Search

Objectives: Sexual risk-taking and its consequences for young women with ADHD(attention deficit hyperactivity disorder) including sexually transmitted diseases, teenage pregnancies and underage parenthood constitute substantial challenges for individuals and midwives. The aim was to investigate current knowledge and specific challenges in reproductive health and contraceptive counselling for women with ADHD at Swedish youth clinics. Method: Inductive qualitative interview study of ten midwives at six youth health clinics in Stockholm and Uppsala County. We used a semi-structured interview guide. The interviews were transcribed verbatim and analyzed with the NVivo 12 qualitative data analysis software. Results: Three main categories were identified: (1) challenges in provision of care of young women with ADHD, (2) standard of care and active adaptations towards women with ADHD and (3) organizational readiness for change;. Several challenges and frustrations, such as difficulties with attention with or without concomitant impulsivity and overactivity, in provision of reproductive health and contraceptive counselling for young women with ADHD were identified. Midwives reported high organizational readiness for improvement of standard of care. Conclusions: Inadequate contraceptive counseling or lack of knowledge on specific challenges in the sexual and reproductive health of young women with ADHD may contribute to this group failing to access, inadequately respond to, or act upon counseling at youth clinics. Support for midwives with evidence-based interventions specifically developed for these women are imperative. Development of such tools should be a priority for research.

The aim of the study is to investigate how upper secondary school teachers of Swedish work with female authors writing in the period 1900–1940. The research questions concern how upper secondary school teachers work with the female authors, how their work interacts with steering documents and textbooks, whether the teachers show any similarities and differences in their work, and how female authors are treated in the textbooks and steering documents that are used. Semi-structured qualitative interviews were conducted with three upper secondary school teachers and one textbook per teacher was analysed together with the steering documents. The study reveals clear similarities and differences in the teachers’ work. The teachers work chronologically, period by period, and they deal with female authors in terms of a societal context, but they do not think that the work with women has any intrinsic value. Textbooks and steering documents have a central role to play in the teaching and are used together with other teaching material. The textbooks have an over-representation of male authors and the female authors are treated on their own, separated from the rest of the text and viewed in relation to male authors. The textbooks maintain a gender system where the man is the norm and the sexes are kept apart. The steering documents explicitly deal with female authors to a small extent and are shown to dictate of fundamental principles for what is considered valuable to consider in school work.

Objectives: The aim of this study was to evaluate the diagnostic accuracy of sensitivity and specificity of cervical lesions by the low-cost, portable Gynocular colposcope and a stationary colposcope, in women referred for colposcopy with abnormal cervical cytology. Methods: A randomized cross-over clinical trial for evaluating the diagnostic accuracy in detecting cervical lesions by the Gynocular and a stationary colposcope. The Swede score systematic colposcopy system was used for evaluation of colposcopic abnormalities. Directed punch biopsy and excisional cone biopsy were used as the gold-standard by histologically confirmed high grade cervical lesions CIN2+ (CIN2, CIN3, CIN3+). In total, 123 women referred for colposcopy due to abnormal cervical cytology were recruited at the Department of Obstetrics and Gynecology, Danderyd Hospital, Stockholm, Sweden. The percentage agreement and the kappa statistic were calculated for Swede score by the Gynocular and a stationary colposcope. Swede scores were compared with the results from directed punch biopsy and excisional cone biopsy. Results: The Gynocular and the stationary colposcope had a high agreement of Swede scores with a Kappa statistic of 0.947, p < .0001. Punch biopsy diagnosed CIN2+ (CIN2, CIN3, and invasive cancer) in 44 (35.7 percent) women while cytology detected CIN2+ in 34 (27.6 percent) women. There were no significant differences of the sensitivity and specificity for different Swede scores by the Gynocular or a stationary colposcope in detecting CIN 2+. Conclusions: There were no significant differences in sensitivity or specificity in detecting cervical lesions by the Gynocular or stationary colposcope. The Gynocular is as accurate in diagnosing cervical lesions as a stationary colposcope.

Syftet är att undersöka hur den svenska romantiken används och uppfattas av svensk­lärare i gymnasieskolan. Studien har genomförts genom kvalitativa intervjuer med verk­sam­ma gymnasielärare i svenska. Forskningsfrågorna är hur lärarna arbetar med och uppfattar den svenska romantiken i svenskundervisningen samt hur lärarna ser på hur epoken berörs i styrdokumenten. Undersökningen visar att arbete med den svenska romantiken främst sker med ut­gångspunkt i en kulturell bildningstradition och genom kronologiska litterära epokar­beten, där tidsbristen är en avgörande faktor för begränsningen av undervisningens volym och upplägg­ning. Det framkommer även att det finns ett värde i att knyta an till elevernas värld och skapa liv och association i undervisningen för att öka elevernas en­gagemang. Därför är val av litteratur avgörande för att skapa engagemang och väcka intresse. Undersökningen visar även att styrdokumenten är öppna för tolkning och skapar något av en paradox, då detta både anses som någonting positivt och negativ. Lärarna diskuterar också vad litterär kanon kan vara, och det faktum att det inte finns någon officiell sådan men en inofficiell eller lokal kanon som påverkar svensk­under­visningen.

