Gustaf III inför sina undersåtar : Konsten att härska och politikens kulturhistoria

The dissertation analyses the political culture of Sweden during the reign of King Gustav III (1771-1792). This period commonly referred to as the Gustavian era followed the so-called Age of Liberty ending half a century of strong parliamentary rule in Sweden. The question at the heart of this study engages with the practice of monarchical rule under Gustav III, its ideological origins and power-political objectives as well as its symbolic expression. The study thereby addresses the very nature of kingship. In concrete terms, why did Gustav III, his court, and his civil service vigorously pursue projects that contemporaneous political opponents and, in particular, subsequent historiography have variously pictured as irrelevant, superficial, or as products of pure vanity? The answer, the study argues, is to be found in patterns of political practice as developed and exercised by Gustav III and his administration, which formed a significant part of the political culture of Gustavian Sweden. The dissertation is divided into three parts. The first traces the use and development of royal graces chivalric orders, medals, titles, privileges, and other gifts issued by the king. The practice of royal reward is illustrated through two case studies: the 1772 coup d état that established Gustav III s rule, and the birth and baptism of the crown prince, Gustav Adolf, in 1778. The second part deals with the establishment of the Court of Appeal in Vasa in 1776. The formation of the Appeals Court was accompanied by a host of ceremonial, rhetorical, emblematic, and architectural features solidifying its importance as one of Gustav III s most symbolic administrative reform projects and hence portraying the king as an enlightened monarch par excellence. The third and final part of the thesis engages with war as a cultural phenomenon and focuses on the Russo-Swedish War of 1788-1790. In this study, the war against Russia is primarily seen as an arena for the king and other players to stage, create and re-create as well as articulate themselves through scenes and roles adhering to a particular cultural idiom. Its codes and symbolic forms, then, were communicated by means of theatre, literature, art, history, and classical mythology. The dissertation makes use of a host of sources: protocols, speeches, letters, diaries, newspapers, poetry, art, medals, architecture, inscriptions and registers. Traditional political source material and literary and art sources are studied as totalities, not as separate entities. Also it is argued that political and non-fictional sources cannot be understood properly without acknowledging the context of genre, literary conventions, and artistic modes. The study critically views the futile, but nonetheless almost habitual juxtaposition of the reality of images, ideas, and metaphors, and the reality of supposedly factual historical events. Significantly, the thesis presumes the symbolic dimension to be a constitutive element of reality, not its cooked up misrepresentation. This presumption is reflected in a discussion of the concept of role , which should not be anachronistically understood as roles in which the king cast himself at different times and in different situations. Neither Gustav III nor other European sovereigns of this period played the roles as rulers or majesties. Rather, they were monarchs both in their own eyes and in the eyes of their contemporaries as well as in all relations and contexts. Key words: Eighteenth-Century, Gustav III, Cultural History, Monarchs, Royal Graces, the Vasa Court of Appeal, the Russo-Swedish War 1788–1790.

"Kirjailijoiden tapaus" Venäjällä vuonna 1997

In the autumn of 1997, Russian government was faced with media pressure when owners of the TV channels ORT and NTV joined forces against it. This study is based on media sources from October 1997 to December 1997. It shows clearly how the enormous power of the media was able to dictate what happened in Russia. In the mid-1990s Russians started to talk about political technology, which became a commonly used term by professionals, journalists, politicians and intelligence services. As a result of this action, two leading reformers in the government, Anatoliy Chubais and Boris Nemtsov, were dismissed from their highly influential posts as finance and energy ministers respectively, but retained their power as first deputy prime ministers. According to the correspondents, the real reason was to resolve a conflict within the parliament, which had demanded the dismissal of Mr. Chubais. This demand was presented after Chubais had accepted $90,000 as a reward for co-writing a book on privatization. Chubais was considered to be Russia’s “business card” towards the west – the"Authors’ case" (Delo avtorov) was only solved after President Boris Yeltsin took part in the public debate. According to the research, the media owned by powerful businessmen Boris Berezovsky and Vladimir Gusinski, was able to use its own security services to expose sensitive material (Russian term ‘kompromat’), if necessary, concerning any given person. The so-called Authors’ case can be considered as a part of the battle and the tip of the iceberg in arrangements designed to organize the funding of the Russian presidential election campaign in 2000. The reason why this particular incident was so widely covered on television was because several programs aimed to reveal to the public "hidden bribes" that, as they claimed, government officials had received. The political aspect, however, was quite mild, when the concrete issues of possible dismissals of Ministers were debated in the Parliament. Everything was dealt with as a “family matter” inside Kremlin. Yeltsin's "family" consisted of practically anybody from oligarch Berezovsky to Chubais, the father of Russia's privatization policy. Methods of critical history implementation analysis has been used in this research in determining the use of the source material. Literature and interviews have also provided a good base for the study. The study proves that any literature dealing with the subject has not paid enough attention to how the dismissal of Alexander Kazakov, deputy of President’s administration, was linked directly with Gazprom, the state gas monopoly. Kazakov had to leave Gazprom and lose his position as Chubais' ally when the influential ORT television company was deteriorated.

