Reproductive changes among women in their 40s : A cross-sectional study

Introduction: The aim was to describe and compare changes in the reproductive pattern of women in their 40s observed over a decade in Scandinavia. Material and Methods: Cross-sectional study using the total population of women aged 40-49 years between 2008-2018 in Denmark, Norway and Sweden (on average n = 1.5 million). Aggregated data concerning birth and induced abortion rate were collected and analyzed from national health registers. National data on redeemed prescriptions of hormonal contraceptives in the three countries were collected from prescription registers. Births after spontaneous and assisted conceptions were identified by using cross-linked data on deliveries from the Medical Birth Registers and National Registers of Assisted Reproduction in the three countries. Results: Use of hormonal contraception increased among women aged 40-44 years in Denmark from 24% to 31%, in Sweden from 27% to 30%, and in Norway from 22% to 24%. The levonorgestrel-releasing intrauterine device was the most frequently used method in all countries. Birth rates among women 40-44 years increased continuously from 9.5 to 12/1000 women in Denmark and from 11.7 to 14.3/1000 in Sweden, but remained stable in Norway at similar to 11/1000 women. There was a doubling of assisted conceptions in Denmark from 0.71 to 1.71/1000 women, Sweden from 0.43 to 0.81/1000 and Norway from 0.25 to 0.53/1000 women 40-49 years of age. Sweden had the highest induced abortion rate (7.7 to 8.1/1000 women) in women aged 40-49 years during the study period. Conclusions: From 2008 to 2018, birth rates continuously increased among women aged 40-49 years in Denmark and Sweden and births resulting from assisted reproductive technology doubled in all three countries.Peer reviewe

Bildpedagogiska processer på distans under pandemin : Dilemman och utvecklingspotential

Syftet med rapporten är att beskriva hur undervisning och examination i ämnet bildpedagogik påverkats av att genomföras helt på distans under pandemiåren 2020–2021. Rapporten bygger på semistrukturerade intervjuer med samtliga lärare som undervisade i bildpedagogik vid Högskolan i Gävle under pandemiåren. Intervjuerna fokuserade på undervisning, examination och framåtblick. I en tematisk innehållsanalys togs teman fram under dessa rubriker. Resultatet visar att all undervisning och examination i bildpedagogik inte går att genomföra digitalt på distans med bibehållen kvalité. Delar av den digitala undervisningen som generellt fungerar väl är föreläsningar och individuell handledning. I bildpedagogisk undervisning länkas teori och praktik samman. Under pandemin har det praktiska arbetet påverkats negativt och därmed har också kopplingen till teoretiska perspektiv försvagats. Den digitala undervisningen under pandemin har inneburit merarbete för lärare i ämnet då nya eller omformulerade uppgifter och examinationer har behövt tas fram. The aim of the report is to describe how teaching and examination in the subject of art education has been affected by taking place entirely at a distance during the pandemic years 2020–2021. The report is based on semi-structured interviews with all teachers who taught art education at the University of Gävle during the pandemic years. The main focus of the interviews was education, examination and visions of the future. In a thematic content analysis, themes were brought out under these headings. The result shows that all teaching and examination in art education cannot be carried out digitally at a distance with maintained quality. Lectures and individual tutoring are parts of the digital teaching that generally work well. In teaching art education theory and practice are linked together. During the pandemic, the practical work has been negatively affected and thus the connection to theoretical perspectives has weakened. The digital teaching during the pandemic has meant extra work for teachers in the subject as new or reformulated assignments and examinations have had to be prepared

Bildpedagogiska processer på distans under pandemin : Dilemman och utvecklingspotential

Syftet med rapporten är att beskriva hur undervisning och examination i ämnet bildpedagogik påverkats av att genomföras helt på distans under pandemiåren 2020–2021. Rapporten bygger på semistrukturerade intervjuer med samtliga lärare som undervisade i bildpedagogik vid Högskolan i Gävle under pandemiåren. Intervjuerna fokuserade på undervisning, examination och framåtblick. I en tematisk innehållsanalys togs teman fram under dessa rubriker. Resultatet visar att all undervisning och examination i bildpedagogik inte går att genomföra digitalt på distans med bibehållen kvalité. Delar av den digitala undervisningen som generellt fungerar väl är föreläsningar och individuell handledning. I bildpedagogisk undervisning länkas teori och praktik samman. Under pandemin har det praktiska arbetet påverkats negativt och därmed har också kopplingen till teoretiska perspektiv försvagats. Den digitala undervisningen under pandemin har inneburit merarbete för lärare i ämnet då nya eller omformulerade uppgifter och examinationer har behövt tas fram. The aim of the report is to describe how teaching and examination in the subject of art education has been affected by taking place entirely at a distance during the pandemic years 2020–2021. The report is based on semi-structured interviews with all teachers who taught art education at the University of Gävle during the pandemic years. The main focus of the interviews was education, examination and visions of the future. In a thematic content analysis, themes were brought out under these headings. The result shows that all teaching and examination in art education cannot be carried out digitally at a distance with maintained quality. Lectures and individual tutoring are parts of the digital teaching that generally work well. In teaching art education theory and practice are linked together. During the pandemic, the practical work has been negatively affected and thus the connection to theoretical perspectives has weakened. The digital teaching during the pandemic has meant extra work for teachers in the subject as new or reformulated assignments and examinations have had to be prepared

Kompetensutveckling i socialt arbete : en komparativ studie av kompetensutveckling inom den sociala barnavården i Köpenhamn respektive Malmö

