Browsing by Subject "health care"

Sort by: Order: Results:

Now showing items 1-12 of 12
  • Qian, Cao (Helsingfors universitet, 2011)
    The Master’s thesis is qualitative research based on interviews of 15 Chinese immigrants to Finland in order to provide a sociological perspective of the migration experience through the eyes of Chinese immigrants in the Finnish social welfare context. This research is mainly focused upon four crucial aspects of life in the settlement process: housing, employment, access to health care and child care. Inspired by Allardt’s theoretical framework ‘Having, Loving and Being’, social relationships and individual satisfaction are examined in the case of Chinese interviewees dealing with the four life aspects. Finland was not perceived as an attractive migration destination for most Chinese interviewees in the beginning. However, with longer residence in Finland, the Finnish social welfare system gradually became a crucial appealing factor in their permanent settlement in Finland. And meanwhile, social responsibility of attending their old parents in China, strong feelings of being isolated in Finland, and insufficient integration into the Finnish society were influential factors for their decision of returning to China. Social relationships with personal friends, migration brokers, schools, employers and family relatives had great influences in the four life aspects of Chinese immigrants in Finland. The social relationship with the Finnish social welfare sector is supportive to Chinese immigrants, but Chinese immigrants do not heavily rely on Finnish social protection. The housing conditions were greatly improved over time while the upward mobility in the Finnish labour market was not significant among Chinese immigrants. All Chinese immigrants were satisfied with their current housing by the time I interviewed them while most of them had subjective feelings of being alienated in the Finnish labour market, which seriously prevented them from integrating into the Finnish society. In general, Chinese immigrants were satisfied with the low cost of accessing the Finnish public health care services and affordable Finnish child day care services and financial subsidies for children from the Finnish social welfare sector. This research also suggests that employment is the central basis in well-being. Support from the Finnish social welfare sector can improve the satisfaction levels among immigrants, especially when it mitigates the effects of low-paid employment. As well, my empirical study of Chinese immigrants in Finland shows that Having (needs for materials), Loving (needs for social relations) and Being (needs for social integration) are all involved in the four concrete aspects (housing, employment, access to health care and child care).
  • Ståhl, Tore (Helsingfors universitet, 2001)
    The aim of the study was to explore why the MuPSiNet project - a computer and network supported learning environment for the field of health care and social work - did not develop as expected. To grasp the problem some hypotheses were formulated. The hypotheses regarded the teachers' skills in and attitudes towards computing and their attitudes towards constructivist study methods. An online survey containing 48 items was performed. The survey targeted all the teachers within the field of health care and social work in the country, and it produced 461 responses that were analysed against the hypotheses. The reliability of the variables was tested using the Cronbach alpha coefficient and t-tests. Poor basic computing skills among the teachers combined with a vulnerable technical solution, and inadequate project management combined with lack of administrative models for transforming economic resources into manpower were the factors that turned out to play a decisive role in the project. Other important findings were that the teachers had rather poor skills and knowledge in computing, computer safety and computer supported instruction, and that these skills were significantly poorer among female teachers who were in majority in the sample. The fraction of teachers who were familiar with software for electronic patient records (EPR) was low. The attitudes towards constructivist teaching methods were positive, and further education seemed to utterly increase the teachers' readiness to use alternative teaching methods. The most important conclusions were the following: In order to integrate EPR software as a natural tool in teaching planning and documenting health care, it is crucial that the teachers have sufficient basic skills in computing and that more teachers have personal experience of using EPR software. In order for computer supported teaching to become accepted it is necessary to arrange with extensive further education for the teachers presently working, and for that further education to succeed it should be backed up locally among other things by sufficient support in matters concerning computer supported teaching. The attitudes towards computing showed significant gender differences. Based on the findings it is suggested that basic skills in computing should also include an awareness of data safety in relation to work in different kinds of computer networks, and that projects of this kind should be built up around a proper project organisation with sufficient resources. Suggestions concerning curricular development and further education are also presented. Conclusions concerning the research method were that reminders have a better effect, and that respondents tend to answer open-ended questions more verbosely in electronically distributed online surveys compared to traditional surveys. A method of utilising randomized passwords to guarantee respondent anonymity while maintaining sample control is presented.