Work Stress and Early Atherosclerosis: Do Genetic Background and Pre-Employment Risk Factors Explain Conflicting Findings?

According to the models conceptualizing work stress, increased risk of health problems arise when high job demands co-occur with low job control (the demand-control model) or the efforts invested by the employee are disproportionately high compared to the rewards received (effort-reward imbalance model). This study examined the association between work stress and early atherosclerosis with particular attention to the role of pre-employment risk factors and genetic background in this association. The subjects were young healthy adults aged 24-39 who were participating in the 21-year follow-up of the ongoing prospective "Cardiovascular Risk in Young Finns" study in 2001-2002. Work stress was evaluated with questionnaires on demand-control model and on effort-reward model. Atherosclerosis was assessed with ultrasound of carotid artery intima-media thickness (IMT). In addition, risk for enhanced atherosclerotic process was assessed by measuring with heart rate variability and heart rate. Pre-employment risk factors, measured at age 12 to 18, included such as body mass index, blood lipids, family history of coronary heart disease, and parental socioeconomic position. Variants of the neuregulin-1 were determined using genomic DNA. The results showed that higher work stress was associated with higher IMT in men. This association was not attenuated by traditional risk factors of atherosclerosis and coronary heart disease or by pre-employment risk factors measured in adolescence. Neuregulin-1 gene moderated the association between work stress and IMT in men. A significant association between work stress and IMT was found only for the T/T genotype of the neuregulin-1 gene but not for other genotypes. Among women an association was found between higher work stress and lower heart rate variability, suggesting higher risk for developing atherosclerosis. These associations could not be explained by demographic characteristics or coronary risk factors. The present findings provide evidence for an association between work stress and atherosclerosis in relatively young population. This association seems to be modified by genetic influences but it does not appear to be confounded by pre-employment adolescent risk factors.

Tohtoriksi tulemisen tarina

The study examines the dissertation process. The thesis is based on twenty-three autobiographical stories. They were collected from PhDs who had taken their doctoral degrees at the University of Helsinki. The purpose is to investigate the experiences of these PhD recipients and find out what they recall of the events, traditions, and meanings associated with their PhD studies. An anthology collected from PhDs in the historical sciences, which was published in 1998, was used as reference material. This study begins with a general presentation of the history and values of the university and the traditions of the academic community in Finland. Thereafter, the data and the methodological framework of the study are presented. Attention is paid to the discipline background, sex and age of these PhDs, which may have affected their storytelling. The former studies concerning the academic life together with the experiences of the writers revealed that the process of becoming a PhD graduate is generally considered as an academic rite of passage. The change from student status to becoming a fully accepted professional member of one’s field is real, transforming and at certain points, ritualized. The finding of an inner logic to the doctoral process, which included meaningful turning points, was central to the narrative analysis approach. During the process there were different kinds of struggles and highlights. The family background, university studies and time in employment had directed the doctoral studies of some PhD students enormously. But generally the most memorable and value laden were the phases of actually writing the dissertation, the public examination, and the celebration party in the evening called “karonkka”. The picture that emerged from these various life-stories demonstrated that there was no ivory tower where doctoral candidates live an isolated existence. Everyday cares in ordinary life and tasks in academic life are both demanding and rewarding at the same time. The main point is that the academic community in general and PhD supervisors in particular should concentrate not only on the thesis-writing process their students but also on the doctoral students´ wider life situation. Doctoral students need scientific, financial, and mental support. Somebody must be available to inspire and offer encouragement otherwise the process will be disturbed. The successful completion of the PhD ritual gives the PhD graduate self-confidence and respect but its’ influence on the doctors’ subsequent academic career is diverse. The dissertation process is a personal and unique experience. The aim of the PhD graduation is that this traditional ritual leads to a successful completion and ensures a positive reward for the PhD graduate and the academic community. Keywords: autobiography, narratives, academic traditions, PhD graduates.

