Background: Patient involvement in the interdisciplinary bedside round (IBR) increases care quality and safety but is influenced and perceived differently by different round participants. Nursing and medical students are still not structurally embedded in the healthcare system, and they participate in interdisciplinary bedside rounds for educational purposes. Thus, the students may give a valuable perspective on patient involvement from the 'outside view'.

Aim: This study aimed to describe nursing and medical students' perceptions of patient involvement in IBRs.

Methods: This study has a qualitative design with individual interviews. Eighteen informants were recruited with the help of gatekeepers from two sites in Sweden: a university training health clinic and a county hospital. They participated in one-to-one semi-structured interviews, which were analysed with an inductive qualitative content analysis approach.

Ethical Issues and Approval: The study has been approved by the Swedish Ethical Review Authority. Informed consent was received from all participants.

Results: The results yielded five categories. Two sub-themes and one theme of meaning emerged as a 'red thread' across the categories. The theme of meaning was: 'In hospital rounds, the patient is a respected guest, but with a disadvantaged "alien status" due to the hosts' difficult medical language and unclear routines'. Students perceive patients are not fully involved in IBRs, and the healthcare team controls this involvement due to patients' lack of knowledge and vulnerability, the hectic hospital environment, and complicated medical language. Doctors lead IBRs and encourage or discourage patient involvement and nurses act as patient advocates, supporting their involvement.

Conclusions: According to nursing and medical students, patients are seldom involved in IBRs due to multiple interaction barriers and despite communicational facilitators. Their involvement depends on healthcare professionals. Further research should investigate other IBRs stakeholders' perspectives on patient involvement in IBRs to facilitate it.

Violence against women (VAW) is a global challenge also in the childbearing period. Despite high gender equality, there is a high prevalence of VAW in the Nordic countries. This scoping review aims to explore predictors for and consequences of a history of violence on women's pregnancy and childbirth in the Nordic countries, including women's experience of the impact of violence and the interventions used to detect, address consequences, and prevent further violence. The framework by Arksey and O'Malley was followed, and English, Finnish, Icelandic, Norwegian, Danish, and Swedish literature was included. The population was women aged ≥18 residing in the Nordic countries during the perinatal period. Eight databases were searched: MEDLINE, CINAHL, PubMed, PsycINFO, Web of Science, ASSIA, Social Services-, and Sociological abstracts. There was no limitation of the search time frame. The initial screening resulted in 1,104 records, and after removing duplicates, 452 remained. Finally, 61 papers met the inclusion criteria. The results covering the past 32 years indicated that childbearing women with a history of violence are at greater risk of common complaints and hospitalization during pregnancy, fear of childbirth, Cesarean section, breastfeeding difficulties, and physical and mental health problems. While extensive research was found on the associations between a history of and current violence and outcomes related to pregnancy, there was a lack of intervention studies and studies from Finland. Efforts must be made to scientifically test the methods used to reduce and treat the adverse effects of a history of violence and prevent further violence.

Objective: To investigate the meaning of the concept of ‘obstetric violence’ to women in Sweden, whoreported a negative birth experience.

Design: An inductive qualitative approach with individual narratives. A thematic qualitative content anal-ysis was used.

Setting: Three midwifery clinics in southwest Scania.

Participants: Twelve women who had given birth less than three years previously and reported a nega-tive/traumatic birth experience.

Findings: The key findings showed that the women had experienced psychological and physical abuse during childbirth which may be interpreted as ‘obstetric violence’. Four categories emerged from the analyses describing the women’s experiences: Lack of information and consent including poor informationand no right to participate in decisions concerning the process of labour, Insufficient pain relief, which encompassed unbearable pain without pain relief, Lack of trust and security where the women experi-enced staff with bad attitudes and jargon, and The experience of abuse including threats of violence from midwives and where the birth experience was compared to rape.

Key conclusions: The study shows that physical and psychological abuse during childbirth exists in Sweden and that women experience this as being subjected to ‘obstetric violence’ during childbirth. The phenomenon of obstetric violence is very complex. The abuse of women during childbirth might be asignificant problem and quality assurance is required to secure the rights of women giving birth.

Implications for practice: In order to secure the rights of birthing women and to promote respectful andsupportive care for new mothers, quality development programs are required

INTRODUCTION Families may benefit from increased focus on partner emotional well-being during pregnancy and the perinatal period. Our aim was to explore the risk for depression and anxiety during pregnancy and one year postpartum in relation to partners' self-reported health, sense of coherence, social support, and lifestyle factors.

METHODS This is a longitudinal cohort study using three questionnaires that were answered twice during pregnancy and at one year postpartum. Participants (n=532) were recruited between April 2012 and September 2013, and follow-up was between April 2012 and March 2015, in Sweden.

