1.  Title: Interventions for pain with intrauterine device insertion. Author: Allen RH; Bartz D; Grimes DA; Hubacher D; O'Brien P Source: Cochrane Database of Systematic Reviews. 2009;(3):CD007373. Abstract: BACKGROUND: Fear of pain during intrauterine device (IUD) insertion is a barrier to use of this contraceptive method. Interventions for pain during IUD insertion include non-steroidal anti-inflammatory drugs (NSAIDs), local cervical anesthetics, and cervical ripening agents such as misoprostol. OBJECTIVES: To review all randomized controlled trials that have evaluated a treatment for IUD insertion-related pain. SEARCH STRATEGY: We searched the computerized databases MEDLINE, POPLINE, CENTRAL, and EMBASE for relevant trials. We also examined reference lists of pertinent articles and wrote to known investigators for information about other published or unpublished trials. SELECTION CRITERIA: We included all randomized controlled trials in any language that evaluated a treatment for IUD insertion-related pain. The intervention could be compared to a placebo or another active intervention. DATA COLLECTION AND ANALYSIS: Two authors independently abstracted data from relevant trials and data were entered into RevMan 5.0 for analysis. For dichotomous variables, the Peto odds ratios with 95% confidence intervals was calculated. For continuous variables, the mean differences with 95% confidence interval was computed. MAIN RESULTS: Four trials met the inclusion criteria; the total number of participants was 2204. Nonsteroidal anti-inflammatory drugs of varying types and doses were not effective for reducing pain during IUD insertion. Misoprostol for cervical ripening did not reduce pain with IUD insertion in nulliparous women. Two trials evaluated pain that occurs after IUD insertion using nonsteroidal anti-inflammatory drugs. In one trial, naproxen taken prior to IUD insertion was effective in reducing pain compared with placebo in the first two hours after IUD insertion in mostly nulliparous women. However, this trial utilized the Dalkon Shield, an IUD with a wider diameter than modern IUDs. In another trial, ibuprofen 600 mg taken before IUD insertion did not show evidence of an effect on pain four to six hours after IUD insertion. AUTHORS' CONCLUSIONS: No interventions that have been properly evaluated reduce pain during or after IUD insertion. One poorly controlled trial suggested that topical lidocaine gel may reduce insertion-related pain and warrants further investigation. Language: English Keywords: UNITED STATES OF AMERICA | CHILE | DENMARK | SWEDEN | LITERATURE REVIEW | CLINICAL TRIALS | IUD | INSERTION | PAIN | DRUGS | ADMINISTRATION AND DOSAGE | MISOPROSTOL | Developed Countries | North America | Americas | Developing Countries | South America, Southern | South America | Latin America | Europe, Northern | Europe | Clinical Research | Research Methodology | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology Document Number: 342475 |
| 2. Title: Hysteroscopic female sterilization with Essure in an outpatient setting. Author: Andersson S; Eriksson S; Mints M Source: Acta Obstetricia Et Gynecologica Scandinavica. 2009;88(6):743-6. Abstract: The aim of this study is to evaluate the short and long-term results of hysteroscopic sterilization in an outpatient setting. Sixty-one women underwent hysteroscopic sterilization. At follow-up, all of the women were asked to complete a questionnaire concerning possible pregnancy, bleeding patterns, side-effects, or need for further therapy after sterilization. Technical feasibility, complications, patient satisfaction, and tubal occlusion based on X-ray or ultrasound were measured. Fifty-eight (95%) women were sterilized according to this method. Successful bilateral device placement was achieved in 52 women (85%) during the first attempt and in six (9.8%) during the second. A total of 50 (81.9%) women submitted completed outcome questionnaires. The mean follow-up period was 23 (range 7-67) months. No pregnancies were reported. All questionnaire respondents expressed overall satisfaction with the procedure. To conclude, Essure sterilization is a safe effective method for female sterilization thatis feasible in the outpatient setting. Language: English Keywords: SWEDEN | RESEARCH REPORT | CLIENTS | FEMALE STERILIZATION | HYSTEROSCOPY | COMPLICATIONS | SIDE EFFECTS | TUBAL OCCLUSION | SATISFACTION | SAFETY | Developed Countries | Europe, Northern | Europe | Program Activities | Programs | Organization and Administration | Sterilization, Sexual | Family Planning | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Treatment | Psychological Factors | Behavior | Public Health Document Number: 341444 |
| 3. Title: HIV-infected African parents living in Stockholm, Sweden: disclosure and planning for their children's future. Author: Asander AS; Bjorkman A; Belfrage E; Faxelid E Source: Health and Social Work. 2009 May;34(2):107-15. Abstract: In Sweden, most HIV-infected parents are of African origin. The present study explored the frequency of HIV-infected African parents' disclosure of their status to their children and custody planning for their children's future to identify support needs among these families. Semistructured interviews were conducted with 47 parents (41 families). The study population included first-generation immigrants, with a total of 87 children less than 18 years of age. Only women had disclosed their HIV status, and only to eight of 59 children older than six. Half of the parents had talked to someone about future custody arrangements. These parents had more contact with a social worker at the social welfare office and with a medical social worker at the HIV clinic. Most parents (30) wanted their children to be cared for by a relative in Sweden or by their HIV-negative partner. Neither disclosure nor custody planning was associated with clinical status or antiretroviral treatment. This study highlights the low HIV-disclosure rate to children of HIV-infected African immigrant parents and the importance of support from social workers. Language: English Keywords: SWEDEN | AFRICA | RESEARCH REPORT | PARENTS | PERSONS LIVING WITH HIV/AIDS | IMMIGRANTS | CHILD CUSTODY | PLANNING | INTERPERSONAL COMMUNICATION | INTERVIEWS | Developed Countries | Europe, Northern | Europe | Developing Countries | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Migrants | Migration | Population Dynamics | Demographic Factors | Population | Child Rearing | Behavior | Organization and Administration | Communication | Data Collection | Research Methodology Document Number: 341675 |
| 4. Title: Limited knowledge on progestogen-only contraception and risk of venous thromboembolism. Author: Bergendal A; Odlind V; Persson I; Kieler H Source: Acta Obstetricia et Gynecologica Scandinavica. 2009;88(3):261-266. Abstract: Objective. To assess the current knowledge concerning progestogen-only contraception (POC) and risks of venous thromboembolism (VTE). Design and setting. Systematic review of the literature on observational and analytical studies reporting risk estimates for VTE in women exposed to POCs. Methods and main outcome measures. We performed a computerized literature search in the Pub Med, Embase, and the Cochrane Library for studies published between 1966 and February 13, 2008. Based on the evaluated studies we calculated an overall risk estimate for VTE in association with POC. Results. Four case-control studies and one cohort study were included. Of the case-control studies, three reported an increased risk and one a decreased risk of VTE. The cohort study found divergent results depending on the type of statistical analysis used. None of the results was statistically significant. The overall odds ratio for POC-associated VTE in the four case-control studies was 1.45 (95% CI=0.92-2.26). Conclusions. The risk of VTE associated with use of POCs is poorly investigated. The slightly elevated overall risk estimate might suggest an association between POC and an increased risk for VTE. The results must, however, be interpreted with caution due to the possibility of residual confounding. Well-designed studies with sufficient statistical power to evaluate risks of VTE with POC are warranted. Language: English Keywords: SWEDEN | RESEARCH REPORT | EPIDEMIOLOGY | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | THROMBOEMBOLISM | RISK FACTORS | KNOWLEDGE | Europe, Northern | Europe | Developed Countries | Public Health | Health | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Embolism | Vascular Diseases | Diseases | Sociocultural Factors Document Number: 329655 |
