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Background: Women are recommended to perform regular exercise during pregnancy but the impact of physical fitness on duration of gestation including miscarriage is inconsistent. In addition, an increased risk of miscarriage in early pregnancy among women with higher levels of physical activities has been noted. Previous studies have mostly used an epidemiologic method. Larger studies using careful measurement of physical fitness are needed. Besides physical fitness, elevated maternal circulating levels of the hormone relaxin have been associated with decreased duration of gestation. Methods: A prospective cohort including 20 women with miscarriage and 460 women with spontaneous start of labour, recruited from maternal health care centres in central Sweden, were examined regarding estimated absolute peak oxygen uptake (V̇O2 peak, est..) by cycle ergometer test, and maternal circulating relaxin levels in early pregnancy. Results: Women with miscarriage displayed the highest level of absolute V̇O2 peak, est. (2.61 l/min) and the lowest serum relaxin levels (640 ng/l). Among women with spontaneous start of labour, the mean absolute V̇O2 peak, est. increased successively from the lowest level (2.31 l/min) among those with preterm birth (n=28), to 2.49 l/min among women with post term birth (n=31). An opposite trend was shown regarding serum relaxin levels from women with miscarriage to those with post term birth. Serum relaxin concentrations, but not absolute V̇O2 peak, est. was significantly and independently associated with duration of gestation in women with miscarriages, and absolute V̇O2 peak, est., age and multiple pregnancy were independently associated with duration of gestation in women with spontaneous start of labour. Conclusions: Physical fitness appears to be a protective factor of established pregnancies and not significantly involved in the risk of early miscarriage. Additional studies are needed to more clearly define the role of relaxin in miscarriage.

Objectives To assess physical fitness in pregnancy and to evaluate its effect on perceived health, back pain, blood pressure and duration of gestation. Also, to evaluate the effect of serum relaxin levels on blood pressure and duration of gestation. Material and methods A prospective cohort of 520 pregnant women were examined in early pregnancy and five months postpartum with regard to socio-demographic characteristics and estimated peak oxygen uptake (V̇O2 peak, est.). Serum concentrations of relaxin were carried out in early pregnancy. Physical exercise, possible back pain and blood pressure were measured repeatedly throughout pregnancy. Results Absolute V̇O2 peak, est. in early pregnancy was positively correlated to perceived health, which was lower during than after pregnancy. The average absolute V̇O2 peak, est. in early pregnancy of 2.4 l/minute was 0.02 l/minute less than the V̇O2 peak, est. postpartum, while regular physical exercise decreased throughout pregnancy. Absolute V̇O2 peak, est. in early pregnancy was not associated to the incidence of any low back pain location in pregnancy or postpartum, but inversely to intensity of back pain and diastolic blood pressure and positively with duration of gestation. Elevated serum relaxin levels were associated with decreased diastolic blood pressure and higher duration of gestation among women with miscarriage. Conclusions Perceived health, diastolic blood pressure and duration of gestation were positively affected by physical fitness while no effect was shown on the incidence of back pain. The effect of physical fitness on duration of gestation and diastolic blood pressure might have clinical implications as well as the increased serum relaxin levels on miscarriages.

The purpose of this thesis is to shed light on how evidence-based librarian and information practice (EBLIP) is understood and practised at some Swedish hospital libraries, and also to analyze how EBLIP functions as a strategy to bridge the gap between research and practice as described by Haddow & Klobas. The theoretical framework for the study is partly based on Haddow & Klobas description of the gap between research and practice in the field of LIS and partly a description of the EBP-process which plays a key role in the use of EBLIP. Interviews have been done with four people, three librarians, all with management experience, and an academic development officer, active at three different hospital libraries where EBLIP is practiced. All informants believed that it is important to make use of research results in order to improve services and practice. In their efforts to apply the research findings the informants face a number of hindrances, which indicates a gap between research and practice. The majority of the informants describe EBLIP as a concept by which they mean an approach, a process and skills training. With regard to the EBP process two approaches could be distinguished. First, to follow the EBP process stepwise with the aim of changing the work. Second, to elaborate on each step aiming to introduce the process and training skills in using scientific material and EBLIP. A number of activities at the different libraries have been identified to be included in the implementation of EBLIP. These activities seem to serve as strategies to bridge most, the extent not established, of the different forms of gaps between research and practice.