Landslide susceptibility maps are useful for spatial decision-making to minimize the lossof lives and properties. There are many studies related to the development of landslidesusceptibility maps using various methods such as Analytic Hierarchy Process, Weight ofEvidence and Logistic Regression. Commonly, the geospatial data required for such analysis(such as land cover and soil type maps) are only locally available and pertinent to smallcase studies. Transferable and scalable approaches utilizing publicly available, large scaledatasets (ie., global or continental) are necessary to develop susceptibility maps in areaswhere local data is not available or when large-scale analysis is required. To develop suchapproaches, a systematic comparison between locally available, fine resolution, and largerscale, openly available but coarser resolution datasets is essential. The objective of this study isto investigate the efficiency of globally available public data for landslide susceptibility mappingby comparing it with the performance of the data provided from local institutions. For this purpose, the Göta river valley in Sweden and the country of Rwanda were selectedas study areas. Göta river valley was used for the comparison of local and open data.While Rwanda was used as a study area to ensure the efficiency of open data analysis andtransferability of the framework. The selected landslide impact factors for this study are;elevation, slope, soil type, land cover, precipitation, lithology, distance to roads, and distanceto drainage network. Landslide susceptibility maps were prepared by using the state-of-the-artFrequency Ratio method. The validation results using the prediction rate curve technique show92.9%, 90.2%, and 83.1% area under curve values for local and open data analyses of Göta rivervalley and open data analysis of Rwanda country, respectively. The results show that globallyavailable open data demonstrate strong potential for landslide susceptibility mapping whenhigh-resolution local data are not available.

Bakgrund: Endometrios är en kronisk inflammatorisk sjukdom som drabbar en av tio kvinnor i fertil ålder. Vanliga symtom är intensiv smärta i samband med menstruation, kraftiga och oregelbundna blödningar, samlagssmärta och infertilitet. Det tar ofta flera år innan kvinnor får en diagnos vilket medför ett stort lidande. Forskning om endometrios går framåt men det finns fortfarande okunskap inom vården och vårdpersonalen behöver fortbildning för att kunna ge stöd och råd. Den teoretiska referensram som användes var Joyce Travelbees omvårdnadsteori samt personcentrerad omvårdnad. Syfte: Att belysa hur kvinnor med endometrios upplever bemötandet i vården. Metod: Litteraturstudien genomfördes med en kvalitativ ansats. Efter kvalitetsgranskningen återstod tio artiklar som användes i litteraturstudien. Resultat: De tio artiklar som ligger till grund för resultatet kommer från Sverige, Ungern, Australien, Storbritannien och Nederländerna. Dataanalysen genererade i tre kategorier: Vårdpersonalens förminskande attityd, Kunskap och information samt Fertilitet, med sex subkategorier som representerade olika aspekter av upplevelsen av bemötandet i vården. Kvinnorna upplevde att de fört en kamp under flera år för att få en diagnos, vårdpersonalen tog dem inte på allvar samt normaliserade deras symtom. Kvinnorna upplevde även att vårdpersonalen hade bristande kunskaper om sjukdomen samt fokuserade för mycket på fertiliteten. Positiva upplevelser var när vårdpersonalen lyssnade och bekräftade dem. Konklusion: Kvinnorna hade övervägande negativa upplevelser av bemötandet i vården och saknade stöd från vårdpersonalen. Det är viktigt att höja kunskapsnivån för att minska det långdragna lidandet. Sjuksköterskan behöver arbeta empatiskt och personcentrerat för att kunna tillgodose kvinnornas behov. / Background: Endometriosis is a chronic inflammatory disease that affects one in ten women in their fertile age. Typical symptoms of endometriosis are dysmenorrhea, heavy irregular bleedings, dyspareunia and infertility. The diagnostic delay is often many years, which could cause suffering. Research of endometriosis is progressing, yet there still exists ignorance in health care and health care staff need training to be able to provide support. The theoretical frameworks used were the nursing theory by Joyce Travelbee and person-centered nursing. Aim: To illustrate how women with endometriosis experience health care encounters. Method: The literature review was performed with a qualitative approach. After the quality review ten articles remained that were included in the literature review. Results: The ten articles used in the literature review came from Sweden, Hungary, Australia, United Kingdom and the Netherlands. The data analysis generated three categories: Health care provider ́s diminishing attitude, Knowledge and information and Fertility, with six subcategories that represented different aspects of the experience in the health care encounter. The women fought several years to get a diagnosis, health care providers did not take them seriously and normalized their symptoms. The women also felt that the health care providers lacked knowledge about the disease and focused too much on fertility. Positive health care encounters were when the health care providers listened and confirmed them. Conclusion: Women mostly had negative experiences of health care encounters and lacked support from the health care staff. It is significant to raise the level of knowledge in order to reduce women’s suffering from the disease. The nurse needs to work empathically with a person-centered approach to be able to meet the women’s needs.

