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INTRODUCTION The underlying factors of oral squamous cell cancers (OSCC) have been elucidated, but studies have focused little on etiological differences in affected oral cavity sites. The aim of this retrospective study was to clarify the role of carcinogen exposure in OSCC of different oral cavity areas. METHODS A cross-sectional study of patients with primary OSCC was conducted retrospectively, based on patient records from Helsinki University Hospital, Finland, between January 2016 and December 2020. The patients' self-reported history of tobacco smoking and alcohol use was explained by tumor site, age, sex, tumor size, and lymph node status in a logistic regression model. The information on smoking and alcohol use was compiled from a patient background form. RESULTS In 519 patients, tumors occurred most often in the tongue (51%), gingiva (21%), or floor of the mouth (FOM; 15%). FOM had 26-fold greater odds for a history of smoking and alcohol use than other tumor sites (OR=25.78; 95% CI: 8.02-82.95; p<0.001). Gingival and buccal sites were associated significantly less with smoking and alcohol use (OR=0.43, 95% CI: 0.28-0.67; p<0.001 and OR=0.47; 95% CI: 0.25-0.92; p<0.026, respectively). Patients of older age were less likely to have a history of smoking and alcohol use (AOR=0.95; 95% CI: 0.94-0.97; p<0.001) than younger patients. Tumor size (T3-4) and FOM increased the odds for history of smoking and alcohol use (AOR=1.73; 95% CI: 1.15-2.60; p=0.009 and AOR=26.15; 95% CI: 8.01-84.84; p<0.001, respectively). CONCLUSIONS OSCC of oral cavity sites has notable differences in etiology. FOM seems to be related almost exclusively to conventional smoking and heavy alcohol use. [ABSTRACT FROM AUTHOR]

Healthy lifestyle is one of the most important factors in the prevention of premature deaths, chronic diseases, productivity loss, obesity, and other economic and social aspects. The workplace plays an important role in promoting the physical activity and wellbeing of employees. Previous studies are mostly focused on individual interviews, various questionnaires that are a conceptual information about individual health state and might change according to question formulation, specialist competence, and other aspects. In this paper the work ability was mostly related to the employee's physiological state, which consists of three separate systems: cardiovascular, muscular, and neural. Each state consists of several exercises or tests that need to be performed one after another. The proposed data transformation uses fuzzy logic and different membership functions with three or five thresholds, according to the analyzed physiological feature. The transformed datasets are then classified into three stages that correspond to good, moderate, and poor health condition using machine learning techniques. A three-part Random Forest method was applied, where each part corresponds to a separate system. The obtained testing accuracies were 93%, 87%, and 73% for cardiovascular, muscular, and neural human body systems, respectively. The results indicate that the proposed work ability evaluation process may become a good tool for the prevention of possible accidents at work, chronic fatigue, or other health problems. [ABSTRACT FROM AUTHOR]

Background: Health sciences education prepares students for social‐ and healthcare by developing evidence‐based nursing, leadership and working life skills, including collaboration. Due to the changes caused by the global pandemic, health sciences education has shifted more to online and hybrid contexts, which can challenge students' competence development. Students' competence development and interaction in collaborative hybrid learning is a little researched area. Objectives: To observe and evaluate health sciences students' competence development in a collaborative hybrid learning context. Methods: This quasi‐experimental mixed‐method study was implemented by providing educational intervention. First‐year Bachelor's degree health sciences students (n = 18) of a Finnish university completed an educational intervention with synchronous online and face‐to‐face learning. Students' collaborative hybrid learning and interaction were video observed, while self‐evaluation of competence development was made with a questionnaire. Results: In the collaborative interactions, the students showed analytical thinking, problem‐ solving and communication and technology skills. Extensive knowledge of health sciences and ethics skills was not strongly visible in interaction. The students effectively used collaborative work time to perform tasks. Cognitive interaction (monitoring and evaluating learning) was observed in 85% and socio‐emotional interaction (expressions of emotions and motivation) in 53% of the data. Related to the students' learning results, the students' ability to communicate and interact with culturally different people improved after the educational intervention. Conclusion: Collaborative learning methods in hybrid learning can create opportunities for students to construct their competence in interaction. Attention should be paid to different areas of competence and the role of socio‐emotional interaction. Lay Description: What is already known about this topic: Health sciences education prepares students for social and healthcare by developing working life skills, including collaboration.Hybrid learning brings benefits but challenges the equity of students with different attention modes.Collaborative learning is widely used but has not been studied much in hybrid context.Students' competence development and interaction in collaborative hybrid learning is a little researched area. What this paper adds: The purpose was to observe and evaluate health sciences students' competence development in a collaborative hybrid learning context.Hybrid collaborative interaction encourages students to construct knowledge in health sciences.The students utilised the collaborative time appropriately.Socioemotional interactions were very visible in collaborative learning. Implications for practice: This study helps educational organisations to design hybrid model education.The design requires pedagogical and technical competence and should include collaborative methods.Attention should be paid to different areas of competence in collaborative learning.The role of socio‐emotional interaction needs more focus in hybrid learning. [ABSTRACT FROM AUTHOR]

