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Research Interests: Medicine, Counseling, Finland, Pregnancy, Humans, and 4 moreFemale, Pubmed, Maternity Care, and Prenatal Care
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ABSTRACT. This paper reports variation in birth interventions by 25 midwives among 2 135 births in a Finnish hospital. The rate of cesarean sections varied from 0 to 18%, and that of instrumental deliveries from 0 to 8%. Mother's and... more
ABSTRACT. This paper reports variation in birth interventions by 25 midwives among 2 135 births in a Finnish hospital. The rate of cesarean sections varied from 0 to 18%, and that of instrumental deliveries from 0 to 8%. Mother's and infant̂s characteristics and rates of vaginal breeches suggest that a low rate of cesarean sections was not explained only by selection to easy births. This study suggests that the skills, attitudes and routines of midwives may explain part of the variation found in birth interventions.
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Research Interests: Sociology, Anthropology, Family Medicine, Doctor-patient communication, Urban Health, and 15 moreMaternal Health, Medicine, Finland, Social Science & Medicine, Pregnancy, Humans, Female, Patient Satisfaction, Newborn Infant, Maternity Care, Adult, Boolean Satisfiability, Waiting Time, Prenatal Care, and Referral and consultation
Many surveys have shown that women using postmenopausal hormone therapy have a lower incidence of cardiovascular diseases and lower overall mortality. The purpose of this study was to compare past and non-users with current users of... more
Many surveys have shown that women using postmenopausal hormone therapy have a lower incidence of cardiovascular diseases and lower overall mortality. The purpose of this study was to compare past and non-users with current users of hormone therapy in regard to characteristics known to, or assumed to, predict poor subsequent health (indicators). The main data source was a survey in 1989 of a random sample (n = 2000, 86% response rate) of 45-64 year-old Finnish women. Among women with their uterus, after adjusting for age and urbanism, of the 21 indicators studied, 10 suggested a poorer and none a better health prognosis for the non-users than for current users. Many differences were greater among older women, suggesting a cohort effect or long-term users being an especially selected group. Among hysterectomized women, differences between users and non-users were similar or smaller than among women with uteri. The past users were more similar to non-users than current users. Our study suggests that women with a better health prognosis are selected or select themselves for hormone therapy, and that may impede interpretation of observational studies on hormone therapy and health.
Research Interests: Incidence Geometry, Clinical Epidemiology, Menopause, Medicine, Finland, and 15 morePostmenopausal Women, Humans, Mathematical Sciences, Female, Cohort Study, Cohort, Risk factors, Hysterectomy, Middle Aged, Cardiovascular Diseases, Hormone Therapy, Risk Factors, Observational Study, Cross Sectional Studies, and Medical and Health Sciences
ABSTRACT The current controversy over the need of iron supplementation lead us to study the growth and health of infants given iron-fortified (6.5mg/l) and non-fortified (0.5mg/l) milk-based formulas during the first six months. The two... more
ABSTRACT The current controversy over the need of iron supplementation lead us to study the growth and health of infants given iron-fortified (6.5mg/l) and non-fortified (0.5mg/l) milk-based formulas during the first six months. The two formulas were identical except for iron content. Healthy, term infants with a mean age of 1.3 months and not being breast-fed were randomly allocated to receive iron-fortified formula (n=164) and non-fortified formula (n=158), being followed up to the age of one year. Data were compiled by health visitors and physicians from their notes and by asking the parents. Our results give no clear evidence of clinical benefit from iron fortification. It is suggested, that iron is not needed in the formula consumed during the first six months of life. Because formulas are widely and increasingly used, further trials of iron fortification in different circumstances are needed.