Childhood and adolescent antecedents of work stress and early atherosclerosis

Work stress is after musculoskeletal disorders the second most common work-related health problem in the European Union, affecting 28% of EU employees. Furthermore, a 50% excessive cardiovascular disease risk among employees with work stress is reported. High job demands combined with low job control according to the Job Demands-Job Control model, or high effort combined with low rewards according to Effort-Reward Imbalance model, are likely to produce work stress in the majority of employees. Atherosclerotic wall thickening is a validated marker of an increased risk of cardiovascular disease. This study examined the role of childhood and adolescent factors as antecedents of work stress and early atherosclerosis, and in the relationship between them. The Cardiovascular Risk in Young Finns Study, (the CRYF project) started in 1980 when the participants were at the age of three to 18 years. Follow-ups have been conducted every three years until 1992, after that in 1997 and 2001, and the latest is ongoing in 2008. The participants parents reported their socioeconomic position in 1980 and 1983, and their life satisfaction in 1983. Biological risk factors were measured in 1980 and 2001. Type A behaviour was reported in 1986, 1989 and 2001. In the 2001 follow-up when the participants were aged 24 to 39, work stress was assessed from responses to questionnaires on job demands-job control and effort-reward imbalance, and education. Ultrasound measurement of the carotid intima-media thickness (CIMT) was used to assess atherosclerosis. There were 755, 746, 1014 and 494 participants in studies I-IV, respectively. The results showed that low parental socioeconomic position and parental life dissatisfaction during childhood and adolescence predicted higher levels of job strain 18 years later, and that education mediated the relationship between parental socioeconomic position and job strain. Childhood and adolescent family factors were not related to the effort-reward imbalance. Parental life satisfaction was associated with high rewards at work among the men, and high parental socioeconomic position was associated with high reward among the women. Among the men, the eagerness-energy component of Type A behaviour across different developmental periods predicted increased CIMT. Among the women, hard-driving component of Type A behaviour predicted decreased CIMT. Low leadership characteristic in adolescence and early adulthood was associated with both high job strain and increased CIMT, and attenuated the relationship between job strain and CIMT to non-significance in men. The current findings add to the literature on the relationship between job strain and health literature in adopting a developmental perspective. The results imply that work stress does not completely originate from work. There are childhood and adolescent environmental and dispositional effects on work stress and CIMT several years later, and these partly seem to operate through educational attainment.

Cloningerin psykobiologisen teorian temperamenttipiirteiden yhteys alkoholinkäyttöön nuorilla aikuisilla

The temperamental traits of Cloninger’s personality theory (novelty seeking, harm avoidance, reward dependence and persistence) reflect independent systems of central nervous system deciding responses toward new, rewarding and aversive stimuli. Thus, certain temperamental traits and their combinations may predispose to heavy drinking and alcohol dependence. Hence, the aim of the present study was to investigate associations between temperamental traits and the amount of alcohol consumption, frequency of heavy drinking and the maximum number of drinks per occasion. In this study, we investigated also whether these associations are only confounded by between-family differences in genetic and environmental factors. Furthermore the associations between temperamental trait combinations that reflect Cloninger's typology of alcoholism and alcohol use were studied. The subjects (n=401) in the current study were a group of FinnTwin16 study participators, Finnish twins born in 1974-79. Temperament was measured with TCI-R (Temperament and Character Inventory-Revised) a self-report form. The amount of alcohol consumption was asked by Semi-structured interview (Semi-Structured Assessment of Genetics of Alcoholism = SSAGA). The frequency of heavy drinking and maximum number of drinks per occasion were asked by mail form. In accordance with previous studies, novelty seeking had a positive relationship with the amount of alcohol consumption, frequency of heavy drinking and the maximum number of drinks per occasion in both genders. In this study, the association was proven independent of between-family differences in genetic and environmental factors that are associated to both novelty seeking and alcohol use. Surprisingly, reward dependence was negatively related to the maximum number of drinks per occasion in both genders. Persistence had a weak positive relationship with maximum number of drinks per occasion in men. The temperamental trait combinations that reflect Cloninger's typology of alcoholism did not differ from the other combinations in regard to alcohol use as hypothesized. The results confirm the previous finding about the relationship between novelty seeking and alcohol use. Support for Cloninger's typology of alcoholism in regard to combinations of temperamental trait was not achieved in this study.