| 5. Title: Prolonged use of intrauterine contraceptive device as a risk factor for tubo-ovarian abscess. Author: Charonis G; Larsson PG Source: Acta Obstetricia Et Gynecologica Scandinavica. 2009;88(6):680-684. Abstract: Objective. The intrauterine contraceptive device (IUCD) is the most preferred method of reversible contraception in the world today. The Swedish Medical Products Agency currently recommends that women who had a copper IUCD inserted around age 40 do not need to have it extracted until one year after the menopause. Design. Retrospective study. Setting. Skovde Central Hospital, Sweden. Population. All 114 women receiving in-patient treatment for pelvic inflammatory disease (PID) over five years between January 2001 and December 2005. Methods. Comparison between cases of tubo-ovarian abscesses and salpingitis with focus on the effects of IUCDs used continually for >5 years after insertion. Main outcome measures. Age-adjusted risk of PID within or after five years of use, microbiological findings in blood, intraabdominal pus, cervical secretions or on extracted IUCDs. Results. There were 31 cases of tubo-ovarian abscesses, 63 of salpingitis, four of endometritis, and 16 of mild genital infection. When comparing women with the same IUCD>5 years to women having the same IUCDLanguage: English Keywords: SWEDEN | RESEARCH REPORT | WOMEN | PELVIC INFLAMMATORY DISEASE | IUD | GENITAL EFFECTS, FEMALE | RISK FACTORS | Developed Countries | Europe, Northern | Europe | Demographic Factors | Population | Reproductive Tract Infections | Infections | Diseases | Contraceptive Methods | Contraception | Family Planning | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Health Document Number: 341046 |
| 6. Peer Reviewed Title: Risk of urinary incontinence symptoms in oral contraceptive users: a national cohort study from the Swedish Twin Register. Author: Iliadou A; Milsom I; Pedersen NL; Altman D Source: Fertility and Sterility. 2009 Aug;92(2):428-33. Abstract: OBJECTIVE: To assess the impact of oral contraceptives on lower urinary tract dysfunction in premenopausal women. DESIGN: Nationwide cohort study. SETTING: National registry. PATIENT(S): A total of 10,791 women (born 1959-1985) from the population- based Swedish Twin Registry who participated in a web-based survey of common diseases. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Symptoms of urinary incontinence. RESULT(S): For users of oral contraception there was a significantly reduced risk for symptoms of stress urinary incontinence, mixed urinary incontinence, and urgency urinary incontinence. The reduction remained significant when adjusting for age, body mass index, and pregnancy history. A reduced prevalence of symptoms of overactive bladder in oral contraceptive users was also observed although the association was nonsignificant. There were no significant associations between lower urinary tract symptoms and women using a levonorgestrel-releasing intrauterine device compared with noncontraceptive users, with the exception of nocturia. CONCLUSION(S): Oral contraceptive use reduces the overall risk for symptoms of urinary incontinence. Language: English Keywords: SWEDEN | RESEARCH REPORT | COHORT ANALYSIS | CONTRACEPTION | ORAL CONTRACEPTIVES | IUD | IUD SIDE EFFECTS | GENITAL EFFECTS, FEMALE | Developed Countries | Europe, Northern | Europe | Research Methodology | Family Planning | Contraceptive Methods | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology Document Number: 342587 |
| 7. Peer Reviewed Title: Contraceptive use and pregnancy outcome in three generations of Swedish female teenagers from the same urban population. Author: Lindh I; Blohm F; Andersson-Ellstrom A; Milsom I Source: Contraception. 2009 Aug;80(2):163-9. Abstract: BACKGROUND: The primary objective of the study was to describe contraceptive use, reasons for discontinuation of contraception and pregnancy outcome in three generations of female teenagers over a period of 20 years. The secondary objective was to describe the relationship between contraception, smoking, body mass index (BMI) and socioeconomic status (SES). STUDY DESIGN: A cross-sectional comparison of 19-year-old women born in 1962, 1972 and 1982 and living in the city of Gothenburg, Sweden, in 1981, 1991 and 2001 was conducted. Contraceptive use, pregnancy outcome, smoking and weight/height were assessed by a postal questionnaire. RESULTS: Current contraceptive use was unchanged between the 62 (60%) and 72 cohorts (62%) but had increased (p<.01) in the 82 cohort (78%); there was no difference in contraceptive use between SES groups at any time. Condom use alone increased over time (p<.01), and the use of oral contraception and a condom together had increased in the 72 and 82 cohorts compared to the 62 cohort (p<.01). Reasons given for using and discontinuing oral contraceptives in three generations of teenagers were studied over 20 years. In addition to contraception, oral contraception was used to reduce dysmenorrhea and heavy bleeding. Discontinuation due to bleeding disturbances decreased (p<.01) over time, whereas discontinuation due to mental side effects increased (p<.01). The percentage of women who had been pregnant at < or =19 years of age in the 82 cohort (7%) was lower (p<.01) than in the 1962 (11%) and 1972 (13%) cohorts. However, there was a successive increase (p<.001) in the percentage of women who had been pregnant more than once at < or =19 years of age (1962/1972/1982: pregnant more than once, 8%/21%/31%). Smoking decreased over time (p<.01) and was no longer related to SES in the 82 cohort. BMI increased (p<.01) over time. There was no difference in BMI between SES groups in the 62 and 72 cohorts but was higher in the low-SES group in the 82 cohort compared to the middle (p<.01) and high (p<.05) SES groups. CONCLUSIONS: Contraceptive use was higher in the 82 cohort where there was a corresponding reduction in the percentage of women who had been pregnant at < or =19 years of age compared with the 62 and 72 cohorts. Discontinuation of oral contraception due to mental side effects increased over time. The prevalence of smoking decreased and BMI increased, and there were changes in smoking prevalence and BMI in the different SES groups over time. Language: English Keywords: SWEDEN | RESEARCH REPORT | COHORT ANALYSIS | ADOLESCENTS, FEMALE | URBAN POPULATION | CONTRACEPTIVE USAGE | CONTRACEPTION TERMINATION | PREGNANCY OUTCOMES | TOBACCO USE | BODY WEIGHT | OBESITY | SOCIOECONOMIC STATUS | Developed Countries | Europe, Northern | Europe | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Pregnancy | Reproduction | Behavior | Physiology | Biology | Socioeconomic Factors | Economic Factors Document Number: 342305 |