The purpose of our essay was to conduct a comparative study of development of competence within child welfare in Frederiksberg, Copenhagen and Kirseberg in the city of Malmö. The purpose was also to describe and analyse the social workers individual experiences of needs and possibilities to take part of recent knowledge within child welfare. Central questions were; is the development of competence regulated in Swedish respectively Danish legislation; how do Frederiksberg and Kirseberg define the terminology "development of competence", based on the 2002 personnel policy documents? The research was based on qualitative interviews with six social workers in child welfare, in conjunction with personnel policy documents acquired from Frederiksberg and Kirseberg. Our findings showed that the development of competence depends on financial resources, time available and the location of the courses. We also found that most knowledge enhancement is down to the individual social worker, and is predominately done during their spare time, without any compensation from the management. Our conclusion was that participating in developing competence seemed like a stress factor for many of the social workers, when they had to put aside the ordinary work

The effect of combined oral contraceptives and age on dysmenorrhoea: an epidemiological study

background: Combined oral contraceptives (COCs) are widely advocated as treatment for primary dysmenorrhoea, but their efficacy has been questioned in a Cochrane review. The aim of this study was to evaluate COCs and the influence of age on the severity of dysmenorrhoea. results: The severity of dysmenorrhoea was lower (P , 0.0001) in COC users compared with non-users. In a longitudinal analysis of the severity of dysmenorrhoea, COC use and increasing age, independently of each other, were associated with the severity of dysmenorrhoea (COC use, VMS score: a reduction of 0.3 units/VAS: a reduction of 9 mm, both P , 0.0001; increasing age, VMS score: a reduction of 0.1 units per 5 years, P , 0.0001/VAS: a reduction of 5 mm per 5 years, P , 0.0001). Childbirth also reduced the severity of dysmenorrhoea (VAS, P , 0.01 with a reduction of 7 mm). Women from the 82-cohort reported a greater severity of dysmenorrhoea compared with the 62 and 72 cohorts at both 19 and 24 years of age. conclusions: In this longitudinal case -control study, COC use and increasing age, independent of each other, reduced the severity of dysmenorrhoea. COC use reduced the severity of dysmenorrhoea more than increasing age and childbirth. There was a trend over time regarding the severity of dysmenorrhoea where women from the 82-cohort reported a greater severity of dysmenorrhoea compared with the 62 and 72 cohorts

Ecological study on the use of hormonal contraception, abortions and births among teenagers in the Nordic countries

Objectives Compare hormonal contraceptive use, birth and abortion rates among teenagers in the Nordic countries. A secondary aim was to explore plausible explanations for possible differences between countries. Design Ecological study using national registry data concerning births and abortions among all women aged 15-19 years residing in Denmark, Finland, Iceland, Norway and Sweden 2008-2015. Age-specific data on prescriptions for hormonal contraceptives for the period 2008-2015 were obtained from national databases in Denmark, Norway and Sweden. Setting Denmark, Finland, Iceland, Norway and Sweden. Participants Women 15-19 years old in all Nordic countries (749 709) and 13-19 years old in Denmark, Norway and Sweden (815 044). Results Both annual birth rates and abortion rates fell in all the Nordic countries during the study period. The highest user rate of hormonal contraceptives among 15-19-year-olds was observed in Denmark (from 51% to 47%) followed by Sweden (from 39% to 42%) and Norway (from 37% to 41%). Combined oral contraceptives were the most commonly used methods in all countries. The use of long-acting reversible contraceptives (LARC), implants and the levonorgestrel-releasing intrauterine systems, were increasing, especially in Sweden and Norway. In the subgroup of 18-19-year-old teenagers, the user rates of hormonal contraceptives varied between 63% and 61% in Denmark, 56% and 61% in Norway and 54% and 56% in Sweden. In the same subgroup, the steepest increase of LARC was seen, from 2% to 6% in Denmark, 2% to 9% in Norway and 7% to 17% in Sweden. Conclusions Birth and abortion rates continuously declined in the Nordic countries among teenagers. There was a high user rate of hormonal contraceptives, with an increase in the use of LARC especially among the oldest teenagers.Peer reviewe

Sexual function and combined oral contraceptives : a randomised, placebo-controlled trial

Objective: The effect of combined oral contraceptives (COCs) on female sexuality has long been a matter of discussion, but placebo-controlled studies are lacking. Thus, the aim of the present study was to investigate if an oestradiol-containing COC influences sexual function. Design: Investigator-initiated, randomised, double-blinded, placebo-controlled clinical trial where 202 healthy women were randomised to a combined oral contraceptive (1.5 mg oestradiol and 2.5 mg nomegestrol acetate) or placebo for three treatment cycles. Methods: Sexual function at baseline and during the last week of the final treatment cycle was evaluated by the McCoy Female Sexuality Questionnaire. Serum and hair testosterone levels were assessed at the same time points. Results: Compared to placebo, COC use was associated with a small decrease in sexual interest (COC median change score: -2.0; interquartile range (IQR): -5.0 to 0.5 vs placebo: -1.0; IQR: -3.0 to 2.0, P=0.019), which remained following adjustment for change in self-rated depressive symptoms (B= -0.80 +/- 0.30, Wald =7.08, P=0.008). However, the proportion of women who reported a clinically relevant deterioration in sexual interest did not differ between COC or placebo users (COC 18 (22.2%) vs placebo 16 (17.8%), P=0.47). Change in other measured aspects of sexual function as well as total score of sexual function did not differ between the two treatments. Conclusions: This study suggests that use of oestradiol-based COCs is associated with reduced sexual interest. However, the changes are minute, and probably not of clinical relevance