The study's aim is to implement a textbook analysis and examine how women are described in history textbooks for high school and in the curriculums Lgy 70, Lpf 94 and Gy 11. The study has a gender perspective and the study's purpose is to make a comparative study and compare textbooks with the current curriculum and compare the results with each other to see if there has been any change over time. The survey's material is three editions of Alla tiders historia from Gleerups förlag. The study refers to editions from 1989, 1996 and 2011. General parts from Lgy 70, Lpf 94 and Gy 11 are also central for my study. The general cur­riculum of history from 1981, the course Historia A in Lpf 94 and Historia 1b in Gy 11 are also studied. The study shows that the role of women doesn’t get much space in textbooks and when women are mentioned explicitly, it’s mainly through illustrations or through texts of statement representation. The role of women has not been treated much in governing documents but equality between men and women is something that is common. The study shows that the governing documents interact with the curricula in a relatively large range, although this varies between the different editions. The results demonstrate that there has been a change over time in administrative documents and textbooks. Content and design have changed based on the societal context in which they were designed. The study shows that men are the norm and men are mentioned more than women, both in textbooks and curriculum.

Background & Aims: Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease in pregnancy. It is associated with hepatobiliary diseases that might predispose to cancer and also with gestational diabetes and preeclampsia. In this study, we examined associations between ICP and cancer, and immune-mediated and cardiovascular diseases. Methods: By linking the Swedish Medical Birth Register and the Swedish Patient Register, we identified 11,388 women with ICP and 113,893 matched women without ICP who gave birth between 1973 and 2009. Diagnoses of cancer and immune-mediated and cardiovascular diseases both before and after delivery were obtained from the Patient Register. The main outcome measures were hazard ratios (HRs), calculated through Cox regression, for the indicated diseases after delivery. Results: ICP was not associated with later overall cancer (HR 1.07, 95% confidence interval [CI] 0.94-1.21), but it was associated with later liver and biliary tree cancer (HR 3.61, 95% CI 1.68-7.77, and 2.62, 95% CI 1.26-5.46, respectively). ICP was also associated with later immune-mediated diseases (HR 1.28, 95% CI 1.19-1.38), and specifically diabetes mellitus (HR 1.47, 95% CI 1.26-1.72), thyroid disease (HR 1.30, 95% CI 1.14-1.47), psoriasis (HR 1.27, 95% CI 1.07-1.51), inflammatory polyarthropathies (HR 1.32, 95% CI 1.11-1.58) and Crohn's disease (HR 1.55, 95% CI 1.14-2.10), but not ulcerative colitis (HR 1.21, 95% CI 0.93-1.58). Women with ICP also had a small increased risk of later cardiovascular disease (HR 1.12, 95% CI 1.06-1.19). Conclusions: Women with ICP have increased risk of later hepatobiliary cancer and immune-mediated and cardiovascular diseases. (C) 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Objectives: The overall objective with the present thesis was to assess pregnancy and delivery associated risk factors for adverse pregnancy outcomes. Specific aims were : 1) to analyze the association between fetal size at the time of dating ultrasound and the risk of preterm delivery, small for gestational age birth (SGA), and macrosomia and to evaluate if the timing of ultrasound, i.e. before 14 weeks of gestation or after 16 weeks, affected this association, 2) to assess the risk of emergency cesarean section among women who were induced to labor in gestational week ≥41 and to evaluate if parity and mode of induction affected this association, and 3) to analyze if starting time for labor induction affected the risk of night-time delivery, and evaluate to what extent the risk was influenced by Bishop score at start of induction, mode of induction, and parity. Study 1 and 2 were retrospective cohort studies based on an obstetrical database containing data on all obstetrical care at Danderyd Hospital from 1998-2004. The data was linked to the Swedish Medical Birth Registry. The analysis included 27 952 women. Of these, 5053 had gestational duration assessed through ultrasound before 14 weeks (early) and 22 889 after 16 weeks (late). Risks of preterm delivery, SGA and macrosomia were calculated. When the expected date of delivery was postponed after ultrasound dating ≥7 days, regardless of time of dating ultrasound, there was an increased risk of SGA. For preterm birth there was an increased risk for fetuses dated late. When the fetus was ≥7 days larger than expected at late ultrasound dating, compared to the expected size according to last menstrual period, there was an increased risk of macrosomia. Fetal size in early pregnancy is not only a function of gestational duration, but also of fetal growth. Accordingly, our studies suggest that surveillance of pregnancies with postponed estimated date of delivery may provide means for increased detection of fetal growth