| 8. Title: Oral contraception, body mass index, and asthma: A cross-sectional Nordic-Baltic population survey. Author: Macsali F; Gomez Real F; Reidar Omenaas E; Bjorge L; Janson C; Franklin K; Svanes C Source: Journal of Allergy and Clinical Immunology. 2009 Jan 2;123:391-7. Abstract: BACKGROUND: Emerging evidence suggests that sex steroid hormones may influence airways obstruction, and that metabolic status may modify potential effects. OBJECTIVE: This study investigated the association between use of oral contraceptive pills (OCPs) and asthma in a Nordic-Baltic population-based study, while taking into account possible interplay with body mass index (BMI). METHODS: Postal questionnaires were sent to subjects in Denmark, Estonia, Iceland, Norway, and Sweden from 1999 to 2001 (response rate in women, 77%). Pregnant women, women using hormone replacement therapy, and women >45 years were excluded. Analyses included 5791 women 25 to 44 years old, of whom 961 (17%) used OCP. Logistic regression analyses included adjustment for smoking, irregular menstruation, BMI, age, type of dwelling, and center. RESULTS: Oral contraceptive pills were associated with increased risk for asthma (odds ratio, 1.42; 95% CI, 1.09-1.86), asthma with hay fever (1.48; 1.08-2.03), wheeze with shortness ofbreath (1.27; 1.02-1.60), hay fever (1.25; 1.06-1.48), and >/=3 asthma symptoms (1.29; 1.05-1.58). The findings were consistent between centers. The associations were present only among normal weight women (BMI 20-25 kg/m(2), asthma: 1.45; 1.02-2.05) and overweight women (BMI >25kg/m(2): 1.91; 1.20-3.02), but not among lean women (BMI <20 kg/m(2): 0.41; 0.12-1.40). Interaction between BMI and OCP in association with asthma was significant (P(interaction) < .05). CONCLUSIONS: Women using oral contraceptive pills had more asthma. This was found only in normal weight and overweight women, indicating interplay between sex hormones and metabolic status in effect on the airways. The findings originate from a cross-sectional postal survey and should be interpreted with caution; it is recommended that asthma symptoms are included in clinical trials of oral contraception. Language: English Keywords: SWEDEN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | WOMEN | BODY WEIGHT | ASTHMA | ORAL CONTRACEPTIVES | ORAL CONTRACEPTIVES, COMBINED | Europe, Northern | Europe | Developed Countries | Research Methodology | Demographic Factors | Population | Physiology | Biology | Pulmonary Effects | Contraceptive Methods | Contraception | Family Planning Document Number: 329675 |
| 9. Peer Reviewed Title: Effect of levonorgestrel and mifepristone on endometrial receptivity markers in a three-dimensional human endometrial cell culture model. Author: Meng CX; Andersson KL; Bentin-Ley U; Gemzell-Danielsson K; Lalitkumar PG Source: Fertility and Sterility. 2009 Jan;91(1):256-64. Abstract: OBJECTIVE: To investigate the effect of levonorgestrel and mifepristone on the expression of endometrial receptivity markers in a three-dimensional endometrial construct. DESIGN: In vitro study. SETTING: University hospital and research laboratory. PATIENT(S): Twelve fertile donors. INTERVENTION(S): Timed endometrial biopsy. MAIN OUTCOME MEASURE(S): Examine the effect of levonorgestrel along with another well-studied fertility-regulating drug, mifepristone, on the expression of endometrial receptivity factors in a three-dimensional stromal and epithelial cell coculture model by immunohistochemistry. RESULT(S): Both epithelial and stromal cells of in vitro endometrial construct showed the presence of estrogen receptor-alpha, estrogen receptor-beta, progesterone receptors-(A+B), vascular endothelial growth factor, leukemia inhibitory factor, interleukin-1 beta, and cyclooxygenase-2, whereas the expression of progesterone receptor-B (AR), integrin alpha(V)beta(3,) and MUC1 were confined to epithelialcells. Mifepristone up-regulated expression of epithelial estrogen receptor-beta and progesterone receptor-B and down-regulated stromal vascular endothelial growth factor and surface molecules MUC1 and integrin alpha(V)beta(3) as observed in vivo. Levonorgestrel had no effect on the expression of endometrial receptivity markers studied. CONCLUSION(S): This in vitro model expresses progesterone-regulated endometrial receptivity factors seen in the physiologic condition. Treatment with levonorgestrel did not affect the expression of these endometrial receptivity markers in contrast to mifepristone. This in vitro model holds the potential to study endometrial receptivity, the embryo-endometrial interaction, and develop new agents for fertility control. Language: English Keywords: SWEDEN | RESEARCH REPORT | IN VITRO | LABORATORY EXAMINATIONS AND DIAGNOSES | LEVONORGESTREL | RU-486 | DECIDUAL CELL REACTION | FERTILITY | Europe, Northern | Europe | Developed Countries | Clinical Research | Research Methodology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Cytologic Effects | Population Dynamics | Demographic Factors | Population Document Number: 329592 |
| 10. Peer Reviewed Title: Expressions of steroid receptors and Ki67 in first-trimester decidua and chorionic villi exposed to levonorgestrel used for emergency contraception. Author: Meng CX; Cheng LN; Lalitkumar PG; Zhang L; Zhang HJ; Gemzell-Danielsson K Source: Fertility and Sterility. 2009 Apr;91(4 Suppl):1420-3. Abstract: Levonorgestrel (1.5 mg) is commonly used for emergency contraception to prevent an unwanted pregnancy after an unprotected intercourse. We found that postovulatory administration of 1.5 mg of levonorgestrel to women with a subsequent or existing early pregnancy did not affect the immunohistochemical expressions of estrogen receptors (ER(alpha), ER(beta)), P receptors (PR(B), PR(A+B)), androgen receptor (AR), or proliferation index Ki67 in the first-trimester decidua and chorionic villi. Language: English Keywords: SWEDEN | RESEARCH REPORT | PREGNANT WOMEN | PREGNANCY, FIRST TRIMESTER | EMERGENCY CONTRACEPTION | HORMONE RECEPTORS | METABOLIC EFFECTS | Developed Countries | Europe, Northern | Europe | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Contraception | Family Planning | Membrane Proteins | Physiology | Biology Document Number: 331189 |
| 11. Title: Breast feeding, but not use of oral contraceptives, is associated with a reduced risk of rheumatoid arthritis. Author: Pikwer M; Bergstrom U; Nilsson JA; Jacobsson L; Berglund G; Turesson C Source: Annals of the Rheumatic Diseases. 2009 Apr;68(4):526-30. Abstract: OBJECTIVE: To determine whether breast feeding or the use of oral contraceptives (OCs) affects the future risk of rheumatoid arthritis (RA) in a community-based prospective cohort. METHODS: A community-based health survey (18 326 women) was linked to regional and national registers, and incident cases of RA were identified. All women with a diagnosis of RA after inclusion in the health survey (n = 136) and four female controls for every case, who were alive and free from RA when the index person was given a diagnosis of RA, were included in a case-control study. Data on lifestyle factors at baseline were derived from a self-administered questionnaire. Potential predictors were examined in logistic regression models. RESULTS: 136 women with incident RA were compared with 544 age-matched controls. A longer history of breast feeding was associated with a reduced risk of RA (OR 0.46 (95% CI 0.24 to 0.91) for women who had breast fed for >/=13 months and OR 0.74 (95% CI 0.45 to 1.20) for those who had breast fed for 1-12 months, compared with those who had never breast fed). The protective effect of longer breast feeding remained significant after adjustment for smoking and level of education in multivariate models, and point estimates were protective also when the analyses were restricted to parous women. Neither parity nor OC use had any significant effect on the risk of RA. CONCLUSION: In this study, long-term breast feeding, but not OC use, was associated with a significant reduction in the risk of RA. Language: English Keywords: SWEDEN | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PROSPECTIVE STUDIES | COHORT ANALYSIS | STATISTICAL REGRESSION | CASE CONTROL STUDIES | WOMEN IN DEVELOPMENT | PREVALENCE | BREASTFEEDING | ORAL CONTRACEPTIVES | RHEUMATOID FACTOR | SKELETAL EFFECTS | TIME FACTORS | Developed Countries | Europe, Northern | Europe | Research Methodology | Studies | Data Analysis | Economic Development | Economic Factors | Measurement | Infant Nutrition | Nutrition | Health | Contraceptive Methods | Contraception | Family Planning | Autoantibodies | Antibodies | Immunologic Factors | Immunity | Immune System | Physiology | Biology | Population Dynamics | Demographic Factors | Population Document Number: 331290 |
