Background: As growing numbers of people may be forced to migrate due to climate change and variability, it is important to consider the disparate impacts on health for vulnerable populations, including sexual and reproductive health (SRH). This scoping review aims to explore the relationship between climate migration and SRH. Methods: We searched PubMed/MEDLINE, CINAHL Plus, EMBASE, Web of Science, Scopus, Global Health and Google for peer-reviewed and gray literature published before 2nd July 2021 in English that reported on SRH in the context of climate migration. Data were extracted using a piloted extraction tool and findings are reported in a narrative synthesis. Results: We screened 1,607 documents. Ten full-text publications were included for analysis: five peer-reviewed articles and five gray literature documents. Reported SRH outcomes focused on maternal health, access to family planning and antiretroviral therapy, sexual and gender-based violence, transactional sex, and early/forced marriage. Recommendations to improve SRH in the context of climate migration called for gender-transformative health systems, education and behavior change programmes, and the involvement of local women in policy planning and programme implementation. Discussion: While the disparate impacts of climate change and migration are well-established, primary data on the scope of impact due to climate migration is limited. The SRH outcomes reported in the literature focus on a relatively narrow range of SRH domains, emphasizing women and girls, over men. Achieving holistic and equitable SRH in the context of climate migration requires engaging all genders across the range of SRH outcomes and migration contexts. This review highlights the need for further empirical evidence on the effect of climate migration on SRH, with research that is context-specific and engages communities in order to reflect the heterogeneity of outcomes and impact in the climate-migration-SRH nexus.

Though much research exists on LGBT+ exclusion from school-based sexual and reproductive health (SRH) education, the strategies used by LGBT+ individuals during their search for knowledge regarding the subject are not as widely documented. Using the ethnographic research method of semi-structured interviews, this research explores the experiences of young LGBT+ adults with formal sexual and reproductive health education and examines the self-education methods employed by this population in the context of exclusionary and cisheteronormative curricula. This project also functions to contribute to existing literature in the field of anthropology and other social sciences regarding the subject of SRH education, particularly LGBT+ SRH education. Furthermore, this study supports the need for additional research through the use of applied anthropology concerning interactions between institutions, policy and individual experiences of health.

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This dissertation develops explainable and sparse predictive models applied to two main healthcare applications: reproductive health and oncology. Through the application of advanced machine learning techniques and survival analysis, we aim to enhance predictive accuracy and provide actionable insights in these critical areas. The thesis is structured into four distinct problems, each focusing on a particular research question. The first problem concerns the prediction of the probability of conception among couples actively trying to conceive. Using self-reported health data from a North American preconception cohort study, we analyzed factors such as sociodemographics, lifestyle, medical history, diet quality, and specific male partner characteristics. Machine learning algorithms were employed to predict the probability of conception demonstrating improved discrimination and potential clinical utility. The second problem explores the application of machine learning algorithms to electronic health record (EHR) data for identifying predictor variables associated with polycystic ovarian syndrome (PCOS) diagnosis. Employing gradient boosted trees and feed-forward multilayer perceptron classifiers, we developed a scoring system that improved the model's performance, providing a valuable tool for early detection and intervention. The third problem focuses on predicting the risk of miscarriage among female participants who conceived during the study period. Utilizing both static and survival analysis, including Cox proportional hazard models, we developed predictive models to assess miscarriage risk. The study revealed that most miscarriages were due to random genetic errors during early pregnancy, indicating that miscarriage is not easily predicted based on preconception sociodemographic and lifestyle characteristics. Finally, the fourth problem focuses on the development of predictive models for managing Chronic Myeloid Leukemia (CML) patients. We developed models to predict whether patients will achieve deep molecular response (DMR) at later treatment stages and maintaining this status up to 60 months post-treatment initiation. These models offer insights into treatment effectiveness and patient management, aiming to support clinical decision-making and improve long-term patient outcomes. By emphasizing the explainability of these models, this dissertation not only aims to provide accurate predictions but also to ensure that the results are interpretable and actionable for healthcare professionals. Overall, this thesis showcases the potential of predictive modeling to improve reproductive health and oncology-related outcomes. The development and validation of various models in these contexts underscore the value of machine learning algorithms in healthcare research, analysis of epidemiologic data, and prediction of critical health events. The findings have significant implications for enhancing patient care, informing clinical practices, and guiding healthcare policy decisions.