Interactions of nandrolone and psychostimulant drugs on central monoaminergic systems

It has been hypothesized that abuse of supra-therapeutic doses of anabolic androgenic steroids (AASs) can lead to dependence and function as a gateway to abuse of other drugs. This is supported by behavioral studies on animal models and psychiatric evaluations of human subjects, although their neurochemical effects remain largely unknown. A large body of evidence suggests that the ability of the drugs to induce a strong elevation of extracellular dopamine (DA) levels in the nucleus accumbens (NAc), especially, plays a crucial role in their reinforcing effects. -- This study had four main aims. The first was to explore the effects of nandrolone decanoate on dopaminergic and serotonergic activities in the brains of rats. The second aim was to assess whether or not nandrolone pre-exposure modulates the acute neurochemical and behavioral effects of psychostimulant drugs in experimental animals. The third was to investigate if the AAS-pre-treatment induced changes in brain reward circuitry are reversible. And the fourth main goal was to evaluate the role of androgen and estrogen receptors in the modulation of the dopaminergic and serotonergic effects of acute injections of stimulant drugs by sub-chronic nandrolone treatment. The results showed that nandrolone decanoate at doses, high enough to induce erythropoiesis, significantly increased the levels of DOPAC and 5-HT in the cerebral cortex. Co-administration of AAS and psychostimulant drugs showed that the increase in extracellular DA and 5-HT concentration evoked by amphetamine, MDMA and cocaine in the NAc was attenuated dose-dependently by pretreatment with nandrolone. Nandrolone pre-exposure also attenuated the ability of stimulants to cause increased stereotyped behavior and locomotor activity. Despite the significant decrease in nandrolone concentration in blood, the attenuation of cocaine’s effects remained unchanged after a fairly long period without nandrolone, suggesting that nandrolone effects could be long lasting. Blockade of androgen receptors with flutamide abolished the attenuating effect of nandrolone pretreatment on amphetamine-induced elevation of extracellular DA concentration. --- In conclusion, the results show that AAS-pretreatment is able to inhibit the reward-related neurochemical and behavioral effects of amphetamine, MDMA and cocaine in experimental animals. Furthermore, it seems that these effects could be long lasting and it appears that the ability of nandrolone to modulate reward-related effects of stimulants is dependent on activation of androgen receptors.

Regulation of GABAergic neuron identity and diversity in the developing midbrain

Gamma-aminobutyric acid (GABA) is the most abundant inhibitory neurotransmitter in the vertebrate brain. In the midbrain, GABAergic neurons contribute to the regulation of locomotion, nociception, defensive behaviours, fear and anxiety, as well as sensing reward and addiction. Despite the clinical relevance of this group of neurons, the mechanisms regulating their development are largely unknown. In addition, their migration and connectivity patterns are poorly characterized. This study focuses on the molecular mechanisms specifying the GABAergic fate, and the developmental origins of midbrain GABAergic neurons. First, we have characterized the function of a zink-finger transcription factor Gata2. Using a tissue-specific mutagenesis in mouse midbrain and anteror hindbrain, we showed that Gata2 is a crucial determinant of the GABAergic fate in midbrain. In the absence of Gata2, no GABAergic neurons are produced from the otherwise competent midbrain neuroepithelium. Instead, the Gata2-mutant cells acquire a glutamatergic neuron phenotype. Ectopic expression of Gata2 was also sufficient to induce GABAergic in chicken midbrain. Second, we have analyzed the midbrain phenotype of mice mutant for a proneural gene Ascl1, and described the variable and region-dependent requirements for Ascl1 in the midbrain GABAergic neurogenesis. These studies also have implications on the origin of distinct anatomical and functional GABAergic subpopulations in midbrain. Third, we have identified unique developmental properties of GABAergic neurons that are associated with the midbrain dopaminergic nuclei, the substantia nigra pars reticulata (SNpr) and ventral tegmental area (VTA). Namely, the genetic regulation of GABAergic fate in these cells is distinct from the rest of midbrain. In accordance to this phenomenon, our detailed fate-mapping analyses indicated that the SNpr-VTA GABAergic neurons are generated outside midbrain, in the neuroepithelium of anterior hindbrain.