| 12. Peer Reviewed Title: Prevalence of psychiatric disorders and premenstrual dysphoric symptoms in patients with experience of adverse mood during treatment with combined oral contraceptives. Author: Segebladh B; Borgstrom A; Odlind V; Bixo M; Sundstrom-Poromaa I Source: Contraception. 2009 Jan;79(1):50-5. Abstract: BACKGROUND: Negative mood symptoms remain one of the major reasons for discontinuation of combined oral contraceptive pills (COCs). The primary aim of this study was to compare the prevalence of mood and anxiety disorders in women with different experience of COCs. STUDY DESIGN: Thirty women currently on COCs with no report of adverse mood symptoms, 28 women currently on COCs and experiencing mood-related side effects, 33 women who had discontinued COC use due to adverse mood effects and 27 women who had discontinued COC use for reasons other than adverse mood symptoms were included. Ongoing psychiatric disorders were evaluated by a structured psychiatric interview and prevalence rates of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) were assessed by daily prospective ratings on the Cyclicity Diagnoser scale. RESULTS: Women with ongoing or past experience of COC-induced adverse mood, more often suffered from mood disorders than women with no reports of adverse mood while onCOC. The prevalence of prospectively defined PMS or PMDD did not differ between prior users with positive or negative experience. Women who had discontinued COC use due to adverse mood symptoms more often had had a legal abortion in the past. CONCLUSION: Women with ongoing or past self-reported adverse mood effects from COCs had a significantly increased prevalence of mood disorders. Language: English Keywords: SWEDEN | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | COMPARATIVE STUDIES | KAP SURVEYS | EVALUATION INDEXES | WOMEN | PREVALENCE | PREMENSTRUAL TENSION | MENTAL DISORDERS | ORAL CONTRACEPTIVES, COMBINED | SIDE EFFECTS | HEALTH STATUS INDEXES | ANXIETY DISORDERS | Developed Countries | Europe, Northern | Europe | Research Methodology | Studies | Surveys | Sampling Studies | Quantitative Evaluation | Evaluation | Demographic Factors | Population | Measurement | Menstruation Disorders | Diseases | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Psychological Factors | Behavior Document Number: 330536 |
| 13. Title: Neuroendocrine response to violence during pregnancy--impact on duration of pregnancy and fetal growth. Author: Valladares E; Pena R; Ellsberg M; Persson LA; Hogberg U Source: Acta Obstetricia et Gynecologica Scandinavica. 2009;88(7):818-23. Abstract: OBJECTIVE: To study the neuroendocrine release of cortisol in response to perceived stress among pregnant women exposed to partner violence and how this affects the duration of pregnancy and the intrauterine growth of the infant. DESIGN: Cross-sectional community-based study. SETTING: Health and Demographic Surveillance System of Leon, Nicaragua. POPULATION: One-hundred and forty-seven pregnant women. METHODS: Standardized scales to measure intimate partner violence, social resources, perceived stress, and socio-economic conditions were applied. Two salivary samples for cortisol were collected in the morning and afternoon on the same day. Linear regression and path analysis were used. MAIN OUTCOME MEASURES: Cortisol levels, gestational age, and weight at delivery. RESULTS: Partner violence during the pregnancy, low social resources, and perceived maternal stress were associated with high level of salivary cortisol. Pregnant women with high cortisol levels were significantly more likely to give birth to small-for-gestational age babies, but not to deliver preterm. A substantial decrease of birthweight, 121-186 g, was associated with an increase in cortisol in association with violence exposure. CONCLUSION: Partner violence during pregnancy is a stressor that provokes high levels of cortisol, which is associated with reduction of birthweight. Language: English Keywords: SWEDEN | RESEARCH REPORT | PREGNANT WOMEN | PREGNANCY | BIRTH WEIGHT | DOMESTIC VIOLENCE | IMPACT | STRESS | ADRENAL CORTEX HORMONES | LOW BIRTH WEIGHT | Developed Countries | Europe, Northern | Europe | Population Characteristics | Demographic Factors | Population | Reproduction | Body Weight | Physiology | Biology | Crime | Social Problems | Sociocultural Factors | Communication | Psychological Factors | Behavior | Hormones | Endocrine System Document Number: 342237 |
| 14. Title: Reproductive history, oral contraceptive use, and the risk of ischemic and hemorrhagic stoke in a cohort study of middle-aged Swedish women. Author: Yang L; Kuper H; Sandin S; Margolis KL; Chen Z; Adami HO; Weiderpass E Source: Stroke; A Journal of Cerebral Circulation. 2009 Apr;40(4):1050-8. Abstract: BACKGROUND AND PURPOSE: Controversy persists as to whether oral contraceptive (OC) use and reproductive history play a role in the etiology of stroke, particularly ischemic stroke. Our aim was to investigate this question in a cohort of middle-aged Swedish women. METHODS: The Women's Lifestyle and Health Cohort Study included 49259 Swedish women, aged 30 to 49 years at baseline (1991 to 1992). Participants completed an extensive questionnaire and were traced through linkages to national registries until the end of 2004. RESULTS: Among the 45699 women included in these analyses, there were 285 cases of incident stroke during follow-up (193 ischemic stroke, 72 hemorrhagic stroke, and 20 of unknown origin). Neither ischemic nor hemorrhagic stroke risk was related to OC use, duration, or type of OC use, even among women who were smokers or hypertensive. Though not statistically significant, risk of hemorrhagic stroke was elevated in women who started using OCs after the age of 30 (Hazard Ratio [HR] 2.3, 95% CI=0.8 to 6.8) and women recommended by a doctor to stop using OC for medical reasons (2.1, 0.9 to 5.0) compared with never users. Compared with nulliparous women, parous women had a statistically significant lower risk of hemorrhagic stroke (0.5, 0.2 to 0.8), but similar association was not found for ischemic stroke (0.9, 0.5 to 1.4). CONCLUSIONS: There was no significant association of OC use with ischemic or hemorrhagic stroke, and the parity was associated with reduced risk of hemorrhagic stroke but not with ischemic stroke. Language: English Keywords: SWEDEN | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | COHORT ANALYSIS | FOLLOW-UP STUDIES | WOMEN | MIDDLE AGED ADULTS | PREVALENCE | ORAL CONTRACEPTIVES, SIDE EFFECTS | CEREBROVASCULAR EFFECTS | ORAL CONTRACEPTIVES, CONTRAINDICATIONS | PARITY | RISK FACTORS | Developed Countries | Europe, Northern | Europe | Research Methodology | Studies | Demographic Factors | Population | Adults | Age Factors | Population Characteristics | Measurement | Contraceptive Safety | Safety | Public Health | Health | Physiology | Biology | Fertility Measurements | Fertility | Population Dynamics Document Number: 331084 |
| 15. Title: Birth spacing and maternal risk of invasive epithelial ovarian cancer in a Swedish nationwide cohort. Author: Baik I; Lambe M; Liu Q; Chie L; Cnattingius S; Mucci LA; Riman T; Ekbom A; Adami HO; Hsieh CC Source: Cancer Causes and Control. 2008 Dec;19(10):1131-7. Abstract: OBJECTIVE: Pregnancies reduce the risk of ovarian cancer, and among multiparous women, levels of circulating progesterone might be higher during pregnancies with wider birth spacing. We hypothesized that childbirth with wider birth spacing might reduce maternal risk of invasive epithelial ovarian cancer more than births with narrower spacing. METHODS: We conducted a case-control study nested in a nationwide cohort of Swedish women from 1961 to 2001. We selected five individually age-matched controls for each case of invasive epithelial ovarian cancer, and analysis for the effect of birth spacing was performed for 5,341 cases and 29,047 controls. We applied unconditional logistic regression analyses adjusting for age, ages at childbirth, educational level, area of residence, and gender of offspring. RESULTS: Relative risk of invasive epithelial ovarian cancer associated with each one-year increase in average birth spacing is 1.00 (95% CI = 0.98-1.01) among all women and 0.99 (0.98-1.01) among those born before 1935 and less likely to have used oral contraceptives. Further analyses on the biparous and triparous women did not find a consistent association between birth spacing and the risk of ovarian cancer. CONCLUSIONS: Birth spacing is unlikely to be a major determinant underlying the protective effects of childbirth on ovarian cancer risk. Language: English Keywords: SWEDEN | RESEARCH REPORT | CASE STUDIES | BIRTH SPACING | PROGESTERONE | OVARIAN CANCER | RISK FACTORS | Europe, Northern | Europe | Developed Countries | Studies | Research Methodology | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Cancer | Neoplasms | Diseases Document Number: 330103 |