Yes / Adolescent sexual and reproductive health (SRH) remains a challenge globally. High school youths without comprehensive sexuality education (CSE) are more likely to engage in high risk sexual behaviors than their peers in schools with CSE. Fiji continues to have very poor adolescents SRH indicators. This study aimed to gauge the perceptions of students towards the delivery of SRH education in schools in Fiji. A qualitative study design was used to collect data from students in year 11-13 in public secondary schools in Suva, Fiji in 2018. Schools with equal ethnic mix were selected. A semi-structured open-ended questionnaire was used to guide Focus Group Discussions (FGDs). A male research facilitator conducted FGD with males while a female research facilitator facilitated that amongst the females. Data collected was analyzed thematically. Seven FGDs were conducted. A total of 46 students (29 males) participated with the age range from 17-19 years old. Eight themes emerged: current SRH education; students' knowledge on adverse consequences of SRH; sources of SRH information; need for sex education; provision of SRH education in schools; characteristics of teachers of SRH education; age-appropriate incremental sex education; and ideal version of SRH. The study shows that Fijian students desired a lot more from sex education than what is currently offered for sexual decision-making. There is a need for mandatory and comprehensive sex education for young people.

The Catholic Church is one of the largest providers of medical care in the US, with 1 in 6 acute-care beds residing in a Catholic hospital. One third of these hospitals are in rural or underserved areas in the US, and advocacy for the vulnerable is a central platform of the Catholic Healthcare Association. Despite this, the Church has been under attack for allegedly putting women at risk of injury or death due to the care restrictions concerning reproductive health stipulated in the Ethical and Religious Directives (ERDs). Additionally, scholars are questioning the distinctiveness of the Catholic healthcare mission in practice, pointing to the increased homogenization of Catholic and non-Catholic hospitals. For these reasons, it is necessary to assess if and how women are being harmed in Catholic hospitals and, if there is harm being done, if there is a way to prevent these harms while preserving the Catholic Social Tradition in medicine. In carrying out this assessment, I read the current literature closely to explore both the origins and the practical consequences of these ethical conflicts. Subsequently, I use Chris Durante's "pragmatic perspectivism" to formulate a proposal that considers both Catholic medical ethics and secular medical ethics on the same plane. The proposal suggests the adoption of an alternative and complementary lens for Catholic health care. Using this framework would allow the Church to pursue its health care mission in a fuller sense, unencumbered by the inertia of the medical industry towards homogenization due to legal and economic pressures. It also provides the potential for Catholics to more easily receive Catholic care in all hospitals, not just those under Catholic sponsorship. Importantly, it would also prevent any American woman from being practically forced to receive Catholic care, circumventing many of the ethical conflicts present in the current system.

Within the Surinamese jurisdiction the Constitution grants women the right to health and imposes a legal duty on the state to facilitate the realization of this right. Also treaty law, in particular, the ICESCR article 12 and the CEDAW article 12 grant women the right to the highest attainable standard of health and the right to non-discriminatory access to healthcare. But due to the criminal law applicable to abortion women lack non-discriminatory access to reproductive healthcare and therefore do not enjoy the highest attainable standard of pregnancy related health. Despite its decision not to enforce the abortion prohibiting criminal laws, Suriname remains in a state of failure to comply with its legal duties as imposed by the Constitution and treaty law. This, due to the state’s reluctance to repeal the criminal laws on abortion and its failure to enact effective health regulations to facilitate women in need of an abortion.

Within the Surinamese jurisdiction the Constitution grants women the right to health and imposes a legal duty on the state to facilitate the realization of this right. Also treaty law, in particular, the ICESCR article 12 and the CEDAW article 12 grant women the right to the highest attainable standard of health and the right to non-discriminatory access to healthcare. But due to the criminal law applicable to abortion women lack non-discriminatory access to reproductive healthcare and therefore do not enjoy the highest attainable standard of pregnancy related health. Despite its decision not to enforce the abortion prohibiting criminal laws, Suriname remains in a state of failure to comply with its legal duties as imposed by the Constitution and treaty law. This, due to the state’s reluctance to repeal the criminal laws on abortion and its failure to enact effective health regulations to facilitate women in need of an abortion.