Bakgrund: Många kvinnor upplever förlossningsrädsla. Föda utan rädsla är en naturlig metod som främjar trygghet och optimerar födandets fysiologi och stärker det positiva i förlossningsupplevelsen. Kvinnans stödperson har en viktig roll under förlossningsarbetet.Syfte: Syftet är att beskriva och undersöka om användandet av metoden Föda utan rädsla (FUR) påverkar den födande kvinnans upplevda vårdkvalitet samt upplevelse och känslor i samband med förlossningen jämfört med tidigare insamlat material.Metod: Mixad metod av fall-kontrollstudie med kvantitativ ansats och en kvalitativ innehållsanalys med induktiv metod. Data samlades in genom QPP-I-enkät och analyserades genom Mann Whitney U-test.Resultat: De kvinnor som upplevde god effekt av FUR upplevde bättre stöd från personal, att partnern fick bättre stöd, uppmuntrades att delta och fick sina fysiska behov tillgodosedda under förlossningen. Kvinnorna upplevde även andra faktorer som påverkade den upplevda vårdkvaliteten.Slutsats: Genom förberedelse i FUR-metoden kan det födande paret upplevaökad trygghet och självförtroende inför förlossning och förlossningsrädsla kan motverkas. FUR kan ge upplevelse av ett bättre bemötande från personal, ökat stöd och respekt. Partnern blir stärkt i sin roll, vågar ta plats och ge stöd till den födande kvinnan.Klinisk tillämpbarhet: FUR-utbildningen är kort och ger en stor vinst tillbaka till både det födande paret samt förlossningspersonalen. / Background: Many women experience fear of childbirth. Confident Birth is a natural method that promotes security and optimizes the physiology of childbirth and strengthens the positive in the birth experience. The woman's support person has an important role during the labor. Aim: The aim is to investigate whether the use of the method Confident Birth affects the woman giving birth's perceived quality of care and delivery experience compared with previously collected material. Method: Mixed method of case-control study with quantitative approach and a qualitative content analysis with inductive method. Data are collected through the QPP-I survey and analyzed by the Mann Whitney U-test. Resultats: Women who experienced good effect of Confident Birth, experienced better support from caregivers, that the partner received better support, was encouraged to participate and had their physical needs met during childbirth. The women also experienced other factors that affected the perceived quality of care. Conclusion: Through preparation in the Confident Birth method, the birthing couple can experience increased security and self-confidence before childbirth and fear of childbirth can be counteracted. Confident Birth can provide an experience of a better response from healthcare personal, increased support and respect. The partner dares to act and provide support to the woman giving birth and the partner´s role is strengthened. Clinical application: Preparation in the Confident Birth method is short and gives a big profit back to both the birth couple and the delivery staff.