Predictors of violent reconvictions and mortality among impulsive alcoholic violent offenders: A prospective study

Acts of violence lays a great burden on humankind. The negative effects of violence could be relieved by accurate prediction of violent recidivism. However, prediction of violence has been considered an inexact science hampered by scare knowledge of its causes. The study at hand examines risk factors of violent reconvictions and mortality among 242 Finnish male violent offenders exhibiting severe alcoholism and severe externalizing personality disorders. The violent offenders were recruited during a court-ordered 2-month inpatient mental status examination between 1990—1998. Controls were 1210 individuals matched by sex-, age-, and place of birth. After a 9-year non-incarcerated follow-up criminal register and mortality data were obtained from national registers. Risk analyses were applied to estimate odds and relative risk for recidivism and mortality. Risk variables that were included in the analyses were antisocial personality disorder (ASPD), borderline personality disorder (BPD), a comorbidity of ASPD and BPD, childhood adversities, alcohol consumption, age, and monoamine oxidase A (MAOA) genotype. In addition to risk analyses, temperament dimensions (Tridimensional Personality Questionnaire [TPQ]) were assessed. The prevalence of recidivistic acts of violence (32%) and mortality (16%) was high among the offenders. Severe personality disorders and childhood adversities increased the risk for recidivism and mortality both among offenders (OR 2.0–10.4) and in comparison between offenders and controls (RR 4.3–53.0). Offenders having BPD and a history of childhood maltreatment emerged as a group with a particularly poor prognosis. MAOA altered the effects of alcohol consumption and ageing. Alcohol consumption (+2.3%) and age (–7.3%) showed significant effects on the risk for violent reconvictions among the high activity MAOA (MAOA-H) offenders, but not among the low activity MAOA (MAOA-L) offenders. The offenders featured temperament dimensions of high novelty seeking, high harm avoidance, and low reward dependence matching Cloninger’s definition of explosive personality. The fact that the risk for recidivistic acts of violence and mortality accumulated into clearly defined subgroups supports future efforts to provide for evidence based violence prevention and risk assessments among violent offenders.

Open Access to Scientific Publications – An Analysis of the Barriers to Change?

One of the effects of the Internet is that the dissemination of scientific publications in a few years has migrated to electronic formats. The basic business practices between libraries and publishers for selling and buying the content, however, have not changed much. In protest against the high subscription prices of mainstream publishers, scientists have started Open Access (OA) journals and e-print repositories, which distribute scientific information freely. Despite widespread agreement among academics that OA would be the optimal distribution mode for publicly financed research results, such channels still constitute only a marginal phenomenon in the global scholarly communication system. This paper discusses, in view of the experiences of the last ten years, the many barriers hindering a rapid proliferation of Open Access. The discussion is structured according to the main OA channels; peer-reviewed journals for primary publishing, subject- specific and institutional repositories for secondary parallel publishing. It also discusses the types of barriers, which can be classified as consisting of the legal framework, the information technology infrastructure, business models, indexing services and standards, the academic reward system, marketing, and critical mass.

Ways of Explaining Workplace Bullying: A Review of Enabling, Motivating, and Precipitating Structures and Processes in the Work Environment

This paper summarizes literature explaining workplace bullying and focuses on organisational antecedents of bullying. In order to better understand the logic behind bullying, a model discussing different types of explanations is put forward. Thus, explanations for and factors associated with bullying are classified into three groups, i.e. enabling structures or necessary antecedents (e.g. perceived power imbalances, low perceived costs, and dissatisfaction and frustration), motivating structures or incentives (e.g. internal competition, reward systems, and expected benefits), and precipitating processes or triggering circumstances (e.g. downsizing and restructuring, organisational changes, changes in the composition of the workgroup). The paper concludes that bullying is often an interaction between structures and processes from all three groupings.

