Browsing by Subject "birth"

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  • Van Der Wel, Kjetil A.; Östergren, Olof; Lundberg, Olle; Korhonen, Kaarina; Martikainen, Pekka; Andersen, Anne-Marie Nybo; Urhoj, Stine Kjaer (2019)
    Aims: Future research on health inequality relies on data that cover life-course exposure, different birth cohorts and variation in policy contexts. Nordic register data have long been celebrated as a ?gold mine? for research, and fulfil many of these criteria. However, access to and use of such data are hampered by a number of hurdles and bottlenecks. We present and discuss the experiences of an ongoing Nordic consortium from the process of acquiring register data on socio-economic conditions and health in Denmark, Finland, Norway and Sweden. Methods: We compare experiences of data-acquisition processes from a researcher?s perspective in the four countries and discuss the comparability of register data and the modes of collaboration available to researchers, given the prevailing ethical and legal restrictions. Results: The application processes we experienced were time-consuming, and decision structures were often fragmented. We found substantial variation between the countries in terms of processing times, costs and the administrative burden of the researcher. Concerned agencies differed in policy and practice which influenced both how and when data were delivered. These discrepancies present a challenge to comparative research. Conclusions: We conclude that there are few signs of harmonisation, as called for by previous policy documents and research papers. Ethical vetting needs to be centralised both within and between countries in order to improve data access. Institutional factors that seem to facilitate access to register data at the national level include single storage environments for health and social data, simplified ethical vetting and user guidance.
  • Hänninen, Kaija (2003)
    Despite the wishes of parents, not all children are born healthy. The purpose of this study was to investigate how information on the disability of a new-born child is passed on from health-care personnel to parents. The process consisting of parents receiving information on the disability of a child is called first information. In the present, first information is the subject of interest in the period when the precise disability of the child is not yet known. This intermediate stage is called liminal (see Turner 1967). The research assignment consisted of the following questions: 1) What were the narratives of the parents regarding the passing of first information upon the birth of a disabled child? 2) What were the experiences of workers regarding these first information situations? 3) What were the experiences of parents and workers of these liminal situations? The purpose of the study was to increase understanding of the experiences of parents in view of the passing on first information and of the views of workers regarding their own work in passing on information. This is a narrative study, the material of which consists of interviews treated as narratives. Through them, information is obtained on the subjective experiences of actors. The research material consists of interviews of 16 families and 77 workers. The narratives, totalling 30, of four families and their close workers are taken into closer narrative interpretative analysis. The four families were chosen for closer analysis. because they were interviewed during the liminal stage. First information is primarily analysed from the perspective of parents. The picture of the passing of first information that is obtained from the narratives of parents is complemented with the perspective of the workers. Emerging from the narratives of the parents is experiential first, information consisting of the passing on of information, crisis experiences and the processes interaction. Experiential first information is divided into delayed, intermittent and fluent information, which are represented in the study by the doubting, emotional and information narratives. The encounters of parents and workers during the first information process are analysed more closely by applying frameworks of analysis developing on the basis of Erving Goffnian's (1986) frameworks of analysis. The encounter episodes are analysed via material-based framework of doubt, emotion and information. The results show that there are not always encounters, in which case by-passing takes place. When encounter takes places at the factual level it is termed collaboration. Successful encounters are called dialogical interaction. First information situations are different, and there is no correct manner of passing on information. The birth of a disabled child produces a crisis for parent. which means that information is best passed on in the information formation process in the dialogical interactions situation, in which emotions are also taken into account. In addition to information, first information situations also call for a humane aspect, which implies care not only for the child but also for the parents. The person providing the information should have the necessary sensitivity to see the parents' needs for support and the ability to respond to them. In first information situations, all information, care and caring provided by workers should he part of the support of parents, permitting them to preserve or create a belief in the sufficiency of their own resources and hope for managing with their child.