  • Kajantie, Mira (2007)
    Administrative registers provide an inexhaustible source of information that is exploited in growing trend by social researchers. Register based research differs in some ways from traditional ways of making research. The purpose of this study was to examine the possibilities that register data provides for equity in health care research and to illustrate how the project can be conducted in practise. The process of register based research was examined through actual research data. Study data was a part of the STAKES research data originally collected to identify and examine differences in treatment of coronary heart disease population in Finland in 1995-1998. Originally for other purposes compiled register data was reworked into retrospective cohort study setting. The purpose was to examine possible socioeconomic differences in treatment histories among patients that underwent their first revascularisation in 1995-1995. Statistical methods used in this study are commonly used in epidemiological research, including logistic and multinomial logistic regression, Poisson regression and Cox regression. Based on previous research it was known that higher socioeconomic groups received more revascularisations than those worse-off in 1990s. This study aimed to conclude whether patients in high socioeconomic groups received the operation in earlier stage of the disease based on their treatment history. According to the results, statistically significant differences that favoured those better-off existed in 1995-1998 in pathways to revascularisation. Patients from higher socioeconomic groups were operated sooner after being diagnosed and had less acute hospitalisations due to coronary heart disease in their treatment histories. The study used several graphic and statistical methods to gain a more detailed picture of the pathways to revascularisation.
  • Rauhala, Anna-Maria Henriikka (2007)
    The topic of this thesis is human development in a Community Health Evangelism (CHE) project in Northern Thailand. The theoretical part of the thesis first examines a number of concepts of human nature briefly. It then focuses on four different theories of human development: Manfred Max-Neef's human scale development, John Friedmann's empowerment theory, the human development of the United Nations and the empowerment theory of the World Bank. The thesis seeks to determine how human development has resulted through the CHE project of Fida International in the village of Na Poo by mirroring the development to the four human development theories mentioned above. Secondly the CHE method is analysed to see how it produces human development. Also the aspect of religion in the development work in Na Poo is dealt with briefly. The main methods of the work, besides analysing the CHE project through the human development theories, are interviews and PRA –type group exercises done by some of Na Poo's residents. Some of the most important sources of the research are Manfred Max-Neef's Development and Human Needs in the book Real-Life Economics: Understanding Wealth Creation (Ekins, P. & Max-Neef, M. [ed.] 1992), John Friedmann's book Empowerment: The Politics of Alternative Development (1992) and lastly Stan Rowland's book Multiplying Light & Truth through Community Health Evangelism (2001, revised version). The main result of the research is that Fida International's CHE project in Na Poo, Northern Thailand, has brought about human development to an extent in the village. For example, an area included in all the four theories is freedom of choice and this has clearly been improved by the project. The theory that has the most resemblances with the ideals of CHE is John Friedmann's theory of empowerment with its focus on the household level. Religion (Christianity) has played an important role in this development project, as the villagers do not often even differentiate between what has been caused by religion and what has been the result of the development work alone.
  • Nurmela, Kirsti; Mattila, Aino; Heikkinen, Virpi; Uitti, Jukka; Ylinen, Aarne; Virtanen, Pekka (2018)
    The study explores whether clinical screening targeted at work disabilities among long-term unemployed people reveals eligible individuals for a disability pension and the importance of depression in granting the disability pensions. A total of 364 participants of the screening project were considered as eligible to apply for disability pension. Among them, 188 were diagnosed as clinically depressed. They were classified into those with earlier depression diagnosis (n = 85), those whose depression had not been diagnosed earlier (n = 103), and those without diagnosed depression (n = 176). The association of this Depression identification pattern' with being granted a disability pension was explored by logistic regression analyses. Compared to those with earlier diagnosis, those whose depression had not been diagnosed earlier were granted disability pension more commonly (72% vs. 54% OR 2.2, p = 0.012). Corresponding figures of the undepressed were 73%, OR 2.3, p = 0.002. The adjustments did not affect the results. Clinical examination of the long-term unemployed people in terms of work disability seems to be worthwhile. In particular, the examination reveals new depression diagnoses, which contribute more to the award of disability pension than depression diagnosed earlier by regular health care. Novel ways to detect depression among the unemployed should be implemented in the health and employment services.