RESULTS In late pregnancy, 8.9% of the prospective partners were at high risk for depression and 8.3% one year postpartum. An increased risk for depression was found amongst those reporting 'fair or very poor' sexual satisfaction and those reporting 'fair or very poor' health during pregnancy and postpartum. High anxiety was reported by 10.8% during late pregnancy and 12.4% one year postpartum. Partners who were unemployed, had financial difficulties, and who scored low on a Sense of Coherence scale, showed significantly higher anxiety in late pregnancy and postpartum. Social support has a significant and positive impact concerning signs of depression and anxiety, both during pregnancy and postpartum.

CONCLUSIONS More than 10% of partners in this study showed depressive symptoms and anxiety, indicating a problem in need of attention by stakeholders. Strengthening social support is of greatest importance. It is time for the introduction of family-focused care aimed at prevention of depression and anxiety, and maintenance of family well- being.

OBJECTIVE: Globally, the role of nurse practitioner is evolving to meet increased healthcare demands. Nevertheless, there are factors hindering the development of this role, one of which involves differences in nurse practitioner education worldwide. Therefore, the objective of the present study is to identify what is known in the research field on the content of nurse practitioner educational programmes.

DESIGN AND DATA SOURCES: The literature scoping review follows a six-stage methodological framework including: i) formulate research questions, ii) identify relevant studies, iii) select studies, iv) chart data, v) collate, summarize and report the results, vi) consultations. Data bases searched included CINAHL, PubMed and ERIC and were followed by manual searching of reference list in the included papers. Of the 1553 papers identified, 16 met the aim of this study.

REVIEW METHODS: To answer the research questions 'what is the content of curricula in nurse practitioner education?' a deductive content analysis was used.

RESULTS: Two main categories emerged. The first was related to the professional nurse practitioner role and includes research and nursing theories, leadership and collaboration, and organizational, political, economic, regulatory and legislative issues. The second is related to becoming an autonomous practitioner and includes health promotion and disease prevention, and other medically oriented content.

CONCLUSIONS: The content identified is consistent with the core competencies that nurse practitioners are expected to have after graduation, which have been described by the International Council of Nurses and by other researchers. Given the lack of recent research in nurse practitioner education, the results of the present study advance knowledge in this research field. Additionally, this study may be of practical value in developing new nurse practitioner educational programmes.

BACKGROUND: Victimisation of women is encountered in all countries across the world, it damages the mental and physical health of women. During pregnancy and the postpartum period, women are at a greater risk of experiencing violence from an intimate partner. The aim of this study was to explore childbirth outcomes in a Swedish population of women reporting a history of violence including domestic violence during pregnancy.

METHODS: A longitudinal cohort design was used. In total, 1939 pregnant women ≥18 years were recruited to answer two questionnaires, both questionnaires were administered in the early and late stages of their pregnancy. The available dataset included birth records of 1694 mothers who gave birth between June 2012 and April 2014. Statistical analyses included descriptive statistics, T-test and bivariate logistic regression.

RESULTS: Of 1694 mothers 38.7% (n = 656) reported a history of violence and 2% (n = 34) also experienced domestic violence during pregnancy. Women who were single, living apart from their partner, unemployed, smoked and faced financial distress were at a higher risk of experiencing violence (p = 0.001). They also had significant low scores on the SOC-scale and high EDS-scores ≥13 (p = 0.001) when compared to women without a history of violence (p = 0.001). Having a history of violence increased the woman's risk of undergoing a caesarean section (OR 1.33, 95% CI 1.02-1.70). A history of emotional abuse also significantly increased the risk of having a caesarean section irrespective of whether it was a planned or an emergency caesarean section (OR 1.50, 95% CI 1.09-2.06). Infants born to a mother who reported a history of violence, were at significant risk of being born premature < 37 weeks of gestation compared to infants born by mothers with no history of violence (p = 0,049).

CONCLUSIONS: A history of violence and/or exclusively a history of emotional abuse has a negative impact on childbirth outcomes including caesarean section and premature birth. Therefore, early identification of a history of or ongoing violence is crucial to provide women with extra support which may have positive impact on her birth outcomes.

INTRODUCTION Worldwide every third women is exposed to physical and/or sexualviolence and pregnancy is no safe period for the women. The aim was to elucidatemidwives experience of violence-exposed pregnant women who had been referred to aprenatal ward and were hospitalized.METHODS An inductive qualitative method was used with four focus-group interviewsperformed with sixteen midwives working at in-hospital prenatal ward. The data wereanalyzed with content analysis.RESULTS Three categories emerged. ‘Professional area of responsibility’, the midwivesworking at in-hospital prenatal ward considered it was the responsibility of the midwivesworking at antenatal care to ask routinely in order to detect violence-exposed women.Signs of help-seeking were based on the pregnant woman’s behavior. Suspicion ofintimate-partner violence was based on gut feeling. ‘Conditions for support’, the midwivesstrived to support pregnant women who were already identified as violence-exposed orif they had a suspicion that the pregnant woman was in a relationship where intimatepartnerviolence occurred. ‘Barriers for giving support’, both the work-place layout androutines constituted a barrier. The midwives own emotional state could affect her handlingof the situation.CONCLUSIONS The midwives working in-hospital considered it the responsibility of themidwives at antenatal healthcare to identify these women. The midwives had limitedexperience in dealing with violence-exposed pregnant women but recognized a number ofsigns and symptoms that could cause suspicion. They felt uncomfortable in the situationand expressed a need for both education and an action plan.