Background: Early patient contacts are considered important in medical education. Aims: We studied the influence of a real patient trigger on study motivation and learning in problem-based study groups of first-year medical and dentistry students. Methods: 156 eligible students were allocated into 17 groups. Six randomly selected groups received both the real patient and paper trigger, and 11 groups received only the paper trigger. The immediate and later effects of the trigger were assessed with qualitative and quantitative questionnaires and exam scores. The tutors answered questionnaires concerning learning outcomes. Results: The students reported that the real patient trigger significantly improved their study motivation, understanding of the learning objectives and confidence in future patient encounters. The real patient trigger was considered significantly more interesting than the paper case. No statistically significant difference was observed in the exam scores. The tutors observed that groups with poor previous performance gained better results in study sessions. Conclusions: Real patient triggers motivate students to learn basic medical sciences. Ways to present real patients to students should be considered in medical curricula from early on. [ABSTRACT FROM AUTHOR]

This scoping review explores the professional literature in allied healthcare to determine which self-assessments of mentor skills are the most valid and reliable for use in occupational therapy doctoral capstone programs. The aims of this scoping review include mapping evidence related to mentor assessments in healthcare, exploring implications for occupational therapy doctoral mentor training programs, and identifying common characteristics of mentor self-assessments for occupational therapy programs to consider when developing capstone mentoring resources. Researchers applied and reported via PRISMA Extension for Scoping Reviews (PRISMA-ScR). A librarian and authors formulated keywords and database selections to search PubMed/MEDLINE/PMC, and Embase were searched from across healthcare professions for training outcomes, mentor self-assessment, mentor attributes, and use of researcher-developed assessments. The search was limited to English publications from the last 20 years. Data were extracted for quantitative information regarding study characteristics and qualitative information about mentoring skills. A total of 852 results were delivered across all databases. Nineteen papers met the final eligibility criteria and were included in the data extraction. Populations were included from several healthcare professions, including 11 nursing, four healthcare researchers, one pharmacy, one midwifery, one medicine, and one medical dietetics. Countries included the United States (n = 7), Finland (n = 5), United Kingdom (n = 4), Japan (n = 1), South Africa (n = 1) and Canada (n = 1). The authors identified four valid self-assessment tools, demonstrating III and IV levels of evidence, that may be implemented by occupational therapy programs as they develop resources for mentor programs. Occupational therapy programs can use the mentor attributes found in this scoping review to create their own mentor assessment measures or may choose to use a validated tool. The authors recommend additional research in mentor education and mentor skill acquisition. [ABSTRACT FROM AUTHOR]

Managerialism in higher education has gained prominence in recent decades. One of the crucial elements of this approach is the steering of the higher education sector, including the introduction of multiple forms of evaluation of academic work. Little is known about how academics evaluate themselves in comparison to their colleagues. Therefore, the focus of this paper is on how academics evaluate their own performance in teaching and research. The article uses survey data (2014–2015) from Norway, Finland and Sweden. Professors’ and associate professors’ answers were considered. Our research relies on social-cognitive theory to develop a set of hypothesis. The empirical findings show that academics are likely to perceive their own and their unit’s research performance as higher when compared to that of their peers and similar units. Associate professors consider themselves to be more performative in teaching, whilst professors highlight their research performance. Finally, the gender differences were found to be minimal. [ABSTRACT FROM AUTHOR]