I barnmorskans ansvarsområde ingår handläggning av normal förlossningen. Studier visar att förlossningsvården blir alltmer medikaliserad och att barnmorskor har svårt att främja den normala förlossningen eftersom tydliga gränser för vad som anses vara normalt saknas. Syftet med studien är att undersöka barnmorskors uppfattning kring normal förlossning. I studien används en kvalitativ metod med induktiv ansats. Totalt har tio barnmorskor deltagit i tre fokusgruppdiskussioner under våren 2015. Texten har analyserats enligt kvalitativ innehållsanalys. Analysen har resulterat i tre kategorier, med det övergripande temat Osäkerhet kring innebörden av begreppet normal förlossning. Kategorierna visar olika aspekter som bidrar till barnmorskors osäkerhet, dessa är; Olika synsätt på normal förlossning, Det som är vanligt blir normalt samt Barnmorskor känner sig styrda. Resultatet visar att barnmorskor har olika uppfattning av vad en normal förlossning innebär. De upplever också att läkare har ett annat synsätt på normal förlossning. Medicinska interventioner som är vanligt förekommande har normaliserats och uppfattas ingå i normal förlossning. Även förlossningsavdelningarnas organisation och riktlinjer påverkar synen och handläggningen av normal förlossning. I barnmorskans huvuduppgifter ingår det att främja normal förlossning och att stödja och stärka kvinnor i barnafödandet. Det är av stor vikt att barnmorskan har kunskap om den normala förlossningen så att rätt stöd och beslut om adekvata åtgärder vidtas för att främja den. / Normal childbirth is the midwife´s responsibility. Previous studies shows that the normal childbirth becomes more and more medicalised. Midwives have a hard time promoting normal birth, since there are no distinct boundaries. The aim for this study is to examine the midwives perceptions of the normal childbirth. The study was conducted with a qualitative inductive approach. A total of ten midwives participated in three focus groups discussions during spring 2015. The interviews were analyzed according to a qualitative content analysis. The analysis resulted in three categories, with a connecting theme Uncertainty about the concept of normal childbirth. The categories show different aspects that contribute to the midwives uncertainty, they are; Different approach to normal childbirth, What’s commonly used becomes normal and Midwives feels controlled. The result shows the midwives have different perceptions of what a normal birth entails. They also feel that doctors have a different approach to normal childbirth. Medical interventions that were commonly used become normalized and are now a part of normal childbirth. The organization and guidelines set by the ward also affected the perspective and management of normal birth. The midwife has a responsibility to promote normal childbirth but also to support and empower women during the delivery. It is therefore important that the midwife has knowledge of the normal childbirth so she can give the right support and make appropriate decisions to promote it.

När den reproduktiva hälsan sviktar kan känslor av att vara mindre värd uppkomma och såväl manlighet som kvinnlighet är begrepp som tycks vara starkt knutna till människans förmåga att reproducera sig. Infertilitet är ett problem vilket uppstår i en relation. Trots detta har det under lång tid setts som ett kvinnligt problem. Studien syftar till att belysa fenomenet infertilitet ur mäns perspektiv och utgår från ett livsvärldsperspektiv. Totalt deltog sju män i studien, livsvärldsintervjuer genomfördes och materialet analyserades utifrån en fenomenologisk hermeneutisk ansats. Materialet mynnade ut i sammanlagt tolv subteman vilka resulterade i fyra stycken teman. Framtidstro, Intimitet, Maktlöshet samt Uthärdande tycks tillsammans stå för innebörden av fenomenet. Männen har ett behov av att finna strategier och på så vis öka känslan av att hantera och begripa den egna livssituationen vilket ses som en röd tråd genom resultatet. Männen tycks se sina upplevelser kring infertilitet som något positivt. De har intagit en ny roll och en stärkt relation till partnern belyses. Kopplingar till Antonovskys teorier kring KASAM kan ses och vikten av delaktighet betonas i resultatet. Diskussion förs även kring huruvida skillnader i bakomliggande orsaker till infertiliteten kan påverka resultatet. / When reproductive health is failing and feelings of being less worthy arise and both masculinity and femininity are concepts that seem to be strongly linked to man's ability to reproduce. Infertility is a problem which arises in a relationship. Despite this, it has for a long time been seen as a women's problem. The study aims to shed light on the phenomenon of infertility from men´s perspective and based on a life-world perspective. The study includes seven men, life-world interviews and material reviewed on the basis of a phenomenon logical hermeneutical approach. The material resulted in a total of twelve subthemes resulting four themes. Optimism in the future, Intimacy, Powerlessness and Persevering seem to stand together for the meaning of the phenomenon. The men have a need to find strategies and thereby increase the feeling of manage and comprehend their life situation. The men seem to see their experiences of infertility as something positive. They have taken on a new role and a stronger relationship with the partner is illuminated. Links with Antonovskys theories about KASAM can be seen and the importance of participation is emphasized in the outcome. There are also discussions on whether the differences in the underlying causes of infertility can affect results.