Background

This case control study aimed to investigate whether symptoms of sexual dysfunction are more common in males from infertile couples than in the general population and to explore whether symptoms of sexual dysfunction are associated to hypogonadism.

Objectives

Participants were 165 subfertile men in infertile heterosexual relationships, 18-50 years of age, with sperm concentrations < 15 x 10(6)/mL. The controls were 199 men from a population-based group, matched for age.

Material and methods

Logistic regression was applied in order to calculate odds ratios (ORs) for seven different symptoms of sexual dysfunction. In a multivariate model, we tested independent effects of infertility and primary as well as secondary hypogonadism.

Results

Statistically significant association between subfertility and symptoms of sexual dysfunction was found for lack of ability to control ejaculation (OR 2.2, 95% CI: 1.2-4.2). For hypogonadism, statistical significance was seen both in relation to low sexual interest/desire for sex (OR 2.3, 95% CI: 1.0-5.5) and for being worried about the size or shape of the penis (OR 3.6, 95% CI: 1.3-9.5). These associations remained statistically significant in males with primary but not those with secondary hypogonadism.

Discussion

Our study showed that men from infertile couples have an increased risk of symptoms of sexual dysfunction and this risk is linked to androgen deficiency.

Conclusion

Assessment of reproductive hormone levels and sexual function should routinely be done in this group of males.

Introduction Globally, nurse practitioner (NP) has become an important nursing role in the pursuit of a more efficient healthcare, possessing the necessary expert skills to work as autonomous practitioners. Nevertheless, there are barriers in the implementation of this role. One barrier concerns the different levels of education required for NPs. Previous studies demonstrate the importance of acting for a uniform international education. The aim of the scoping review was to compile research about education to become an NP, focusing on the content of curricula and learning objectives.

Methods and analysis The six-stage methodological framework by Arksey and O’Malley will guide the scoping review through the following stages: identifying the research questions; identifying relevant studies; study selection; charting the data; collating, summarising and reporting the results; and consultation. The research questions are as follows: What is the content of curricula in NP programmes? What are the learning objectives in NP programmes? The literature searches will be conducted between March and June 2019 in the following databases: PubMed, CINAHL and ERIC, followed by hand searching reference lists of key studies. Grey literature will be searched in Google Scholar, Libsearch, existing networks and relevant organisations. Two researchers will screen titles and abstracts. Included full-text articles will be screened by three researchers and assessed for their methodological quality by the use of the Critical Appraisal Skills Programme. The PreferredReporting Items for Systematic Reviews and Meta-Analyses flow diagram will be used to demonstrate included and excluded articles. The findings will be presented through a numerical summary of the included articles, followed by a thematic analysis.

Ethics and dissemination Research ethics approval is not required for a scoping review. The scoping review will be submitted to a peer-reviewed journal. Additionally, the findings will be disseminated to stakeholders representing political, educational, professional and union organisations through a Delphi study as part of the consultation stage of the Arksey and O’Malleys framework.

Objective; The aim of this study was to investigate whether women, who reported “symptoms of depression” during pregnancy and up to 1.5 years postpartum, who reported domestic violence or not, were treated with antidepressant medication. Material and Methods; A prospective longitudinal cohort study recruited primi- and multiparous women (n=1939). The Edinburgh Postnatal Depression Scale (EPDS), the NorVold Abuse Questionnaire, and a questionnaire about medication during pregnancy were distributed and administered three times, during early, late pregnancy and during the postpartum period. Antidepressant medication was compared between women with EPDS scores < 13 and scores EPDS ≥ 13 as the optimal cut-off for lower and higher symptoms of depression. Results; EPDS scores > 13 were detected in 10.1 % of the women during the whole pregnancy, of those 6.2 % had depressive symptoms already in early pregnancy and 10.0 % during the postpartum period. Women with EPDS scores ≥ 13 and non-exposure to domestic violence were more often non-medicated (p < 0.001). None of the women with EPDS scores ≥ 13 exposed to domestic violence had received any antidepressant medication, albeit the relationship was statistically non-significant. Conclusion; Pregnant women who experienced themselves as having several depressive symptoms, social vulnerability and even a history of domestic violence, did not receive any antidepressant treatment during pregnancy nor postpartum. This study shows the importance of detecting depressive symptoms already during early pregnancy and a need for standardized screening methods.