Aims : The impact of indoor mould on employees' long-term absence from sickness (more than 10 days of absence) is poorly understood. This paper examines whether self-reported mould was related to long-term absences from work between 1 and 3 years later. Methods : By using negative binomial modelling, we analysed a representative sample of the working-age population in Finland (N = 16,084) from the Finnish Quality of Work Life Surveys in 1997, 2003, 2008 and 2013 combined with the register-based follow-up data of participants' long-term sickness absences covering a period of 1 to 3 years after the Finnish Quality of Work Life Surveys was collected. Results : After all necessary background, work- and health-related factors were included in the model, employees who reported mould in their work had 1.20 higher rates of long-term sickness absence than those who did not report mould (mould: estimated marginal mean = 13.45 days; no mould: estimated marginal mean = 11.23). If employees perceived that mould caused strain, they had 1.30 higher rates of long-term absence than those who did not report such strain (mould caused strain: estimated marginal mean = 14.64 days; mould did not cause strain: estimated marginal mean = 11.25). In total, 10% (N =1628) of employees reported mould in their workplace and 6% (N =987) reported that mould caused strain. Conclusions : Supervisors, occupational physicians and other authorities need to take employees' complaints of mould in the workplace seriously. [ABSTRACT FROM AUTHOR]

Aims: Insufficient physical activity (PA) is one of the largest public health challenges of our time and requires a multisectoral public-health response. PA recommendations state that all children and adolescents should accumulate at least 60 minutes of moderate-to-vigorous PA (MVPA) daily and carry out vigorous PA (VPA) three times weekly. While participation in sports club activities is known to enhance the probability of reaching the recommended overall PA level, less is known about the contribution of sports club participation to VPA, and few cross-national comparisons have been carried out. The purpose of this paper is to study whether participation in sports club activities is associated with meeting the overall PA and VPA recommendations among children and adolescents across six European countries, namely Belgium (Flanders), Czech Republic, Finland, France, Ireland and Sweden. Methods: Analyses were carried out on existing self-reported national data sets using descriptive statistics and logistic regression. Results: Results indicate that approximately two-thirds of children and adolescents take part in sports club activities in the given countries. Sports club participants were more likely to meet the overall PA recommendations (OR 2.4–6.4) and VPA recommendation (OR 2.8–5.0) than non-participants. Conclusions: The extent to which overall PA and/or VPA is gained through sports club participation versus other settings needs to be further studied. Nonetheless, it can be argued that sports clubs have an important position in PA promotion for younger populations. [ABSTRACT FROM AUTHOR]

This study examined affect during high school students' face‐to‐face collaborative inquiry learning in science, supported by the web‐based software Virtual Baltic Sea Explorer. Self‐reported affective states during the inquiry process in peer groups were related to evaluations of a group's collaboration and performance in three phases of interdisciplinary science inquiry (biology and chemistry). Results indicate that despite high cognitive demands, positive affect prevailed whereas negative affect was infrequent. Structural equation modelling was used to analyse the significance of affect on collaboration and group performance. The relationship between affect, collaboration, and the groups' productive outcome revealed that self‐assurance had a significant effect on collaboration and support, intertwined with scientific understanding and group performance. Furthermore, a cross‐lagged analysis showed a reciprocal relation between positive affect, scientific understanding, collaboration, and support. These outcomes contribute to the scarce literature on the nature and importance of affect in the process of face‐to‐face computer‐supported collaborative inquiry and learning in science. Lay Description: What is already known about this topic: Positive collaboration in groups promotes positive affect.Positive affect is crucial for attitudes and motivation towards science learning.Affect is an important factor in virtual learning environment design, but there is a lack of understanding on occurrence and influence of affect during face‐to‐face virtual learning.What this paper adds: Students report mainly positive affect during virtual science inquiry despite tough task demands and the level of productive group outcome.Positive activating affect prevails throughout collaborative inquiry, whereas negative deactivating affect is subordinate.Joviality and notably self‐assurance has a great impact on collaboration and support, and achievement, whereas feelings of displeasure and insecurity may have negative implications.Implications for practice and/or policy: Self‐assurance promotes collaboration and support and the aim at coconstruction of shared understanding during virtual science inquiry learning.Efforts should be made to enhance positive affect and especially self‐assurance in virtual learning. [ABSTRACT FROM AUTHOR]