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This study analyzes the role of the midwife in prenatal care by exploring the history of the midwifery profession in Finland and by interviewing midwives. Midwifery education started in Finland in the beginning of the 19th century due to... more
This study analyzes the role of the midwife in prenatal care by exploring the history of the midwifery profession in Finland and by interviewing midwives. Midwifery education started in Finland in the beginning of the 19th century due to the utilitarian population policy aiming to reduce the high infant mortality rate. Because of a shortage of physicians professional midwives attained an important status in the care of births. With industrialization a state-directed welfare policy with state-subsidized health care developed. After World War II, the midwifery were legally defined as care during pregnancy, delivery, and the postpartum period. In the 1950s, the scope of work of midwifery was further altered because hospital deliveries had become routine. Some midwives provided prenatal care in ambulatory maternity health centers while others worked in hospitals managing normal childbirths. Separate midwifery education ended in 1968 and resumed 1986. Since 1972, public health nurses have increasingly provided prenatal and postnatal care in maternity centers, and specialized nurses have managed normal childbirths. In the future, public health nurses may totally replace midwives in prenatal care, and the role of midwives may return to care of normal deliveries. Midwife interviews revealed the "medicalization" of pregnancy caused both by physicians and midwives' own medical concept of pregnancy and by clients' demands for good care.
Research Interests: Nursing, Obstetrics, Health Care, Forecasting, Midwifery, and 15 morePublic Health, Maternal Health, Medicine, Finland, Pregnancy, Population, Humans, Female, Public Health Nursing, History Modern, Infant Mortality, Infant Mortality Rate, Prenatal Care, postpartum period, and Paediatrics and reproductive medicine
Aims.There is a need of more quantitative standardised data to compare local Mental Health Systems (MHSs) across international jurisdictions. Problems related to terminological variability and commensurability in the evaluation of... more
Aims.There is a need of more quantitative standardised data to compare local Mental Health Systems (MHSs) across international jurisdictions. Problems related to terminological variability and commensurability in the evaluation of services hamper like-with-like comparisons and hinder the development of work in this area. This study was aimed to provide standard assessment and comparison of MHS in selected local areas in Europe, contributing to a better understanding of MHS and related allocation of resources at local level and to lessen the scarcity in standard service comparison in Europe. This study is part of the Seventh Framework programme REFINEMENT (Research on Financing Systems’ Effect on the Quality of Mental Health Care in Europe) project.Methods.A total of eight study areas from European countries with different systems of care (Austria, England, Finland, France, Italy, Norway, Romania, Spain) were analysed using a standard open-access classification system (Description an...
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Research Interests: Geography and Immigration
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The purpose of this study was to investigate the effect of physicians' gender when sex-specific conditions are being treated in a country where almost half of the physicians are women. Five Finnish surveys originally conducted for... more
The purpose of this study was to investigate the effect of physicians' gender when sex-specific conditions are being treated in a country where almost half of the physicians are women. Five Finnish surveys originally conducted for other purposes were reanalyzed. Two surveys examined physicians' and medical students' views about hormone therapy during and after menopause, one survey examined medical students' attitudes about medicines, one survey examined physicians' obstetric practices, and one examined contraceptive counselling. All the surveys showed more similarities than differences in the clinical decision-making of women and men physicians. In opinions about menopause the physician's medical specialty was more important than gender. Physicians' obstetrical practices were also similar in five cases out of six, but in one situation where medical factors were not a deciding issue, women physicians acted differently. These results suggest that socialization into the medical profession makes physicians' practices more alike and diminishes gender differences.