  • Tamminen, Tuire; Sahlin, Lena; Masironi-Malm, B.; Dahlbom, Merja; Katila, Terttu; Taponen, Juhani; Vapaavuori, Outi (2019)
    This study aimed to examine the etiology of canine dystocia by measuring the relative expression of oxytocin receptor (OXTR) mRNA and the concentration of serum progesterone, plasma PGF(2 alpha) metabolite (PGFM), and blood ionized calcium (iCa) near term and in dystocia. Altogether 58 bitches were included in this study, 41 of which underwent cesarean section (CS). The four CS groups were based on history: complete uterine inertia (CUI; n = 7), partial uterine inertia (PUI; n = 13), obstructive dystocia (OD; n = 10), and elective cesarean section (ECS; n = 11). An additional group of medically treated dystocia without CS (MD; n = 8) and a control group (C; n = 9) with normal parturition (without CS and medical treatment) were also formed. Blood samples were taken prior to CS or medical treatment. Progesterone concentrations were highest in the ECS and a significant difference (p <0.05) was observed between the ECS and the OD and between the ECS and the combined dystocia (CUI, PUI, OD, MD) groups (COMB). Highest concentrations of PGFM was observed in the C, the difference being significant (p <0.05) between the C and the ECS and between the C and the COMB group. The progesterone:PGFM ratio was significantly (p <0.05) higher in the ECS than in the C and the COMB group. No significant difference (p> 0.05) was observed in iCa concentrations between the groups. Relative OXTR mRNA expression was evaluated with real-time PCR from full-thickness uterine samples taken from the incision site during CS. The expression was highest in the ECS and the difference in expression was significant (p <0.05) between the ECS and the OD and between ECS and the combined dystocia (CUI, PUI, OD) groups (COMB2). The study supports previous reports of decreasing progesterone and increasing PGFM during prepartum luteolysis. Upregulation of OXTR occurs near term. In obstructive dystocia, a prolonged influence of oxytocin and uterine exhaustion may lead to downregulation of OXTR. Complete primary uterine inertia may have a different etiology as no clear decrease in OXTR was observed in CUI as in OD. It remains unclear if parturition ceases because of uterine inertia or if uterine inertia occurs because of ceased parturition and desensitization of receptors. (C) 2019 Elsevier Inc. All rights reserved.
  • Aarniosuo, Mauri (Helsingin yliopisto, 2020)
    Assuming that living is not always categorically good or categorically bad for the life’s subject, ‘wellbeing’ must be a value that is measured on a non-ratio scale. This entails that there is no significant zero point on the wellbeing level scale. The arbitrary zero point on a non-ratio scale does not signify a lack. Thus, the states of living and non-living are incomparable from the perspective of wellbeing-related interests, for a subject does not have any wellbeing level while not alive. A similar argument was put forward already by Epicurus and Lucretius. The concepts of ‘a life worth living’ and ‘a life not worth living’ are flawed. Birth and death, as coming into existence and ceasing to exist, can never either harm or benefit a life’s subject wellbeing-wise. This is true a priori. As wellbeing levels are non-ratio values, they do not cumulate. Hence, it makes little sense in trying to compare the wellbeing values of wholes, like complete lives, especially if they are of different duration. The thesis starts from a premise of ‘wellbeing’ relating to moments of time, this being the undisputed part of the different interpretations of the term. Only after carefully examining the concept of a ‘wellbeing level’ and its features, a theory is built to address the question of how to compare values of temporal wholes. In the process, all of the possible symmetrical and asymmetrical theories of the personal value of birth and death are laid out, and their relationship with the concept of ‘wellbeing’ is analyzed. The term ‘biosignificantism’ is introduced to refer to a theory according to which birth and death may both be either beneficial or detrimental to a subject from a wellbeing-point-of-view. The claims of biosignificantism are refuted by demonstrating why a significant zero point on a non-ratio scale cannot be defined. The type of non- cumulative wellbeing that a non-ratio scale entails is logically combined with features that pose some limitations on how wellbeing may be affected either causally or non-causally. These limitations are outlined. Finally, the broad implications of a theory that is named ‘bioindifferentism’ and that reduces personal value on non-ratio wellbeing are formulated. The relevant literature that is utilized in the research is largely divided: mostly separate fields of research have been devoted to the relationship of birth and wellbeing, and, on the other hand, the relationship of death and wellbeing. This master’s thesis brings the issues together. Derek Parfit’s Reasons and Persons (1984) and Ben Bradley’s Well-Being & Death (2009) are central references. Past research has been largely conducted in terms of moral philosophy which seems to have led to a lot of confusions. The thesis’s axiological focus is intended to bring the discussion back to the atom level to lay down the groundwork for also ethics.