The aim of this paper is to investigate the association between structural and cognitive aspects of social capital and self-rated health among adults aged 50 or more, living in three countries: Finland, Poland and Spain. The study, which was based on data from the European Social Survey (2008/09), was a part of the EU research project COURAGE in Europe. More specifically the paper assesses the association between social capital indicators – informal social network and general trust – and good self-rated health through single-level and joint effects analyses. The results showed that Finland was a country of high social capital, in terms of both social networks and general trust, while Spain showed low levels of general trust and Poland low levels of informal social networks. As to the association between social capital and self-rated health, high levels of general trust and high networks were found to be associated with good health among all countries' respondents. Older persons living in partnerships, with higher education, higher levels of engagement in informal networks and general trust, were found to be more likely to show good self-rated health. Our comparative analyses revealed different associations between social capital and health according to country. [ABSTRACT FROM PUBLISHER]

Childhood aggression and its resulting consequences inflict a huge burden on affected children, their relatives, teachers, peers and society as a whole. Aggression during childhood rarely occurs in isolation and is correlated with other symptoms of childhood psychopathology. In this paper, we aim to describe and improve the understanding of the co-occurrence of aggression with other forms of childhood psychopathology. We focus on the co-occurrence of aggression and other childhood behavioural and emotional problems, including other externalising problems, attention problems and anxiety-depression. The data were brought together within the EU-ACTION (Aggression in Children: unravelling gene-environment interplay to inform Treatment and InterventiON strategies) project. We analysed the co-occurrence of aggression and other childhood behavioural and emotional problems as a function of the child’s age (ages 3 through 16 years), gender, the person rating the behaviour (father, mother or self) and assessment instrument. The data came from six large population-based European cohort studies from the Netherlands (2x), the UK, Finland and Sweden (2x). Multiple assessment instruments, including the Child Behaviour Checklist (CBCL), the Strengths and Difficulties Questionnaire (SDQ) and Multidimensional Peer Nomination Inventory (MPNI), were used. There was a good representation of boys and girls in each age category, with data for 30,523 3- to 4-year-olds (49.5% boys), 20,958 5- to 6-year-olds (49.6% boys), 18,291 7- to 8-year-olds (49.0% boys), 27,218 9- to 10-year-olds (49.4% boys), 18,543 12- to 13-year-olds (48.9% boys) and 10,088 15- to 16-year-olds (46.6% boys). We replicated the well-established gender differences in average aggression scores at most ages for parental ratings. The gender differences decreased with age and were not present for self-reports. Aggression co-occurred with the majority of other behavioural and social problems, from both externalising and internalising domains. At each age, the co-occurrence was particularly prevalent for aggression and oppositional and ADHD-related problems, with correlations of around 0.5 in general. Aggression also showed substantial associations with anxiety-depression and other internalizing symptoms (correlations around 0.4). Co-occurrence for self-reported problems was somewhat higher than for parental reports, but we found neither rater differences, nor differences across assessment instruments in co-occurrence patterns. There were large similarities in co-occurrence patterns across the different European countries. Finally, co-occurrence was generally stable across age and sex, and if any change was observed, it indicated stronger correlations when children grew older. We present an online tool to visualise these associations as a function of rater, gender, instrument and cohort. In addition, we present a description of the full EU-ACTION projects, its first results and the future perspectives. [ABSTRACT FROM AUTHOR]