Talouskäsitysten vaikutus hallituksen suosioon Puolassa 2006–2007

Tutkimuksessa tarkastellaan äänestäjien talouskäsitysten vaikutusta hallituksen suosioon Puolassa vuosina 2006 ja 2007. Tutkimusasetelma juontaa juurensa poliittisten suhdannevaihteluiden teoriaan, jonka mukaan poliitikot pyrkivät manipuloimaan taloutta vaalien alla tullakseen uudelleen valituiksi. Vastuullisuushypoteesin mukaan äänestäjät palkitsevat poliitikot hyvästä taloustilanteesta. Näin ollen mikäli äänestäjät ovat tyytyväisiä talouteen he äänestävät hallitusta. Mikäli eivät, he äänestävät oppositiota. Miten äänestäjät sitten tekevät arvionsa taloudesta? Tutkielmassa selvitetään vaikuttiko äänestäjien mielipiteisiin käsitys nykyisestä vai tulevaisuuden taloustilanteesta. Käsitys nykyisestä taloustilanteesta perustuu havaintoihin jo toteutuneesta talouspolitiikasta. Tätä käsitystä kutsutaan retrospektiiviseksi näkemykseksi. Prospektiiviset talousnäkemykset koostuvat näkemyksestä ja odotuksista talouden tulevasta tilasta ja uskosta hallituksen kykyyn tarjota paras vaihtoehto suotuisalle talouskehitykselle. Aikaulottuvuuden lisäksi tutkielmassa testataan, vaikuttaako äänestäjiin enemmän heidän oma taloustilanteensa vai näkemys yleisestä talouden tilanteesta. Mikäli hallituksen suosio perustuu näkemyksiin henkilökohtaisen talouden tilasta, ovat äänestäjät egotrooppisia. Mikäli kannatuspäätös perustuu näkemykseen kansantalouden tilasta, ovat äänestäjät puolestaan sosiotrooppisia. Aineistona tutkielmassa käytetään uusinta saatavilla olevaa Puolan mielipidetiedustelun (Centrum Badania Opinii Publicznej) keräämää kyselyaineistoa vuosilta 2006 ja 2007. Tutkielmassa on yhdistetty kyselyaineistot 22:n kuukauden ajalta. Aineistoa on analysoitu logistisen regressioanalyysin menetelmin. Tutkielman perusteella talousnäkemyksistä suurin vaikutus hallituksen suosioon on äänestäjien näkemyksillä kansantalouden tulevaisuuden tilasta. Henkilökohtaisen talouden osalta positiiviset tulevaisuudennäkymät vaikuttavat positiivisesti myös hallituksen kannatukseen. Retrospektiivinen arvio henkilökohtaisesta taloudesta toimii kuitenkin teorian vastaisesti; oman taloudellisen tilanteen hyväksi arvioineiden todennäköisyys kannatta hallitusta oli pienempää kuin niillä, jotka arvioivat oman taloustilanteensa huonoksi. Kontrollimuuttujiksi valittiin joukko aiemmassa tutkimuksessa äänestyskäyttäytymiseen Puolassa vaikuttaneita tekijöitä. Näitä olivat ikä, sukupuoli, koulutus, asuinpaikka, näkemys työllisyystilanteesta, ideologinen sijoittuminen oikeisto–vasemmisto-akselilla sekä uskonnollisuus. Kontrollimuuttujista merkitseviksi osoittautuivat uskonnollisuus, oikeisto–vasemmisto-ideologia, koulutus, asuinpaikka sekä ikä. Kun edellä mainitut taustamuuttujat on kontrolloitu, taloustekijät selittävät noin viidesosan hallituksen kannatuksen todennäköisyyden vaihtelusta.