  • Thunnissen, Erik; Weynand, Birgit; Udovicic-Gagula, Dalma; Brcic, Luka; Szolkowska, Malgorzata; Hofman, Paul; Smojver-Jezek, Silvana; Anttila, Sisko; Calabrese, Fiorella; Kern, Izidor; Skov, Birgit; Perner, Sven; Dale, Vibeke G.; Eri, Zivka; Haragan, Alex; Leonte, Diana; Carvallo, Lina; Prince, Spasenja Savic; Nicholson, Siobhan; Sansano, Irene; Ryska, Ales (2020)
    A questionnaire on biomarker testing previously used in central European countries was extended and distributed in Western and Central European countries to the pathologists participating at the Pulmonary Pathology Society meeting 26-28 June 2019 in Dubrovnik, Croatia. Each country was represented by one responder. For recent biomarkers the availability and reimbursement of diagnoses of molecular alterations in non-small cell lung carcinoma varies widely between different, also western European, countries. Reimbursement of such assessments varies widely between unavailability and payments by the health care system or even pharmaceutical companies. The support for testing from alternative sources, such as the pharmaceutical industry, is no doubt partly compensating for the lack of public health system support, but it is not a viable or long-term solution. Ideally, a structured access to testing and reimbursement should be the aim in order to provide patients with appropriate therapeutic options. As biomarker enabled therapies deliver a 50% better probability of outcome success, improved and unbiased reimbursement remains a major challenge for the future.
  • Ovaskainen, Harri; Airaksinen, Marja; Närhi, Ulla (Suomen farmasialiitto, 2004)
    This article provides an overview of the role of medicines in Finnish health care, and the structure of pharmaceutical services. The major public health concerns will be briefly presented to give a gramework for understanding national drug consumption patterns. In this connection, the main principles of the public social insurance system covering the whole population and most of the prescription medications for chronic diseases will be discussed. The different actors in the drug distribution chain are also introduced, including community pharmacies. At the end of the article, there will be a short overview on the Finnish pharmaceutical education system that is based on two academic degreesÖ Bachelor and Master of Science in Pharmacy, both of whick have their own professional roles in health care. At the end, a short review presents the goals of drug policy by 2010, set by the ministry of Social Affairs and Health in September 2003.
  • Tähtinen, Katja; Remes, Jouko; Karvala, Kirsi; Salmi, Kari; Lahtinen, Marjaana; Reijula, Kari (2020)
    Objectives: The study examined the extent and prevalence of perceived indoor environment-related (IE-related) symptoms environmental complaints and psychosocial work environmental factors in Finnish office, school and health care environments. Material and Methods: The data were collected from non-industrial workplaces (N = 455) in 2011-2012 and 2015-2017 using the Finnish Institute of Occupational Health's Indoor Air Questionnaire (IA Questionnaire). Suspicion of IE-related problems was reported in 59% of workplaces. The data consisted of 28 826 employees' responses. Results: The employees reported symptoms and environmental discomfort in office environments less often than in school or health care environments. The most often reported IE-related complaints were stuffy air (39% of respondents), dry air (34%) and insufficient ventilation (33%). The most often reported symptoms were irritation of the nose (27% of respondents), irritation of the eyes (26%), and hoarse or dry throat (24%). The results showed differences between the perceived IE in office, school and health care environments. Conclusions: Compared to earlier findings, the most often perceived IE-related symptoms and complaints have increased in Finnish health care environments. The office employees' perceptions of psychosocial work environment remained fairly unchanged whereas health care personnel more often assessed their psychosocial environment as positive compared to previous reports. Instead of exact reference values, comparing the results of IA Questionnaires with the distributions and mean values of the results of this study may be more informative for those striving to solve IE-related problems. The presented distribution and mean values of perceived symptoms, environmental complaints and psychosocial work environment might help to relate the results to other workplaces. This, in turn, might increase the understanding that IA Questionnaire results are influenced by many factors. The results presented can be used as new reference material when interpreting the results of IA Questionnaires in office, school and health care environments.