Background: The health care systems in the Nordic countries and worldwide are under pressure due to increased longevity and a shortage of nurses. Providing nurses with a high level of education, such as advanced practice nursing, is of great importance to ensure effective, safe and high-quality care. Aim: The aim of this study was to investigate self-reported competence using the Nurse Professional Competence Scale Short-Form for the first time among master's students of advanced practice nursing in the Nordic countries and to relate the findings to age, work obligations, child-rearing responsibilities, level of education and clinical nursing experience. Methods: A multicentre, cross-sectional design was used in this study conducted at five universities in Denmark, Finland and Norway. The Nurse Professional Competence Scale Short-Form consisting of six competence areas was used with a maximum score of 7 per item for the analysis of single items and a transformed scale from 14.3 to 100 for analysing the competence areas (higher score equals higher self-reported competence). Descriptive and comparative statistics were used to analyse the data. Results: The highest mean score was found for the competence area 'Value-based nursing care'. Students living with home-dwelling children (≤ 18 years) reported significantly higher competence in 'Nursing care', while students ≥33 years reported significantly higher competence in 'Nursing care' and 'Value-based nursing care'. No significant differences were found between students working and those not working alongside their studies, between students with and without further nursing-related education, or between students with long and short experience as nurses. Conclusions: The findings from this study might help to further develop curricula in advanced practice nursing master's programmes to ensure high-quality nursing and sustainable health care in the future. Future high-quality master's programmes might benefit from systematic collaboration between Nordic higher education institutions as also Sweden is planning master's programme. Higher age, having children at home and working while studying should not be considered causes for concern. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore the relationship between sensory impairment and home care client's received care time. Design: A cross- sectional multi-source study. Methods: Data from a self-reported staff survey on care time allocation were merged with registry data from the Resident Assessment Instrument registry (n = 1477). The data were collected during 1 week from 17 home care units in Finland in October 2021. The relationship between sensory impairment and clients received care time was examined using linear regression analyses. Results: The linear regression analyses showed that having vision impairment alone increased care time, while dual sensory impairment resulted in decreased received care time. Hearing impairment alone was not statistically significantly associated with care time. Conclusion: The holistic care need of home care clients with dual sensory impairment may not be adequate. To ensure equality and the individually tailored care of clients, further attention must be paid to clients with sensory impairments, especially those with dual sensory impairment. Furthermore, the competence of home care workers to encounter and communicate with clients with sensory impairment must be developed to support the holistic care. Implications for the patient care: The sensory impairments of home care clients must be identified in time and considered in care planning and encountering clients. Impact: As there is a risk that clients with dual sensory impairment are not able to fully express themselves, it is imperative that further attention is paid to clients with sensory impairments, to better understand and support this vulnerable group. Increased awareness and continuous education are needed to better identify and support home care clients with sensory impairment. Reporting Method: The study adheres to the STROBE reporting guidelines. Patient or public contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Kuninkaanniemi H, Villberg J, Vanhala M, Poskiparta M. International Journal of Nursing Practice 2011; 17: 470-477 Behaviour-change interventions in primary care: Influence on nutrition and on the metabolic syndrome definers The purpose of this paper was to examine whether interventions influenced patients' (i) consumption of fish; whole grain products; fruits and vegetables; (ii) overall nutrition, that is, the three former as an index; and (iii) clinical outcomes in terms of metabolic syndrome definers. A questionnaire was delivered to adult patients entering the nine health centres on November 2006 ( n = 1211). During the year the ward personnel conducted intervention on patients with unhealthy habits. The 12-month follow up was conducted by mailings. Also clinical data of pre- and post-intervention values of metabolic syndrome definers were collected. For the analyses, intervention was divided into brief (≤ 15 min, at most three visits) and extended (> 15 min, more than three visits) intervention. Logistic Regression and manova were used to measure changes in the outcomes. Nutrition-related intervention was conducted on 218 patients (brief intervention n = 179, extended intervention n = 39). In the extended intervention group it was three times more likely to have a positive change in the nutrition index than in the brief intervention group ( P = 0.017, confidence interval 1.223-7.773). In conclusion, brief interventions were commonly used in the primary care. However, they were not enough to produce changes in the patients' nutrition or in the clinical outcomes. [ABSTRACT FROM AUTHOR]