| 16. Title: Adverse mood effects of combined oral contraceptives in relation to personality traits. Author: Borgstrom A; Odlind V; Ekselius L; Sundstrom-Poromaa I Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2008 Dec;141(2):127-30. Abstract: OBJECTIVE: Mood symptoms, such as depressed mood, anxiety and increased irritability, remain one of the major reasons for discontinuation of combined oral contraceptive (COC) pills. The aim of this study was to compare personality traits in women with ongoing or previous use of COCs and different experiences from these compounds with respect to adverse mood symptoms. STUDY DESIGN: Thirty women currently on COCs with no reports of adverse mood symptoms, 28 women currently on COCs and experiencing mood-related side effects, 27 women who had discontinued COC use for reasons other than adverse mood symptoms and 33 women who had discontinued COC use due to adverse mood effects were included. All participants were asked to fill out the Swedish universities Scales of Personality (SSP) to assess different personality traits. RESULTS: The women who were experiencing mood-related side effects on their current COC use exhibited higher scores on the somatic anxiety and stress susceptibility traits as comparedto the women who did not experience any mood-related side effects from their current COCs. Women who had discontinued COC treatment because of adverse mood effects had higher scores of detachment and mistrust compared to women who had discontinued COC for reasons unrelated to mood effects. CONCLUSION: Higher scores on specific personality traits such as somatic anxiety and stress susceptibility are found in women with ongoing experience of adverse mood symptoms from COC. Higher scores of mistrust and detachment are more common among women who have discontinued COC treatment due to adverse mood effects. Language: English Keywords: SWEDEN | RESEARCH REPORT | RISK ASSESSMENT | WOMEN | PERSONALITY | ESTROGENS | DEPRESSION | ORAL CONTRACEPTIVES, COMBINED | STRESS | Developed Countries | Europe, Northern | Europe | Evaluation | Demographic Factors | Population | Psychological Factors | Behavior | Hormones | Endocrine System | Physiology | Biology | Mental Disorders | Diseases | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning Document Number: 330844 |
| 17. Peer Reviewed Title: An historical overview of second trimester abortion methods. Author: Bygdeman M; Gemzell-Danielsson K Source: Reproductive Health Matters. 2008 May;16(31 Suppl):196-204. Abstract: The methods used for abortion in the second trimester have changed considerably in recent years. The surgical procedure dilatation and evacuation (D&E) has replaced hysterotomy. Instead of injecting different compounds, such as hypertonic saline, prostaglandin analogues are administered by non-invasive routes. The most effective medical method is combining a prostaglandin analogue with mifepristone. The consequence of these developments is that abortion in the second trimester can be be performed significantly more effectively and that the currently recommended methods being used are associated with fewer side effects and complications. Language: English Keywords: SWEDEN | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | HYSTEROTOMY | ABORTION | PREGNANCY, SECOND TRIMESTER | PROSTAGLANDINS | CHANGES | Europe, Northern | Europe | Developed Countries | Demographic Factors | Population | Gynecologic Surgery | Urogenital Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Endocrine System | Physiology | Biology | Social Change | Sociocultural Factors Document Number: 330090 Notification |
| 18. Peer Reviewed Title: Nicotine in breast milk influences heart rate variability in the infant. Author: Dahlstrom A; Ebersjo C; Lundell B Source: Acta Paediatrica. 2008;:[5] p. Abstract: The aim was to study the effects of postnatal exposure to nicotine on the regulation of heart rate and blood pressure in infants. Thirty-eight mother-infant pairs were studied. Twenty nonsmoking and 18 smoking (2-20 cigarettes per day) mothers were included. All infants were healthy, exclusively breastfed and their postnatal age was 6 weeks. During a home visit infant's urine and mothers' milk were sampled and concentrations of nicotine and cotinine were analyzed. Infants' electrocardiogram (ECG) were recorded, sleep state documented and blood pressure during sleep was measured. Heart rate variability (HRV) was calculated with spectral analysis of R-R intervals. The smoking mothers exposed their infants to nicotine in milk with a median nicotine concentration of 47 (8-192) microg/L. Analysis of infants' urine showed that the nonsmoking group had 0.8 (0-5.2) and the smoke group 60 (17-139) microg cotinine/L (p less than 0.01). The frequency domain low-to-high frequency (LF/HF) ratio, was correlatedto milk nicotine concentrations in the milk sample, from smoking mothers. HRV decreased, with increasing milk nicotine, ingested by the boys (r = -0.74, p = 0.02) but not the girls (r = -0.13, p = 0.76). The differences of mean arterial pressure between sleep states in the infants, were significantly lower in the smoke group 5.8(6.8) compared to the nonsmoke group 11.5(7.2) mmHg (p = 0.03). Postnatal exposure to nicotine influences autonomic cardiovascular control in infants. (author's) Language: English Keywords: SWEDEN | RESEARCH REPORT | INFANT | MOTHERS | BREASTFEEDING, EXCLUSIVE | TOBACCO USE | EXAMINATIONS AND DIAGNOSES | BLOOD PRESSURE | MOTHER-TO-CHILD TRANSMISSION | EXPOSURE | CARDIOVASCULAR EFFECTS | Europe, Northern | Europe | Developed Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Breastfeeding | Infant Nutrition | Nutrition | Health | Behavior | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Hemic System | Physiology | Biology | Transmission | Infections | Diseases | Risk Factors Document Number: 327168 |
| 19. Peer Reviewed Title: Women with non-Swedish speaking background and their children: a longitudinal study of uptake of care and maternal and child health. Author: Fabian H; Radestad I; Rodriguez A; Waldenstrom U Source: Acta Paediatrica. 2008 Dec;97(12):1721-8. Abstract: AIM: To study uptake of care at the antenatal and child health clinic (CHC), and maternal and child health up to 5 years after the birth, as reported by mothers with a non-Swedish speaking background (NSB). METHODS: A sample of 300 women with a NSB, 175 originated from a poor country and 125 originated from a rich country, were compared with a reference group of 2761 women with a Swedish speaking background. Four postal questionnaires were completed: during pregnancy, and 2 months, 1 year and 5 years after the birth. RESULTS: Mothers with a NSB from a poor country of origin did not differ from the reference group of mothers with a Swedish speaking background regarding number of clinic visits, but they had a lower attendance rate at antenatal and postnatal education classes. Depressive symptoms, parental stress and poor self-rated health were more common in these women, and they reported more psychological and behavioral problems in their 5-year olds. Women with a rich country origin did not differ from the reference group regarding maternal and child health, but had a lower uptake of all out-patient care, except parental classes after the birth. CONCLUSION: Women originating from a poor country seem to be under great stress during pregnancy and the child's first years. Language: English Keywords: SWEDEN | RESEARCH REPORT | LONGITUDINAL STUDIES | CROSS-CULTURAL COMPARISONS | KAP SURVEYS | WOMEN | CHILDREN | IMMIGRANTS | MATERNAL-CHILD HEALTH SERVICES | UTILIZATION OF HEALTH CARE | ANTENATAL CARE | LANGUAGE | ORIGIN | DEPRESSION | STRESS | Europe, Northern | Europe | Developed Countries | Studies | Research Methodology | Comparative Studies | Surveys | Sampling Studies | Demographic Factors | Population | Youth | Age Factors | Population Characteristics | Migrants | Migration | Population Dynamics | Primary Health Care | Health Services | Delivery of Health Care | Health | Maternal Health Services | Communication | Mental Disorders | Diseases | Psychological Factors | Behavior Document Number: 330293 |
