate, with eight participants (14%) reporting severe pain (PSI ≥ 7). Satisfaction with IQOL for the entire sample was good (scale 1-7, where 1 equals poor quality of life): median 5, interquartile range (IQR) 2.75 and there was no difference in satisfaction with IQOL between those reporting pain/not reporting pain (median 5, IQR 2/median 5, IQR 3.5, Mann-Whitney U = 249, p = 0.452). There was neither any correlation between pain severity and satisfaction with IQOL, nor between disease severity and satisfaction with IQOL. Conclusions: The results add to the hypothesis that associations between non-motor symptoms such as pain prevalence and pain severity and IQOL in MND are weak. Pain prevalence was high and the results pointed to that some participants experienced high pain severity, which indicate that pain assessments and pain treatments tailored to the specific needs of the MND population should be developed and scientifically evaluated. [ABSTRACT FROM AUTHOR]

The study aimed to explore the meaning for adolescents of living with a parent with amyotrophic lateral sclerosis (ALS). The design is qualitative. Interviews were conducted between December 2020 and April 2022 with 11 adolescents (8-25 y), living in households with a parent with ALS in Sweden. The analysis was phenomenologically hermeneutical. The adolescents were in a difficult and exposed situation, especially if the parent had a severe disability and assistant care providers were in the home. Witnessing the gradual loss of the parent in an indefinite battle against time, while still needing them, elicited grief-filled and hard-to-manage emotions. Everyday life was turned upside down, resulting in greater responsibility for the adolescents, not only in helping with household chores and assisting the ill parent, but also in emotionally protecting both parents. It forced the adolescents to mature faster and put their own life on hold, triggering experiences of being limited. This, together with changing family roles yet being more attached to home, reinforced the imbalance in the adolescents' lives. The interpreted whole of the adolescents' narratives revealed that living with a parent with ALS meant a challenging and grieving transition during an already transition-filled adolescence, which left the adolescents struggling to keep a foothold on a life torn apart. The unbalanced life situation may hinder the adolescents' identity formation and emancipation, which are developmentally important for managing a healthy and independent adulthood. The results emphasize the importance of early targeted support to reach this vulnerable group in order to secure their health. • Living with a parent with amyotrophic lateral sclerosis (ALS) was challenging. • The adolescents' lives were turned upside down, bringing increased responsibility. • They were forced to mature faster while becoming more attached to home. • This unbalanced life situation may disturb the identity formation and emancipation. • Early, targeted support is crucial to secure this vulnerable group's health. [ABSTRACT FROM AUTHOR]

Background: Rising rates of caesarean section (CS) are a concern in many countries, yet Sweden has managed to maintain low CS rates. Exploring the multifactorial and complex reasons behind the rising trend in CS has become an important goal for health professionals. The aim of the study was to explore Swedish obstetricians' and midwives' perceptions of the factors influencing decision-making for CS in nulliparous women in Sweden.Methods: A qualitative design was chosen to gain in-depth understanding of the factors influencing the decision-making process for CS. Purposive sampling was used to select the participants. Four audio-recorded focus group interviews (FGIs), using an interview guide with open ended questions, were conducted with eleven midwives and five obstetricians from two selected Swedish maternity hospitals after obtaining written consent from each participant. Data were managed using NVivo© and thematically analysed. Ethical approval was granted by Trinity College Dublin.Results: The thematic analysis resulted in three main themes; 'Belief in normal birth - a cultural perspective'; 'Clarity and consistency - a system perspective' and 'Obstetrician makes the final decision, but...', and each theme contained a number of subthemes. However, 'Belief in normal birth' emerged as the core central theme, overarching the other two themes.Conclusion: Findings suggest that believing that normal birth offers women and babies the best possible outcome contributes to having and maintaining a low CS rate. Both midwives and obstetricians agreed that having a shared belief (in normal birth), a common goal (of achieving normal birth) and providing mainly midwife-led care within a 'team approach' helped them achieve their goal and keep their CS rate low. [ABSTRACT FROM AUTHOR]