Growing evidence supports the existence of clinically significant social-emotional/behavioral (SEB) problems among as young as 1-year-old infants. However, a substantial proportion of early SEB problems remain unidentified during contacts with child healthcare professionals. In this study, child healthcare nurse (CHCN; N = 1008) and parental ( N = 518) reports about SEB worries were gathered, along with the maternal and paternal Brief Infant-Toddler Social and Emotional Assessment (BITSEA) ratings, for 12-month-old infants randomly recruited through Finnish child health centers. Only 1.4-1.8 % of CHCNs, 3.9 % of mothers, and 3.2 % of fathers reported of being worried about the assessed child's SEB development. When the CHCNs' and parental reports were combined, 7.7 % (33/428) of the infants assessed each by all three adults had one (7.0 %), two (0.7 %) or three (0 %) worry reports. Even the combination of the CHCN's and parental worry reports identified only 7.0-13.8 % of the infants with the maternal and/or paternal BITSEA Problem or Competence rating in the of-concern range. Identified associations across the three informants' worry reports, parental BITSEA ratings and sociodemographic factors are discussed in the paper. Routine and frequent use of developmentally appropriate screening measures, such as the BITSEA, might enhance identification and intervening of early SEB problems in preventive child healthcare by guiding both professionals and parents to pay more attention to substantial aspects of young children's SEB development and encouraging them to discuss possible problems and worries. [ABSTRACT FROM AUTHOR]

This paper examines whether alcohol consumption is related to long-term labor market outcomes. We use twin data for Finnish men and women matched to register-based individual information on employment and earnings. The twin data allow us to account for the shared environmental and genetic factors. The quantity of alcohol consumption was measured by weekly average consumption using self-reported data from three surveys (1975, 1981 and 1990). The average of an individual's employment months and earnings were measured in adulthood over the period 1990-2009. The models that account for the shared environmental and genetic factors reveal that former drinkers and heavy drinkers both have almost 20% lower earnings compared with moderate drinkers. On average, former drinkers work annually approx. 1 month less over the 20-year observation period. These associations are robust to the use of covariates, such as education, pre-existing health endowment and smoking. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Perceived health (PH) has become an important outcome measure among coronary heart disease (CHD) patients. Poor PH has been shown to predict morbidity and mortality among CHD patients. Objective: The objective of this paper was to examine CHD patients’ PH after percutaneous coronary intervention (PCI). Methods: This descriptive cross-sectional study (n = 416) was conducted across five hospitals in Finland during 2013. A self-report questionnaire of PH was used, which comprises EuroQoL five-dimensional scale (EQ-5D-5L), EuroQoL visual analog scale (EQ-VAS), and 18 background variables. Data were analyzed using descriptive statistics and multivariate methods. Results: Female gender, previous PCI, physical inactivity and slight vegetable consumption were associated with reduced PH among post-PCI patients. Seventy percent of the sample reported problems in some PH dimension. Conclusions: Post-PCI patients should be encouraged to pursue a healthy lifestyle, which seems to have a beneficial effect on PH. Females, elderly, or those demonstrating lower education, physical inactivity, slight vegetable consumption, longer duration of CHD, hypertension, hypercholesterolemia, or previous invasive treatment should be afforded special attention. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Stigma related to mental illnesses is a great burden on societies globally. Factors associated with nurses' attitudes towards people with mental illness in health-care settings are discrepant., Stigmatized attitudes among staff members towards patients with mental illness have widely been studied in various specialized health care contexts, but less often in primary health-care settings., What this paper adds to the existing knowledge? Nurses' attitudes towards people with mental illness in general were positive in primary care health settings. Younger nurses expressed feeling afraid of mentally ill patients., They not only lacked a feeling of safety around these patients but were also often of the opinion that people with mental illness should be segregated from the general population., What are the implications for practice? Systematic and continuous mental health on-the-job training for primary care nurses is recommended to strengthen the positive attitudes of young nurses towards patients., Young nurses especially should be prevented from developing stigmatized attitudes towards patients with mental problems and to ensure a skilled workforce for the future in this demanding area of health care., Abstract Introduction Despite the development of mental health services in many countries, nurses working in different health care specialties may still have concerns and negative attitudes towards people with mental illness. Aim To describe nurses' attitudes towards people with mental illness and examine factors associated with their attitudes in primary care health centres. Method The data were collected from nursing staff ( N = 264, response rate 84%) in 15 primary care health centres in two Finnish cities (spring 2014) with a self-report questionnaire (Attribution Questionnaire-27, Corrigan 2003) and analysed by descriptive statistics and multiway covariance analysis. Results Nurses' attitudes towards people with mental illness were generally positive. The nurses mostly reported willingness to help and feelings of concern and sympathy towards these patients. However, younger nurses or those without additional mental health training expressed a fear of patients. Discussion Special attention should be paid to nursing education and on-the-job training to prevent young nurses from developing stigmatized attitudes towards patients. Implications for practice Higher confidence in nursing staff could ensure a skilled work force in areas of mental health in the future, prevent young nurses from developing a fear of patients at work and support positive attitudes towards patients with mental problems. [ABSTRACT FROM AUTHOR]