| 20. Title: Effects of pre- and postmenopausal use of exogenous hormones on receptor content in normal human breast tissue: a randomized study. Author: Hallberg G; Persson I; Naessen T; Magnusson C Source: Gynecological Endocrinology. 2008 Aug;24(8):475-80. Abstract: OBJECTIVE: To examine the effects of exposure to endogenous and exogenous hormones on estrogen receptor-alpha (ERalpha) and progesterone receptor (PR) levels in normal human breast tissue. METHODS: In a randomized study of women scheduled for mammary reduction plasty (n = 81), ERalpha and PR content in breast parenchyma was analyzed in premenopausal (n = 49) and postmenopausal (n = 16) women. Premenopausal women were randomized to surgery in the follicular or luteal phase of the menstrual cycle or after oral contraceptive treatment for 2 months. Postmenopausal women were randomized to sequential or estrogen-only therapy for 2 months prior to surgery. RESULTS: ERalpha content was higher in parous than in nulliparous (p = 0.009) premenopausal women and displayed a positive association with age (r(s) = 0.51, p = 0.0002). Compared with premenopausal women in the follicular phase, postmenopausal women had higher ERalpha content (p = 0.040) whereas premenopausal women on oral contraception had lower ERalpha (p = 0.048) and PR (p = 0.007) content. Smokers had lower PR content than non-smokers (p = 0.02). CONCLUSION: In the present study ERalpha content was higher in parous than in non-parous women and associated with premenopausal age. Short-term oral contraceptives yielded lower ERalpha and PR contents. Postmenopausal estrogen/progestogen combined therapy yielded lower PR content than estrogen-only therapy. Language: English Keywords: SWEDEN | RESEARCH REPORT | WOMEN | MENOPAUSE | SURGERY | BREAST EXAM | ORAL CONTRACEPTIVES | PROGESTERONE | ESTROGENS | EXPOSURE | CANCER | Europe, Northern | Europe | Developed Countries | Demographic Factors | Population | Reproduction | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physical Examinations and Diagnoses | Examinations and Diagnoses | Contraceptive Methods | Contraception | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Risk Factors | Neoplasms | Diseases Document Number: 329582 |
| 21. Peer Reviewed Title: Nitric oxide production in the exhaled air of patients with pulmonary tuberculosis in relation to HIV co-infection. Author: Idh J; Westman A; Elias D; Moges F; Getachew A; Gelaw A; Sundqvist T; Forslund T; Alemu A; Ayele B; Diro E; Melese E; Wondmikun Y; Britton S; Stendahl O; Schon T Source: BMC Infectious Diseases. 2008;8:146. Abstract: BACKGROUND: Nitric oxide (NO) is essential for host defense in rodents, but the role of NO during tuberculosis (TB) in man remains controversial. However, earlier observations that arginine supplementation facilitates anti-TB treatment, supports the hypothesis that NO is important in the host defense against TB. Local production of NO measured in fractional exhaled air (FeNO) in TB patients with and without HIV co-infection has not been reported previously. Thus, our aim was to investigate levels of FeNO in relation to clinical symptoms and urinary NO metabolites (uNO). METHODS: In a cross sectional study, FeNO and uNO were measured and clinical symptoms, chest x-ray, together with serum levels of arginine, tumor necrosis factor alpha (TNF-alpha) and interleukin 12 (IL-12) were evaluated in sputum smear positive TB patients (HIV+/TB, n = 36, HIV-/TB, n = 59), their household contacts (n = 17) and blood donors (n = 46) from Gondar University Hospital, Ethiopia. RESULTS: The proportion of HIV-/TB patients with an increased FeNO level (> 25 ppb) was significantly higher as compared to HIV+/TB patients, but HIV+/TB patients had significantly higher uNO than HIV-/TB patients. HIV+ and HIV-/TB patients both had lower levels of FeNO compared to blood donors and household contacts. The highest levels of both uNO and FeNO were found in household contacts. Less advanced findings on chest x-ray, as well as higher sedimentation rate were observed in HIV+/TB patients as compared to HIV-/TB patients. However, no significant correlation was found between FeNO and uNO, chest x-ray grading, clinical symptoms, TNF-alpha, IL-12, arginine levels or sedimentation rate. CONCLUSION: In both HIV negative and HIV co infected TB patients, low levels of exhaled NO compared to blood donors and household were observed. Future studies are needed to confirm whether low levels of exhaled NO could be a risk factor in acquiring TB and the relative importance of NO in human TB. Language: English Keywords: SWEDEN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CLIENTS | LABORATORY EXAMINATIONS AND DIAGNOSES | LABORATORY ANIMALS | TUBERCULOSIS | HIV INFECTIONS | TREATMENT | DRUGS | RISK FACTORS | Europe, Northern | Europe | Developed Countries | Research Methodology | Program Activities | Programs | Organization and Administration | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Clinical Research | Infections | Diseases | Viral Diseases | Biology Document Number: 329356 |
| 22. Title: The role of bacteria in lactational mastitis and some considerations of the use of antibiotic treatment. Author: Kvist LJ; Larsson BW; Hall-Lord ML; Steen A; Schalen C Source: International Breastfeeding Journal. 2008 Apr 7;3:6. Abstract: The role of bacterial pathogens in lactational mastitis remains unclear. The objective of this study was to compare bacterial species in breast milk of women with mastitis and of healthy breast milk donors and to evaluate the use of antibiotic therapy, the symptoms of mastitis, number of health care contacts, occurrence of breast abscess, damaged nipples and recurrent symptoms in relation to bacterial counts. In this descriptive study, breast milk from 192 women with mastitis (referred to as cases) and 466 breast milk donors (referred to as controls) was examined bacteriologically and compared using analytical statistics. Statistical analyses were also carried out to test for relationships between bacteriological content and clinical symptoms as measured on scales, prescription of antibiotics, the number of care contacts, occurrence of breast abscess and recurring symptoms. Five main bacterial species were found in both cases and controls: coagulase negative staphylococci (CNS), viridans streptococci, Staphylococcus aureus (S. aureus), Group B streptococci (GBS) and Enterococcus faecalis. More women with mastitis had S. aureus and GBS in their breast milk than those without symptoms, although 31% of healthy women harboured S. aureus and 10% had GBS. There were no significant correlations between bacterial counts and the symptoms of mastitis as measured on scales. There were no differences in bacterial counts between those prescribed and not prescribed antibiotics or those with and without breast abscess. GBS in breast milk was associated with increased health care contacts (p = 0.02). Women with greater than or equal to 10/7 cfu/L CNS or viridans streptococci in their breast milk had increased odds for damaged nipples (p = 0.003). Many healthy breastfeeding women have potentially pathogenic bacteria in their breast milk. Increasing bacterial counts did not affect the clinical manifestation of mastitis; thus bacterial counts in breast milk may be of limited value in the decision to treat with antibiotics as results from bacterial culture of breast milk may be difficult to interpret. These results suggest that the division of mastitis into infective or non-infective forms may not be practically feasible. Daily follow-up to measure the subsidence of symptoms can help detect those in need of antibiotics. (author's) Language: English Keywords: SWEDEN | RESEARCH REPORT | COMPARATIVE STUDIES | STATISTICAL STUDIES | WOMEN | HUMAN MILK | BACTERIAL AND FUNGAL DISEASES | ANTIBIOTICS | SIGNS AND SYMPTOMS | TREATMENT | Europe, Northern | Europe | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Lactation | Maternal Physiology | Physiology | Biology | Infections | Diseases | Drugs | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 325925 |