Syfte: Att undersöka kvinnors erfarenhet av könsstympning och vilken påverkan det har på deras hälsa med fokus på den perinatala och sexuella hälsan. Metod: Kvalitativ intervjustudie med induktiv ansats. Tio kvinnor som genomgått könsstympning grad I-III deltog. Intervjuerna var semistrukturerade intervjuer och genomfördes på Zoom. Intervjuerna spelades in med mobiltelefoner och sedan transkriberades och analyserades med innehållsanalys på manifest nivå. Resultat: Det utvecklades fyra kategorier och 10 subkategorier. Könsstympning påverkade perinatala och sexuella hälsan i flera avseende i form av flera olika komplikationer så som smärta vid själva ingreppet, men också vid samlag, problem med menstruation och problem under graviditet och förlossning. Kvinnorna blev ofta dåligt bemötta när de sökte vård och märkte att det fanns kunskapsluckor hos barnmorskor. Psykiska hälsan påverkades då kvinnorna hade en känsla av att vara annorlunda och att de blivit bestulna på en kroppsdel som de sörjde. Flera kvinnor hade genomgått rekonstruktion och rekommenderade andra att genomföra det.  Slutsats: Kvinnornas perinatala och sexuella hälsa påverkades negativt av könsstympningen i form av komplikationer. Smärta vid ingreppet, smärta vid samlag som påverkade samlivet och därmed sexuella hälsan negativt. Komplikationer under graviditet och förlossning med upprepade urinvägsinfektioner, stora bristningar och klipp i underlivet. Det dåliga bemötandet samt kunskapsluckan hos barnmorskorna upplevdes som jobbig.    Nyckelord: Förlossning, graviditet, kvalitativ metod, perinatal hälsa och sexuell hälsa / Aim: To examine women's experience of female genital mutilation and the impact it has on their health with a focus on perinatal and sexual health. Method: Qualitative interview study with an inductive approach. Ten women who underwent genital mutilation grade I-III participated. The interviews were semi-structured interviews and were conducted on Zoom. The interviews were recorded with mobile phones and then transcribed and analyzed using manifest level content analysis. Results: Four categories and 10 subcategories were developed. Female genital mutilation affected perinatal and sexual health in several aspects in the form of several different complications such as pain during the procedure itself, but also during intercourse, problems with menstruation and problems during pregnancy and childbirth. The women were often treated poorly when they sought care and noticed that there were gaps in knowledge among midwives. Mental health was affected as the women had a feeling of being different and that they had been robbed of a body part that they mourned. Several women had undergone reconstruction and recommended others to undergo it. Conclusions: The women's health was negatively affected by female genital mutilation in the form of complications. Pain during the procedure, pain during intercourse that negatively affected marriage life and thus sexual health. Complications during pregnancy and childbirth with repeated urinary tract infections, large ruptures and cuts in the female genital. The poor treatment and lack of knowledge among the midwives was perceived as troublesome   Keywords: Childbirth, pregnancy, perinatal health, qualitative method and sexual health

Bakgrund: Intrauterin fosterdöd är en sällsynt händelse, av 1000 förlossningar är det cirka tre till fyra förlossningar där det inträffar i Sverige. Som förälder kan det vara svårt att hantera sorgen vid intrauterin fosterdöd och därmed finns det behov av stöd. Föräldrarna uppger att de inte får den rätta vård och stöd som de är i behov av. Det finns bristfällig kommunikation mellan barnmorskor och föräldrar. Stöd till barnmorskor är lika viktigt, vilket är en förutsättning för att kunna hantera svåra situationer. Syftet: Att beskriva barnmorskors erfarenhet av att stödja föräldrar efter förlossning vid intrauterin fosterdöd. Metod: Kvalitativ metod med induktiv ansats. En webbenkät som besvarades av 25 barnmorskor. Resultat: Fyra kategorier och nio subkategorier utformades. Barnmorskorna ansåg att grunden till god vård för föräldrarna vid intrauterin fosterdöd var att vara närvarande och stödja föräldrarna genom hela vårdtiden. Det kan vara en utmaning att hantera egna känslor samtidigt som det är en hög arbetsbelastning på arbetsplatsen. Behovet av fördjupad kunskap kring stödjandet av föräldrarna föreligger. Slutsats: Barnmorskorna ansåg behovet av vidareutbildning inom ämnet för att kunna hantera svåra situationer. Stödet till barnmorskorna var en viktig faktor för att klara av att bemöta föräldrarna vid intrauterin fosterdöd. / Background: Intrauterine fetal death is a rare event, occurring in approximately three to four out of 1000 births in Sweden. As parents, coping with the grief of intrauterine fetal death can be challenging, and the need for support is crucial. Parents report not receiving the proper care and support they require. There is inadequate communication between midwives and parents. Support for midwives is equally crucial, to be able to manage difficult situations. Aim: To describe midwives' experiences in supporting parents after childbirth in cases of intrauterine fetal death. Method: Qualitative method with an inductive approach. A web- based survey was completed by 25 midwives. Results: Four categories and nine subcategories were formed. Midwives believed that the foundation for providing good care to parents in cases of intrauterine fetal death was to be present and support the parents throughout the entire care period. Managing their own emotions while facing a heavy workload at the workplace can be challenging. There is a need for further education regarding supporting parents going through an intrauterine fetal death. Conclusion: Midwives identified the need for further education on the subject to manage difficult situations. Support for midwives was a crucial factor in being able to support parents in cases of intrauterine fetal death.

During roughly forty years of a woman’s life-span, the fertile female human body prepares itself monthly for the possibility of pregnancy. Science has shown that the fluctuation of the sex steroids progesterone and estrogen have a crucial role in the female body's physiology, determining the menstrual cycle and its general phases. This biological dance of hormones governing the cycle influences a lot of physical, mental and cognitive aspects of life for a fertile ovulating woman. Although the question of whether these changes also affect women's cognitive performance is still unclear, some evidence has been gathered that could bring us closer to answers. Recent research findings show that this hormonal interplay might have a significant role in cognitive and psychological development - modulating brain activity, cognitive performance, higher cognition, emotional status, sensory processing, appetite and more. This thesis aims to uncover to what extent the menstrual cycle affects brain functions, neurobiology, mood, well-being and cognitive performance in menstruating cisgender women.