The built environment (BE) impacts on people's disability and health, in terms of overweight, depression, alcohol abuse, poor self-rated health and presence of psychological symptoms; it is reasonable to assume that BE also impacts on participation levels. This paper presents the validation of the COURAGE Built Environment Self-Reported Questionnaire (CBE-SR), an instrument designed to evaluate BE in the context of health and disability. Subjects participating to COURAGE, a cross-sectional study conducted on 10 800 citizens of Poland, Finland and Spain, completed a protocol inclusive of the CBE-SR. Psychometric properties and factor structure were analysed, and factor scores created. Gender differences, differences between persons from different age groups and persons reporting the environment as facilitating, hindering or neutral were calculated. Eight items were deleted so that the final version of CBE-SR comprises 19 items. Cronbach's alpha ranged from 0.743 to 0.906, and test-retest stability was demonstrated for the majority of items. Four subscales were identified: Usability of the neighbourhood environment; Hindrance of walkable environment; Easiness of use of public buildings, places and facilities; and Risk of accidents and usability of the living place. Younger respondents reported their neighbourhood as more usable but perceived walkways as more hindering and public buildings as less easy to use; gender differences were almost inexistent. The CBE-SR is a four-scale instrument with good psychometric properties that measures the person-environment interaction. It is sensitive across age groups and is consistent with the subject's overall judgement of the degree to which the environment is facilitating or hindering. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Message Poor built environments have a negative impact on the level of a person's participation. However, instruments measuring the person-environment interaction are lacking., The CBE-SR is a valid and reliable instrument that researchers can use to assess the relationships between the intrinsic health state and the objective features of the environment., Understanding this relationship would provide further insight into the need of addressing the individual's functioning either by means of interventions directed to the individual or by making changes to the individual's environment. [ABSTRACT FROM AUTHOR]

Aim: This study examines the amount of sleep and daytime sleepiness, and how these change in a follow‐up cohort study of school‐aged children. Methods: A total of 1351 schoolchildren (aged 10) and their parents were invited to participate in the study and were studied again at ages 12 and 15 years. A survey put forth by the Health Behaviour of Schoolchildren research network was used. Results: The amount of sleep during weekdays dropped significantly from age 10 to 15. At weekends, the amount of sleep increased significantly. During weekdays, the proportion of children reporting having slept enough dropped from 71% at age 10 to 19% at age 15. Frequent daytime sleepiness occurred in 13% of children at age 10 and increased to 24% at the age of 15. Conclusions: It is essential to promote adequate amount of sleep and prevent daytime sleepiness in children growing from age 10 to 15 years. Nurses and other health care professionals should systematically assess and promote healthy sleeping habits while caring for children between these ages. SUMMARY STATEMENT: What is already known about this topic? Sufficient sleep is essential for the healthy development of school‐aged childrenThe amount of sleep drops between ages 10 and 15 years What this paper adds? Daytime sleepiness increases significantly between ages 10 and 15 years, and girls reported more frequent daytime sleepiness compared with boys.The amount of sleep drops more in girls compared with boys between the ages 10 and 15 yearsParents reported their children to sleep more compared with the children themselves The implications of this paper: Daytime sleepiness and amount of sleep should be systematically assessed by nurses and other health care professionals.Gender and age specific differences should be considered when promoting healthy sleep.Future research should focus on developing effective, youth‐driven interventions to promote healthy sleep and prevent daytime sleepiness. [ABSTRACT FROM AUTHOR]