  • Mansnérus, Juli; Lahti, Raimo; Blick, Amanda (Faculty of Law, University of Helsinki, 2020)
    Forum Iuris
    The paradigm of personalized medicine is an emerging topic, triggering some specific legal and ethical challenges as regards data collection, sharing and use, informed consent, privacy and public trust, and the changing status of patients and social equality. These legislative developments and challenges have been discussed in light of the Finnish and the common-European experiences. During recent years, the Finnish legislative processes aiming at generating ‘innovation-friendly’ legislation for scientific research purposes as well as integrating genomic research results into the clinical setting have been heavily challenged by rapid developments in technology and medicine. In particular, there is a need to pursue the right balance between scientific and commercial interests, public health, and individual rights. We aim at providing insights into the legislative processes surrounding personalized medicine with a special focus on how the freedom of science, equitable access to healthcare, public health, and commercial issues that must be balanced with individual rights as expressed in the EU Charter and the Council of Europe’s Oviedo Convention on Human Rights and Biomedicine. A wide spectrum of different types of challenges arises; among other things, there is a need to discuss the Finnish and international legislation of genome testing in terms of consent on behalf of a young child. Also the legal and ethical aspects of disruptive gene-editing technologies need to be analysed: How should we interpret the concept of human dignity in the bioethical discussion surrounding germline editing? Furthermore, an overview of ongoing initiatives to accelerate the market-entry of advanced therapy medicinal products will be provided. The European regulators are now taking measures to create a facilitative regulatory environment that encourages innovation, protects public health, and enables timely patient access to innovative, new therapies whilst ensuring patient safety. The role of risk-proportionate adaptations to clinical trials and GMP manufacture along with the European Medicines Agency’s early-access incentives and initiatives are presented as potential facilitators of market entry. Furthermore, in this context, the role of conditional reimbursement schemes and risk sharing-agreements is also discussed in light of the newest Finnish experiences. Furthermore, in terms of patent law, some specific challenges arise; in this anthology, attention is paid to the recent transatlantic legal dispute over a patent concerning the use of the CRISPR/Cas9 system in eukaryotic cells. Finally, some considerations beyond legal or ethical aspects of personalised medicine are presented. How can machine learning be used to support personalized care that addresses the patient’s needs?
  • Savikurki, Anni (Helsingfors universitet, 2013)
    While a situational analysis by an intervention research program CoS-SIS was being conducted in Lawra and Nadowli regions in Northern Ghana, it was noticed that some farms performed differently: they had more animals, better market off-take or they employed uncommon practices. This raised an interest in this kind of behaviour; what kind of positive deviance exists and what enables it? The objective of this study was to gain understanding on enabling factors for better livelihood outcomes. Study design was a case study where positive deviant (PD) and commercial farmers were contrasted to regular farmers. Qualitative ethnographic methods were used in data collection. Semi-structured interviews with open-ended questions were conducted with the main 12 PD informants. Recorded and transcribed data was analyzed by using thematic content analysis. The findings suggest that subsistence production is most common while commercial farming is rare. Recreational farming exists as well. Only commercials sell animals in sales purposes; commonly animals are sold only in need. The main constraints refer to animal mortality, stealing and lack of water. At the back of the problems there are insufficient service delivery and input dealing as well as farmers’ identity and attitudes towards animal rearing. Positive deviance manifests in larger animal holdings and areas in cultivation. This is attributed to the practices employed: PDs offer supplementary feeding, vaccinate and deworm the animals as well as house them for the night. The practices have been learned through neighbours and relatives as well as through extension and projects. Characteristics to PDs is an off-farm income source which enables investments in agriculture. It can be concluded that PD is about basic practices which have been learned from rather common sources. Creating an enabling environment for small ruminant production requires institutional changes as regards to farmers’ attitudes and service and input delivery. Local practices as responses to constraints would be suitable topics for further research.