Research Interests: Contraception, Family Medicine, Socialization, Medicine, Counseling, and 15 moreFinland, Clinical Decision Making, Medical Students, Humans, Reproductive health, Female, Male, Physicians, Gender Difference, Questionnaires, Public health systems and services research, Sex Factors, Hormone Therapy, Paediatrics and reproductive medicine, and postmenopause
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Artikkeli käsittelee ulkomaalaistaustaisia lapsia ja nuoria lastensuojelun sijaishuollon asiakkaina analysoimalla rekisteritietoja sijoitettujen määrästä, sijoitusten perusteista ja sijoituspaikoista Suomessa vuosina 1991-2015 ja... more
Artikkeli käsittelee ulkomaalaistaustaisia lapsia ja nuoria lastensuojelun sijaishuollon asiakkaina analysoimalla rekisteritietoja sijoitettujen määrästä, sijoitusten perusteista ja sijoituspaikoista Suomessa vuosina 1991-2015 ja vertailemalla tietoja suomalaistaustaista väestöä koskevaan rekisteriaineistoon. Aineisto on luokiteltu pakolaistaustaisiin, muihin ulkomaalaistaustaisiin ja valtaväestöön. Ulkomaalaistaustaiset jaotellaan lisäksi ulkomailla syntyneeseen ja Suomessa syntyneeseen sukupolveen. Tutkimusmenetelminä ovat kuvailevat ristiintaulukoinnit ja ryhmäkeskiarvot. Ulkomaalaistaustaisilla lapsilla ja nuorilla on ollut suhteellisesti enemmän kodin ulkopuolisia sijoituksia kuin valtaväestöllä tutkimusajankohtana. Kiireelliset sijoitukset ja laitossijoitukset korostuvat kaikissa ulkomaalaistaustaisten ryhmissä verrattuna valtaväestöön. Lastensuojelun asiakkuus vaihtelee lapsen ja nuoren etnisen ja maahanmuuttotaustan mukaan. Tulokset indikoivat, että varhaisen tuen ja lastens...
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Öll norrænu ríkin safna ítarlegum gögnum um stöðu barna og unglinga í hópi flóttafólks. Gögnin gera það að verkum að hægt er að bera saman stöðuna milli landa og auka skilning á þeim áhrifum sem félags- og efnahagslegar aðstæður hafa á... more
Öll norrænu ríkin safna ítarlegum gögnum um stöðu barna og unglinga í hópi flóttafólks. Gögnin gera það að verkum að hægt er að bera saman stöðuna milli landa og auka skilning á þeim áhrifum sem félags- og efnahagslegar aðstæður hafa á aðlögun ungra innflytjenda. CAGE verkefnið rannsakaði ójöfnuð varðandi menntun, atvinnuþátttöku og heilsufar ungs flóttafólks á uppvaxtarárum þess. Jafnframt varpaði verkefnið ljósi á áhrif innflytjendastefnu landanna og annarra þjóðfélagsþátta á ójöfnuðinn
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Alle de fire nordiske landene har gode nasjonale registerdata om unge flyktningers situasjon nar det gjelder deres helse og sosiale livsvilkar. Dette gir unike muligheter for sammenligning mellom d ...
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All the Nordic countries have excellent data on the situation of refugee children and youth. This creates unique opportunities for comparison to better understand the links between the socio-econom ...
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Kaikilla Pohjoismailla on kerattyna erinomaista aineistoa pakolaislasten ja -nuorten tilanteesta. Tama luo ainutlaatuisia mahdollisuuksia vertailla ja ymmartaa paremmin kunkin maan sosioekonomisen ...
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Belgium has a rich, but largely forgotten, emigration history. In July 2018, 471,401 Belgians were registered as living abroad. Yet, little academic attention has been given to this population and to the types of relations that the... more
Belgium has a rich, but largely forgotten, emigration history. In July 2018, 471,401 Belgians were registered as living abroad. Yet, little academic attention has been given to this population and to the types of relations that the Belgium state maintains with it. This chapter aims to fill this gap by focusing on the policies developed in Belgium to provide forms of social protection to its citizens abroad. Based on the analyses of online and offline institutional documentation, applicable legislation, parliamentary documentation and specialized publications, the chapter describes the specificity of the Belgian involvement in the protection of its population living abroad. It is argued that the diaspora infrastructure of Belgium is largely characterized by a lack of specialized institutions at the federal level and by the relatively important role of Belgian subnational communities in organizing the relations with the Belgian population abroad. Regarding diaspora’s social protection...