| 23. Title: Female genital mutilation among antenatal care and contraceptive advice attendees in Sweden. Author: Litorp H; Franck M; Almroth L Source: Acta Obstetricia et Gynecologica Scandinavica. 2008;87(7):716-22. Abstract: OBJECTIVE: To explore knowledge of, attitudes toward and practice of female genital mutilation (FGM) among women originally from countries where FGM is customary attending antenatal care and contraceptive advice in Sweden. METHODS: Women in reproductive age living in Sweden who originate from countries where FGM is practiced coming for antenatal care or contraceptive advice at two maternity welfare centers in Stockholm were asked to participate. Interview administered questionnaires and gynecological examination were used for data collection. The data were analyzed by descriptive statistics. RESULTS: Out of 49 women asked, 40 women agreed to participate, of whom 37 had undergone FGM. Most FGM operations had been performed by doctors or midwives. Half of the Muslim women said FGM was allowed by their religion. All women reporting to have undergone 'sunna', an allegedly mild form, had extensive damage to their genitals. At gynecological examination three cases of reinfibulation were detected, of which two had been performed after delivery in Sweden. Twenty-nine women had daughters and three had let their daughters undergo FGM, all of them before settling in Sweden. Problems related to delivery and sexual intercourse were the most commonly mentioned complications of FGM. CONCLUSIONS: The reliability of the self-reported form of FGM is low, which may have implications for research, interventions and health care. Although many women express negative attitudes toward FGM and know about serious complications, the religious justifications, the practice of FGM on daughters, reinfibulation on adults and medicalization of the practice indicate attitudes that favor of the continued practice of FGM. Language: English Keywords: SWEDEN | RESEARCH REPORT | KAP SURVEYS | IMMIGRANTS | PREGNANT WOMEN | DAUGHTERS | FEMALE GENITAL CUTTING | ATTITUDES | KNOWLEDGE | ANTENATAL CARE | FAMILY PLANNING EDUCATION | CONTRACEPTIVE USAGE | ISLAM | COMPLICATIONS | INTERNATIONAL MIGRATION | Europe, Northern | Europe | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Migrants | Migration | Population Dynamics | Demographic Factors | Population | Population Characteristics | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Harmful Traditional Practices | Traditional Health Practices | Culture | Psychological Factors | Behavior | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Education | Contraception | Family Planning | Religion | Diseases Document Number: 328672 |
| 24. Title: Vascular complication after insertion of a subcutaneous contraceptive implant. Author: Mourtialon P; Tixier H; Loffroy R; Maillart JC; Calmelet P; Dellinger P; Vanwymeersch S; El Hassani R; Douvier S; Sagot P Source: Acta Obstetricia et Gynecologica Scandinavica. 2008;87(11):1256-8. Abstract: Implanon is a reliable method of contraception widely used in France and around the world. Cases of difficulties encountered in inserting or removing the implant have been described. We report the first case of an insertion accident that led to occlusion of the right brachial artery and required exploratory vascular surgery. Language: English Keywords: SWEDEN | RESEARCH REPORT | WOMEN | CONTRACEPTIVE IMPLANTS | INSERTION | SIDE EFFECTS | SAFETY | SURGERY | Europe, Northern | Europe | Developed Countries | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health Document Number: 329355 |
| 25. Title: The experience of Middle Eastern men living in Sweden of maternal and child health care and fatherhood: focus-group discussions and content analysis. Author: Ny P; Plantin L; Dejin-Karlsson E; Dykes AK Source: Midwifery. 2008 Sep;24(3):281-90. Abstract: OBJECTIVE: To describe how men from the Middle East experience Swedish maternity and child health care. An integral part of the aim of this study has also been to describe the experiences of men from the Middle East when becoming and being a father in Sweden. DESIGN, SETTING AND PARTICIPANTS: an exploratory, qualitative study using focus-group discussions and individual interviews, with a semi-structured interview guide and content analysis. A total of 16 men participated. Ten Arabic-speaking men from the Middle East living in Sweden participated in three focus-group discussions. Six men from the Middle East living in Sweden, and speaking Swedish, participated in individual interviews. FINDINGS: three main categories were developed: meeting empathic professionals; finding new positions within the family; and experiencing social demands. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: seeing their partners being met individually and with empathy by midwives and child health-care nurses encouraged men to become involved in areas not previously open to them (i.e. pregnancy, childbirth and the care of babies and young children). As the women often lacked knowledge of Swedish, they depended on the help of their partners when meeting maternity and child health-care professionals. The men found the experience of living in an alien country difficult. They were often unemployed, felt they were a burden to their wives after emigrating to Sweden, and that they were no longer a suitable role model for their children. Language: English Keywords: SWEDEN | MIDDLE EAST | RESEARCH REPORT | QUALITATIVE RESEARCH | FOCUS GROUPS | FATHERS | EMIGRANTS | MIGRATION | MATERNAL HEALTH | CHILD HEALTH SERVICES | Europe, Northern | Europe | Developed Countries | Research Methodology | Data Collection | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Migrants | Population Dynamics | Demographic Factors | Population | Health | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care Document Number: 328864 |
26.  Peer Reviewed Title: Sweden: Combining childbearing and gender equality. Author: Olah LS; Bernhardt EM Source: Demographic Research. 2008 Jul 1;19(28):1105-1144. Abstract: Sweden is the forerunner of the Second Demographic Transition. Fertility trends have fluctuated greatly since the 1960s, and the 1990s showed both European-highest and lowest-ever-in-Sweden levels, while the cohort pattern has been relatively stable. Period fluctuations have been accompanied by a postponement of entering committed partnerships and parenthood as well as an increasing instability of family relationships. The awareness and the availability of effective contraceptives have been extensive since the mid-1970s, the year the liberal abortion law was introduced. Post-modern values are dominant in this highly secularized society, but ideal family size is among the highest in the European Union, and childlessness has remained at a relatively low level. Ethnic diversification has increased over time, with about one-fifth of the population having a 'foreign background' in the early 2000s. The level of female labor-force participation is the highest in Europe (although mothers of preschoolers often work part-time), and young women are just as highly educated as men. Family policies, based on the principle of equality across social groups and gender, seem to play an important role in keeping fertility relatively high. In combination with other factors, family policies also play a role in the fluctuations of fertility rates, as eligibility to parental-leave and benefits as well as the availability of public childcare are linked to parents' labor-force attachment. (author's) Language: English Keywords: SWEDEN | RESEARCH REPORT | HISTORICAL REVIEW | FERTILITY CHANGES | FERTILITY DETERMINANTS | DEMOGRAPHIC TRANSITION | CONTRACEPTIVE AVAILABILITY | FAMILY SIZE, IDEAL | FAMILY POLICY | ABORTION | SOCIAL CHANGE | Europe, Northern | Europe | Developed Countries | Fertility | Population Dynamics | Demographic Factors | Population | Contraception | Family Planning | Family Size | Family Characteristics | Family and Household | Sociocultural Factors | Social Policy | Policy | Political Factors | Fertility Control, Postconception Document Number: 327674 Notification |