Pilottitutkimus apteekkien yksilöllisestä tupakoinninvieroituspalvelusta

Apteekkien yksilöllinen tupakoinninvieroituspalvelu on tupakoinnin lopettamiseen motivoituneille asiakkaille tarkoitettu maksullinen erikoispalvelu, joka sisältää 4–6 tapaamista vieroitusohjaajana toimivan farmaseutin tai proviisorin kanssa. Palvelu sisältää asiakkaalle räätälöityä neuvontaa, henkilökohtaisen vieroitussuunnitelman sekä seurantajakson. Apteekkien yksilöllinen tupakoinninvieroituspalvelu perustuu Isossa-Britanniassa kehitettyyn palvelumalliin, ja sitä on tarjottu suomalaisissa apteekeissa vuodesta 2006. Tämä pro gradu -tutkielma käsittelee apteekkien yksilöllisen tupakoinninvieroituspalvelun pilottitutkimusta, joka toteutettiin Suomen Apteekkariliiton ja Helsingin yliopiston farmasian tiedekunnan sosiaalifarmasian osaston yhteistyönä ja se kuului osana Hengitysliitto Heli ry:n koordinoimaa tupakasta vieroituksen hankekokonaisuutta. Tässä pro gradu -tutkielmassa tarkastellaan pilottitutkimuksessa saadun asiakasaineiston avulla apteekkien yksilöllisen tupakoinninvieroituspalvelumallin toimivuutta, asiakkaiden kokemuksia palvelusta, asiakkaiden onnistumista tupaakoinnin lopettamisessa sekä asiakkaiden kyvykkyyden tunteen kehittymistä palvelun aikana. Tässä interventiotutkimuksessa oli mukana 14 apteekkia, jotka rekrytoivat yhteensä 36 palveluasiakasta. Ennen asiakkaiden rekrytointia apteekit perehdytettiin palvelun tarjoamiseen. Apteekit tiedottivat pilottitutkimuksesta paikallisen terveydenhuollon lääkäreitä ja muita terveydenhuollon ammattilaisia, jotka voivat ohjata asiakkaita palveluun. Sosiaali- ja terveysministeriön pilottitutkimukselle myöntämä rahoitus mahdollisti asiantuntijapalkkion maksamisen apteekeille ja palvelun tarjoamisen asiakkaille ilmaiseksi tai pientä omakustannusosuutta vastaan. Asiakkaiden tupakoimattomana pysymistä sekä kokemuksia tupakoinninvieroituspalvelusta kartoitettiin kyselylomakkeilla, jotka asiakkaat saivat täytettäväkseen palvelun alussa sekä noin 3 kuukauden kohdalla palvelun alkamisesta. Asiakkaiden taustatiedot kerättiin ensimmäisen tapaamisen yhteydessä erillisille taustatietolomakkeille ja palvelun aikana tehtyjä huomioita niille tarkoitetuille kaavakkeille. Ensimmäisen kyselylomakkeen palauttaneista 28 henkilöstä 20 ja toisen kyselylomakkeen palauttaneista 17 henkilöstä 13 oli pysynyt tupakoimattomana (55,6 % ja 36,1 % kaikista asiakkaista). Kaikki tupakoinnin lopettaneet käyttivät jotakin tupakasta vieroituslääkettä. Tupakoinnin lopettaneilla asiakkailla kyvykkyyden tunne oli keskimääräistä parempi sekä palvelun alussa että koko palvelun ajan. Asiakkaat pitivät palvelua tarpeellisena ja apteekin vieroitusohjaajalta saatua tukea tärkeänä. Asiakkaat kokivat myös palvelun saamisen apteekista tärkeäksi. Noin 32 % ensimmäiseen kyselyyn vastanneista ja 41 % toiseen kyselyyn vastanneista oli valmis maksamaan palvelusta. Heidän ilmoittamansa maksuvalmius oli keskimäärin noin 45 euroa (10–100 euroa). Muusta terveydenhuollosta lähetettiin palveluun vain vähän tai ei lainkaan asiakkaita. Tästä syystä apteekit rekrytoivat asiakkaita myös ilman kontaktia muuhun terveydenhuoltoon. Palvelun 36 asiakkaasta noin 36 % oli pysynyt tupakoimattomana 3 kuukauden kohdalla. Verrokkiryhmä jouduttiin jättämään tutkimuksesta pois verrokkihenkilöiden rekrytoinnin epäonnistuttua. Tulos on kuitenkin vertailukelpoinen kansainvälisiin tutkimuksiin, joissa on saatu vastaavanlaisia tuloksia. Apteekkien yksilöllisestä tupakoinninvieroituspalvelusta saattaa olla hyötyä tupakoinnin lopettamisessa siihen motivoituneille henkilöille ja erityisesti henkilöille, jotka käyttävät lisäksi tupakasta vieroituslääkettä. Asiakkaat kokivat palvelun tärkeäksi ja tarpeelliseksi, mutta heikko maksuvalmius asettaa haasteita palvelun tarjoamiselle apteekeissa. Yhteistyömallia muun terveydenhuollon kanssa tulisi kehittää.