Research Interests: Political Science, Migration, Argentina, International Migration, Migration Studies, and 15 moreDiaspora Studies, Emigration Research, Diaspora and transnationalism, India, Foreign relations, Migration policies, Emigration, Latvia, Migration and Diaspora, Migration Policy, Migration and Diaspora Studies, Consular Affairs, Migrations and Transnationalism, Foreign policy of Argentina, and Diaspora engagement policies
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Research Interests: Mental Health, Primary Health Care, Health Care Policy, Medicine, Multidisciplinary, and 12 moreFinland, Humans, Mental Health Services Research, Human Resources for Health, Environmental public health, Hospitalization, Mental Disorders, Mental health services, Primary care mental health, Integraton of Mental Health Service in Primary Care, Health Care Costs, and Health Resources
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Many surveys have shown that women using postmenopausal hormone therapy have a lower incidence of cardiovascular diseases and lower overall mortality. The purpose of this study was to compare past and non-users with current users of... more
Many surveys have shown that women using postmenopausal hormone therapy have a lower incidence of cardiovascular diseases and lower overall mortality. The purpose of this study was to compare past and non-users with current users of hormone therapy in regard to characteristics known to, or assumed to, predict poor subsequent health (indicators). The main data source was a survey in 1989 of a random sample (n = 2000, 86% response rate) of 45-64 year-old Finnish women. Among women with their uterus, after adjusting for age and urbanism, of the 21 indicators studied, 10 suggested a poorer and none a better health prognosis for the non-users than for current users. Many differences were greater among older women, suggesting a cohort effect or long-term users being an especially selected group. Among hysterectomized women, differences between users and non-users were similar or smaller than among women with uteri. The past users were more similar to non-users than current users. Our study suggests that women with a better health prognosis are selected or select themselves for hormone therapy, and that may impede interpretation of observational studies on hormone therapy and health.
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This study reports the variation in perinatal problems related to social class in one area in Finland. Data on length of gestation, birthweight, one-minute Apgar score, and need for special care in relation to social class were obtained... more
This study reports the variation in perinatal problems related to social class in one area in Finland. Data on length of gestation, birthweight, one-minute Apgar score, and need for special care in relation to social class were obtained from a large clinical trial (n = 2912) on iron prophylaxis during pregnancy. Social class was determined from the woman's own occupation and education. Occupation was obtained from the women themselves and classified as upper white collar, lower white collar I, lower white collar II, and workers; entrepreneurs, students and women with no information were excluded. Education was obtained by record linkage to the national education register, and all women were classified by the years normally required to attain a certain level: greater than or equal to 13, 12, 10-11, and less than or equal to 9 years of education. Adjusted for age and parity, a week U-shaped curve was found for gestation length and birthweight, best results being found for the women in the second highest social class. The lower the social class, the more infants with poor Apgar scores. As potential intervening variables we studied marital status, pre-pregnancy weight, smoking, and haematocrit in the 28th week of pregnancy. Their inclusion in multivariate analyses influenced only slightly the differences in perinatal problems between the groups. Our results suggest that in Finland there are still differences in perinatal problems between social classes, but that the relationship is not always linear.
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ABSTRACT ABST R A C T The aim of this study was to analyse how Finnish infertility physicians talk about children by conducting semi-structured theme interviews. It is of general interest to study how children are represented in the age... more
ABSTRACT ABST R A C T The aim of this study was to analyse how Finnish infertility physicians talk about children by conducting semi-structured theme interviews. It is of general interest to study how children are represented in the age of assisted reproduction technologies (ARTs), a time when the medical solution to childlessness is preferred over other solutions. Infertility physicians' discourses on children are of particular interest because they are the ones who try to produce children for couples. An understanding of professional agency is crucial to the understanding of how, why and in what context women make reproductive choices. The physicians considered the rst choice for infertile couples to be to have their own biological child, with the second choice being to have a child with the help of donated Finnish gametes or embryos, and the last option being to adopt a child. The socially most desirable children were considered to be genetically and culturally Finnish, white and newborn, and therefore likely to be more healthy and socially acceptable than the adopted child who represents the Other, the socially less appropriate child. The adopted child is usually of foreign cultural and family origins, non-white, older and likely to temporarily have compromised mental and physical health. In this sense some doctors felt that the use of a donated Finnish embryo in IVF is more secure in terms of a child's 'quality'. The physicians' negative talk about adopted children draws lines between us and strangers, between those outside and inside the borders of nations and families. A key value was the ability to know about and thus control the genetic and social characteristics of the child.