  • Ruottu, Maria Eveliina (2007)
    This thesis is a descriptive study about the plural healthcare system on Siberut Island, Indonesia. The study explores the theoretical concepts of medical systems and medical pluralism in relation to the case study of Siberut Island. For the situation encountered on the island, Arthur Kleinman’s model of health care systems and Tapio Nisula’s term medical culture are appropriate. Because the study concentrates on describing the traditional shamanic medical system of Siberut on one hand, and the relatively recent biomedical healthcare on the other, the theoretical chapter includes discussion on ethnomedicine and the medical anthropological study of biomedicine. In this study, biomedicine is viewed as one ethnomedicine among others. Its basis in the Cartesian dualism and how this shows in biomedical theory and practice is discussed. This thesis is written in the spirit of critical medical anthropology (CMA), paying attention to macro-level processes such as national politics and policies, economy, history, questions of identity etc. The thesis is based on data collected during a seven month field work period in 2003, out of which approximately three months were spent in the small village of Ugai on Siberut. Siberut belongs to the Mentawai Archipelago, on the western side of Sumatra. Siberut is the biggest island of the archipelago, and has until recently remained fairly untouched by outside influences. In the last two decades, it has become increasingly known internationally due to its unique nature and indigenous culture. The field data was collected through participant observation, discussions with villagers and people working in healthcare, and some interviews. In addition, available literature on Siberut and on healthcare seeking and medical pluralism has been used. After the theoretical considerations, the thesis first describes Siberut and its history, then the traditional cosmology and healing practices related to it. The history and functioning of biomedical healthcare on the island is discussed next. The last two chapters discuss the plural health care system as a whole, describing what factors affect healthcare seeking. Seven case histories are presented to give the reader an understanding of the lived reality of Siberut’s plural healthcare system. Using Kleinman’s model, three sectors can be identified in the Siberutan health care system: 1) the folk sector (of self-medication with herbal remedies and over the counter biomedical products), 2) the traditional sector (of shamans, herbalists and traditional midwives), and 3) the professional sector (of biomedical doctors and nurses). The sectors are overlapping and complementary. People on Siberut Island use the plural medical system flexibly according to their needs and depending on their situation. They do not view the different kinds of healthcare as separate bounded systems, and see no contradiction in using e.g. shamanic healing and biomedical healthcare simultaneously or consequtively. Especially the providers of biomedical healthcare formulate stricter boundaries between the systems. Still collaboration between the different kinds of healthcare providers has increased and further cooperation is hoped for the future.
  • Silverberg, Emily L.; Sterling, Trevor W.; Williams, Tyler H.; Castro, Grettel; Rodriguez de la Vega, Pura; Barengo, Noel C. (2021)
    One-third of Americans with diabetes will develop diabetic retinopathy (DR), the leading cause of blindness in working-age Americans. Social determinants of health (SDOHs) are conditions in a person's environment that may impact health. The objective of this study was to determine whether there is an association between SDOHs and DR in patients with type II diabetes. This cross-section study used data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS). This study included people with self-reported diabetes in the US in 2018 (n = 60,703). Exposure variables included homeownership, marital status, income, health care coverage, completed level of education, and urban vs. rural environment. The outcome variable was DR. Logistic regression analysis were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Alaskan Native/Native American (OR 2.11; 95% CI: 1.14-3.90), out of work (OR 2.82; 95% CI: 1.62-4.92), unable to work (OR 2.14; 95% CI: 1.57-2.91), did not graduate high school (OR 1.91; 95% CI: 1.30-2.79), only graduated high school (OR 1.43; 95% CI 1.08-1.97), or only attended college or technical school without graduating (OR 1.42; 95% CI: 1.09-1.86) were SDOHs associated with DR in patients with diabetes. Health care providers should identify these possible SDOHs affecting their diabetic patients.