Bakgrund: Ungdomars sexuella och reproduktiva hälsa och rättigheter (SRHR) är ett viktigt folkhälsoarbete och barnmorskan har en central roll när det kommer till att nå ungdomarna med kunskap och information. Det förefaller finnas få studier om barnmorskors uppfattningar om vad ungdomar behöver veta mer om när det kommer till deras sexuella och reproduktiva hälsa och rättigheter. Syfte: Syftet med denna studie var att beskriva barnmorskors uppfattningar om vad ungdomar behöver veta mer om inom området sexuell och reproduktiv hälsa och rättigheter. Metod: Kvalitativ intervjustudie med åtta semistrukturerade intervjuer med barnmorskor. Datamaterial analyserades med en kvalitativ innehållsanalys med induktiv ansats. Resultat: Barnmorskorna uppfattade att ungdomarna hade behov av att veta mer om kroppsutveckling. Även mer om sexuellt överförbara infektioner (STI) och preventivmedel samt att killarna behövde veta mer om deras reproduktiva ansvar. Ungdomarna behövde också veta mer om sexuella relationer och rättigheter, innefattande bland annat lagar och homosexualitet. Barnmorskorna ser idag en ökning av sexuella problem bland ungdomarna och barnmorskorna hade en gemensam uppfattning om att det beror på pornografikonsumtion. Slutsats: Barnmorskor har insikt i vad ungdomar behöver veta mer om inom SRHR. Det finns fortfarande brister i undervisning och utbildning till ungdomar inom SRHR och det är angeläget att fokusera och investera i arbeten för att stärka och främja ungdomars SRHR. Klinisk tillämpbarhet: Denna studie lyfter barnmorskors uppfattningar om vad ungdomar behöver veta mer om inom ämnet SRHR. Studien kan användas i klinisk verksamhet till förbättringsarbeten för olika yrkeskategorier som arbetar med ungdomar gällande SRHR. / Background: The sexual and reproductive health and rights (SRHR) of young people is an important public health work and the midwife has a central role in reaching the young people with knowledge and information. There seem to be few studies on midwives' perceptions about what young people need to know more about when it comes to their sexual and reproductive health and rights. Purpose: The purpose of this study was to describe the views of midwives about what young people need to know more about in the area of sexual and reproductive health and rights. Method: Qualitative interview study with eight semi-structured interviews with midwives. The data material was analyzed with a qualitative content analysis with inductive approach. Result: The midwives perceived that the young people needed to know more about body development. In addition, more about sexually transmitted infections (STIs) and contraceptives and that the young men needed to know more about their reproductive responsibilities. The youth also needed to know more about sexual relations and rights, including, among other things, laws and homosexuality. The midwives today see an increase in sexual problems among young people and the midwives had a common view that this is due to pornography consumption. Conclusion: Midwives have insight into what young people need to know more about in SRHR. There are still shortcomings in education for young people within SRHR, and it is important to focus and invest in work to strengthen and promote young people's SRHR. Clinical application: This study highlights the views of midwives on what young people need to know more about in the subject of SRHR. The study can be used in clinical activities for improvement work for various occupational categories that work with young people regarding SRHR.

This study examines the production and the introduction of a fertility treatment which gained great attention both in Sweden and internationally during the 1960s. In the procedure, hormones were extracted from human pituitary glands which had been collected from autopsies. After this, the hormones were purified and injected into the female patients as a treatment for certain kinds of sterility. Carl Gemzell, professor of obstetrics and gynecology at Uppsala University, was a key figure in the development of the treatment. He was described by the media as a medical pioneer and later became one of Sweden’s most famous doctors and scientists. The fertility treatment also gained a lot of attention in the media as ”the miracle drug that made barren women pregnant”, especially since it often resulted in multiple pregnancies. In the 1960s, pregnancies with quadruplets, quintuplets, sextuplets and even septuplets became world sensations. By using the sociology of expectations as theoretical approach, which focuses on the performativity of expectations and visions in science production, this study aims to investigate how expectations of an effective fertility method were articulated in both the scientific sphere and in the media. This of course also relates to how the risks of the multiple pregnancies were dealt with. The analysis is divided into three chapters, where the first chapter examines the politics of science in Sweden during the post-war period and how Gemzell’s work in Uppsala generated expectations of a scientific milieu on the front line of fertility research. The next chapter is focused on the media’s interest in Gemzell and how he became a celebrity. A central argument for the study is that his public status helped to create scientific credibility for the treatment, especially among the public. The final chapter focuses on the media reporting about the multiple pregnancies. They were often treated as sensations, which was somewhat paradoxical as they were hazardous and frequently resulted in the death of the premature children.