| 27. Peer Reviewed Title: Are donor allocations for humanitarian health assistance based on needs assessment data? Author: Schreeb JV; Unge C; Brittain-Long R; Rosling H Source: Global Public Health. 2008 Oct;3(4):440-447. Abstract: Donors have agreed to fund humanitarian assistance according to needs. We studied if project applications to a major donor, and the subsequent funding decisions for humanitarian health projects contained needs assessment data. In 2003, a total of 258 million SEK (37 million USD) was allocated by Swedish International Development Cooperation Agency (Sida) to 38 humanitarian health projects. Only 14 applications (37%) had data on the size of the target population while reference to any quantified health needs was found in less than 30% of the funding decisions. In contrast to stated policy, interviews with staff at Sida revealed that needs assessment data had a limited role in the funding decisions, whereas the implementing capacity of the applying agency was of great importance. Our findings suggest that needs assessment data has a very limited role in the decision to fund while other, not clearly defined factors are more important. Language: English Keywords: SWEDEN | RESEARCH REPORT | TARGET POPULATION | HUMANITARIAN ASSISTANCE | FUNDS | DECISION MAKING | RESOURCE ALLOCATION | HEALTH | NEEDS ASSESSMENT | Developed Countries | Europe, Northern | Europe | Program Design | Programs | Organization and Administration | Financial Activities | Economic Factors | Behavior | Evaluation Document Number: 340229 |
| 28. Peer Reviewed Title: Interpregnancy weight gain and the male-to-female sex ratio of the second pregnancy: A population-based cohort study. Author: Villamor E; Sparen P; Cnattingius S Source: Fertility and Sterility. 2008 May;89(5):1240-1244. Abstract: The objectives were to investigate whether interpregnancy maternal weight change (difference between body mass index [BMI] at the first antenatal visit of the second pregnancy and BMI at the first antenatal visit of the first pregnancy) or changes in smoking status between pregnancies is related to the sex ratio of the second pregnancy. The design was a population-based cohort study. The setting was a Swedish Birth Registry. The participant(s) were a total of 220,889 women who had their first two consecutive singleton births between 1992 and 2004. Both live births and stillbirths were included. The intervention(s) were the analyses of data collected prospectively in nationwide registries. The main outcome measure(s) were male-to-female sex ratio of the second pregnancy. The sex ratio of the second pregnancy increased linearly with the amount of maternal weight change from the first to the second pregnancies, from 1.024 in women who lost more than 1 unit BMI to 1.080 in women who gained 3 or more units. This association was independent of obstetric complications, length of the interpregnancy interval, and maternal sociodemographic characteristics at the second pregnancy. Change in maternal smoking status from the first to the second pregnancies was not significantly related to the sex ratio of the second pregnancy. There could be a causal relation between prepregnant maternal weight gain and the sex ratio of the offspring. (author's) Language: English Keywords: DEVELOPED COUNTRIES | SWEDEN | RESEARCH REPORT | COHORT ANALYSIS | PREGNANT WOMEN | SEX RATIO | BODY WEIGHT | OBESITY | PARITY SPECIFIC BIRTH RATE | MATERNAL NUTRITION | PREGNANCY OUTCOMES | Europe, Northern | Europe | Research Methodology | Population Characteristics | Demographic Factors | Population | Sex Distribution | Sex Factors | Physiology | Biology | Fertility Rate | Birth Rate | Fertility Measurements | Fertility | Population Dynamics | Nutrition | Health | Pregnancy | Reproduction Document Number: 327228 |
| 29. Title: Prospective follow-up of menstrual disorders in adolescence and prognostic factors. Author: Wiksten-Almstromer M; Hirschberg AL; Hagenfeldt K Source: Acta Obstetricia et Gynecologica Scandinavica. 2008;87(11):1162-8. Abstract: OBJECTIVE: Clinical follow-up of menstrual status and eating behavior in grown-up women diagnosed with menstrual disturbance in adolescence. DESIGN: Prospective follow-up study six years after the initial study. SETTING: A youth clinic that is part of the school health system in Stockholm. POPULATION: Eighty-seven women diagnosed with secondary amenorrhea or oligomenorrhea in adolescence. METHODS: Subjects underwent gynecological examination, evaluation of eating behavior and endocrine status. MAIN OUTCOME MEASURES: Menstrual status and eating behavior changes. RESULTS: Menstrual disturbances were still present in 62% of the subjects not using hormonal contraception, 59% of which fulfilled the criteria for polycystic ovary syndrome (PCOS). The frequency of persistent menstrual disturbance was significantly more common in women with previous oligomenorrhea than secondary amenorrhea. The occurrence of eating disorders was decreased by half to 31% in women diagnosed with secondary amenorrhea at the initial study, whereas it was unchanged (40%) in women with previous oligomenorrhea. Recovery from anorectic behavior, primarily in the group of secondary amenorrhea, significantly predicted resumption with menses. CONCLUSION: Menstrual disturbances and eating disorders were still frequent after six years in a follow-up of women who had menstrual disturbance in adolescence. PCOS was the main cause explaining persistent menstrual disorder, whereas recovery of anorectic eating disorders predicted resumption of menses. The findings call for a continued follow-up of women diagnosed with menstrual disturbance in their teens. Language: English Keywords: SWEDEN | RESEARCH REPORT | FOLLOW-UP STUDIES | ADOLESCENTS, FEMALE | MENSTRUATION | MENSTRUATION DISORDERS | DIET | BODY WEIGHT | Europe, Northern | Europe | Developed Countries | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproduction | Diseases | Nutrition | Health | Physiology | Biology Document Number: 329343 |
| 30. Title: Family structure and child outcomes in the USA and Sweden. Author: Bjorklund A; Ginther DK; Sundstrom M Source: Journal of Population Economics. 2007 Feb;20(1):183-201. Abstract: Previous research shows that living in a non-intact family is associated with educational disadvantages. This paper compares the relationships between childhood family structure, schooling, and earnings in Sweden and the USA. This comparison is interesting because both family structure and public policies differ significantly. We find a negative relationship between living in a non-intact family and child outcomes, and the estimates are remarkably similar in both countries. After using sibling-difference models, the correlation with family structure is no longer significant. These results cast doubt on the causal interpretation of the negative relationship between non-intact family structures and child outcomes. (author's) Language: English Keywords: SWEDEN | UNITED STATES OF AMERICA | RESEARCH REPORT | FAMILY LIFE | CHILD | EDUCATIONAL STATUS | MARRIAGE PATTERNS | Europe, Northern | Europe | Developed Countries | North America | Americas | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Marriage | Nuptiality Document Number: 315907 |
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