Actors involved in the regulation of clinical research : comparison of Finland to England, Canada, and the USA

Background: The relevance and quantity of clinical research has caused concern and regulation is claimed to hinder clinical research. This paper compares clinical research regulations in Finland to those of England, Canada, and the USA around 2010-2011. Methods: Several approaches and data sources were used, including semi-or unstructured interviews of experts. For the analysis, a theoretical framework was made, data from various sources was synthesized, and features of the systems were simplified and classified. The various specific names and terms used in the data were changed into general ones. Results: Common structures for the regulation existed in all four countries, but the details and scope varied. The research regulated within the main system was determined by research type (Finland), the financer of the health system (England), or research site (Canada, USA). Only Finland had specific legislation on medical research. The overriding impression of the regulatory systems was one of complexity. All countries had extra regulation for drug research. The types of drug research covered varied from trials with unlicensed (new) products or new indications (USA and Canada), to all types of interventional drug research (England), where 'interventional' was interpreted broadly (Finland). The complexity of regulations had led to the creation of various big and small businesses to help researchers and sponsors. There was notable variation in the role played by the public research funder. The role played by health care was difficult to study and seemed to involve varying interests as researchers were also health care employees. Research ethics committees were important and their tasks also included aspects other than ethics. Conclusions: This study revealed that a comparison between countries can provide useful insights into the distinctive aspects of each country's system, as well as identifying common features that require international action.Peer reviewe

Eesti arstide arusaamu üleminekueast ja vastutuse jagunemisest selle käsitlemisel

Üheks oluliseks naiste tervishoiu valdkonnaks on üleminekueaga kaasnevate häirete käsitlus ja ravi. Arstide suhtumine klimakteeriumisse ja ravi vajalikkusesse sellel perioodil on erinev. Samuti pole selge, kas klimakteerilisi häireid peaks ravima günekoloog või perearst. Artiklis on analüüsitud Eesti naistearstide ja perearstide suhtumist üleminekueasse, nende hinnanguid erinevate ravimeetodite, omavahelise tööjaotuse ja erialase koolituse kohta. Eesti Arst 2002; 81 (11): 705–70

Postponing Births – Comparing Reasons Among Women in St Petersburg, Estonia and Finland

We compared the reasons for postponing first birth in the three neighbouring areas of St Petersburg (Russia), Estonia and Finland. Data from three population-based surveys among women aged 18–44 years in St Petersburg (response rate 67%); Estonia (54%) and Finland (63%) in the early 2000s were used and analysed with logistic regressions. Childbearing intentions and reasons for postponing parenthood differed between both study areas and age groups. The proportion of women aged 35–44 still planning to have children was highest in Estonia. In the two post-Soviet areas, job insecurity increased postponement intentions among women aged 18–34 years. Enrolment in education was an important reason for postponement among women below 35 years in Estonia and aged 25–34 years in St Petersburg. In Finland, poor economic situation in the youngest age group and desire to advance a career among all women were important reasons to postpone birth. The importance of prolonged education and job insecurity for the timing of births in St Petersburg and Estonia suggests that governments should improve family policy measures to encourage childbearing among the young. In Finland policies to support the reconciliation of family and career and to increase permanent employment could promote parenthood among well-educated women

Eesti naistearstide ja perearstide arusaamu vastutuse jagunemisest naiste tervise probleemidega tegelemisel

Seoses perearstisüsteemi juurutamisega Eestis on paljudel meditsiinierialadel esile kerkinud küsimus, kuidas jaotada töövaldkondi perearsti ja erialaspetsialisti vahel. Seejuures on oluliseks aspektiks, millisel määral suudavad perearstid hakkama saada küsimustega, mis varem kuulusid eriarstide kompetentsi. Artiklis on selgitatud naiste- ja perearstide arusaamu omavahelisest tööjaotusest naiste tervishoiu alal, nende hinnanguid üld- ja erialasele ettevalmistusele ning täienduskoolituse vajadusele. Eesti Arst 2002; 81 (11): 700–70

Reproductive health and sexuality in St. Petersburg: Report of a survey of young men in 2003

The report is a result of collaborative study conducted by Russian and Finnish researchers covering various aspects of reproductive health and family formation. The Reproductive Health and Fertility project aims to provide useful data for solving current health and social problems in the study areas, as well as to increase understanding of the determinants of reproductive health and family formation in general. The survey of St. Petersburg young men is just one of the study instruments. The same questions have been presented to women aged 18-44 years in St. Petersburg and Estonia, and a survey on Estonian men is planned. Most questions have been previously used in Finnish surveys. Various other data collections have been made or are being planned

Socioeconomic differences in self-rated health among women : a comparison of St. Petersburg to Estonia and Finland

Peer reviewe

Kokeelliset tutkimukset sosiaalilääketieteessä

Tausta. Koe on kliinisen tutkimuksen perusasetelma, mutta vähemmän käytetty sosiaalilääketieteessä. Kokeellinen tutkimus. Tutkijan määräämä interventio määrittää tutkimuksen kokeelliseksi. Vertailukelpoisuuden vuoksi pyritään satunnaistamiseen ryhmiin jaossa. Kokeelliset tutkimukset on usein jaettu mekanistiseen ja käytännölliseen. Kokeellisella terveydenhuoltotutkimuksella (KTT) tarkoitamme tutkimusta, joka asettuu käytännöllisen tutkimuksen ja kehittämisinterventioiden välimaastoon. KTT:tä ja sen alatyyppejä on kutsuttu useilla nimillä. Tyypillisiä piirteitä ovat tutkimuksen tilannesidonnaisuus, ryhmä tai organisaatio tutkimusyksikkönä ja havaintojen synty sivutuotteena. KTT poikkeaa kliinisistä kokeista eettiseltä normistoltaan, hallinnoltaan, toteutukseltaan ja rahoitukseltaan. Jatkossa. Suomessa on hyvät edellytykset terveydenhuollon kokeellisen tutkimukseen, mutta tarvitaan opetusta, asenteisiin vaikuttamista sekä tutkimussäädösten ja niiden tulkinnan muutosta. Kustannuksia voi pienentää integroimalla tutkimukset palvelujärjestelmään ja keräämällä lopputulostiedot rutiinitiedostoista