Polycystic ovary syndrome (PCOS) is a complex clinical condition characterized by hyperandrogenism and chronic oligo/anovulation. Infrequent ovulation and metabolic alterations in women with PCOS are associated with subfertility and probably increased miscarriage rates compared with normal fertile women. The overall risk of developing type 2 diabetes and impaired glucose tolerance (IGT) is three- to sevenfold higher in PCOS women, and the onset of glucose intolerance seems to occur at an earlier age than in healthy controls. Women with PCOS also have several risk factors for cardiovascular disease, although it is unclear whether they actually experience more cardiovascular events than other women. Very few studies assessing the long-term reproductive and metabolic consequences in older women with previously confirmed PCOS have been conducted. In this long-term follow-up of women with PCOS, 84 women with a diagnosis of PCOS between 1987 and 1995 and age at the follow-up > 35 years and an age-matched population-based group of control women participated. Data on reproductive outcome, ovarian reserve, endothelial function, insulin sensitivity and beta-cell function were collected. According to our results most women with PCOS had given birth and the rate of spontaneous pregnancies was relatively high. The rate of miscarriages was not increased in PCOS patients and the ultrasound findings together with increased levels of anti-müllerian hormone suggested that their ovarian reserve is superior to women of similar age. PCOS women displayed signs of endothelial dysfunction, but this was largely due to the increased prevalence of independent risk factors for cardiovascular disease such as increased BMI, triglycerides and blood pressures. IGT and type 2 diabetes occurred more often in PCOS women. Free androgen levels and beta-cell function decreased over time whereas insulin sensitivity remained unchanged. Obesity at young age and progressive weight-gain rendered them more prone to be insulin resistant at the follow-up. Beta-cell function was increased in PCOS women in comparison with control subjects but declined over time. Independent of PCOS phenotype at the index assessment and persistence of PCOS symptoms at the follow-up investigation, premenopausal women with PCOS had lower insulin sensitivity and increased beta cell function in comparison with control subjects. Conclusion: The long-term reproductive outcomes of PCOS are similar compared to women with normal ovaries. Although symptoms and androgen levels are normalized over time, women with PCOS continue to display reduced insulin sensitivity and increased beta-cell function and they also have an increased risk of IGT and type 2 diabetes.

The aims were to investigate the accuracy of ultrasound in diagnosis of structural fetal anomalies with special focus on false positive findings (I), to evaluate the additional value of second trimester fetal MRI on pregnancy management (II-III) and to estimate the ascertainment in the Swedish Birth Defects Registry and incidence of spina bifida and cleft lip/palate (IV). Retrospectively, 328 fetal autopsies were identified where pregnancies were terminated due to ultrasonographically diagnosed fetal anomalies. In 175 (53.4 %) cases ultrasound and fetal autopsy were identical, in 124 (37.8 %) ultrasound was almost correct, in 23 (7.0 %)  ultrasound diagnoses could not be verified, but fetal autopsy showed other anomalies with at least the same prognostic value and in six (1.8 %)  ultrasound diagnosis could not be verified and autopsy showed no or less severe anomalies (I). Prospectively, 29 pregnancies with CNS- (II) and 63 with non-CNS-anomalies (III) were included. In the CNS study MRI provided no additional information in 18 fetuses (62 %), additional information without changing the management in 8 (28 %) and additional information altering the pregnancy management in 3 (10%). In the non-CNS study the corresponding figures were 43 (68 %), 17 (27 %) and three (5 %), respectively. MRI in the second trimester might be a clinically valuable adjunct to ultrasound for the evaluation of CNS anomalies, especially when the ultrasound is inconclusive due to maternal obesity (II) and in non-CNS anomalies in cases of diaphragmatic hernia or oligohydramnios (III). In newborns, the ascertainments of birth defects are relatively high and assessable, but in pregnancy terminations they are lower or unknown. The incidence of newborns with spina bifida has decreased because of an increased rate of pregnancy terminations (>60%). There is room for improvement concerning the reporting of anomalies from terminated pregnancies (IV).