Drama, theater and role-playing methods are commonly used in health promotion programs, but evidence of their effectiveness is limited. This paper describes the development, implementation and evaluation of a school-based drama program to enhance social relationships and decrease bullying at school in children in grades 4–5 (mean age of 10.4 years). Students (n = 190) were recruited from two primary schools with similar demographics and socio-economics in the Southern Finland and purposively allocated either to an intervention group or a control group. The drama program included classroom drama sessions, follow-up activities at home and three parents’ evenings concerning issues of social well being during the school year September 2007–May 2008. Data on social relationships in the class room and experiences of bullying were obtained before and after the program using self-completed questionnaire from the same students (n = 134). The response rate was 71%. No differences in socio-demographics existed between intervention group and control group at pretest. The positive effect on social relationships resulting from the intervention approached statistical significance (p = 0.065). Moreover, the positive effect was found to be statistically significant in the high-intensity intervention classes (p = 0.011). Bullying victimization decreased 20.7 percentage units from pretest (58.8%) to posttest (38.1%) in the intervention group (p < 0.05). The study indicates that using applied drama and theater methods in the classroom may improve children's social relationships at school. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2012; 26; 133-143 The professional nursing practice environment and nurse-reported job outcomes in two European countries: a survey of nurses in Finland and the Netherlands The working environment of nurses is receiving international interest, because there is a growing consensus that identifying opportunities for improving working conditions in hospitals is essential to maintain adequate staffing, high-quality care, nurses' job satisfaction and hence their retention. Thus, the aim of this study was to investigate the relationship between nurse work environment characteristics and nurse-reported job outcomes in hospital settings in Finland and the Netherlands and to compare these results. A comparative cross-sectional nurse survey was conducted. Data were collected from the two countries randomly sampling the countries' National Nurses Association' membership databases. In this paper, the results from Registered Nurses working in hospital settings are used. In total, 869 hospital nurses participated: 535 from Finland and 334 from the Netherlands with the response rate of 44.9 and 33.4%, respectively. Fifty-five items from the Nursing Work Index-Revised were used as a main tool for the practice environment. Exploratory factor analysis was used to identify a set of internally consistent subscales. Further, logistic regression analysis and T-tests were used. Three practice environment characteristics were identified: adequacy of resources, supportiveness of management and assurance of care quality via collaborative relationships. Favourable evaluations of the adequacy of resources and supportiveness of management were positively correlated with nurse-assessed quality of care and job-related positive feelings and negatively correlated with intentions to leave a unit, organization or the entire profession. In neither of the participating countries were adverse incidents affecting nurses related to nurses' evaluations of their current professional practice environment. Compared with Finland, in the Netherlands, RN appears to evaluate the majority of work environment characteristics more positively; nevertheless, to some extent, the results were uniform as adequacy of resources and supportiveness of management were main predictors for nurse-reported job outcomes considered. [ABSTRACT FROM AUTHOR]

meretoja r. & koponen l. (2012) A systematic model to compare nurses' optimal and actual competencies in the clinical setting. Journal of Advanced Nursing 68(2), 414-422. Abstract Aim. This paper is a report of a study to develop a model to compare nurses' optimal and actual competencies in the clinical setting. Background. Although future challenge is to focus the developmental and educational targets in health care, limited information is available on methods for how to predict optimal competencies. Method. A multidisciplinary group of 24 experts on perioperative care were recruited to this study. They anticipated the effects of future challenges on perioperative care and specified the level of optimal competencies by using the Nurse Competence Scale before and after group discussions. The expert group consensus discussions were held to achieve the highest possible agreement on the overall level of optimal competencies. Registered Nurses ( n = 87) and their nurse managers from five different units conducted assessments of the actual level of nurse competence with the Nurse Competence Scale instrument. Data were collected in 2006-2007. Results. Group consensus discussions solidified experts' anticipations about the optimal competence level. This optimal competence level was significantly higher than the nurses' self-reported actual or nurse managers' assessed level of actual competence. The study revealed some competence items that were seen as key challenges for future education of professional nursing practice. Conclusion. It is important that the multidisciplinary experts in a particular care context develop a share understanding of the future competency requirements of patient care. Combining optimal competence profiles to systematic competence assessments contribute to targeted continual learning and educational interventions. [ABSTRACT FROM AUTHOR]

In Europe, national quality assurance systems of higher education have begun to be established. In Finland, this development has had the consequence of forcing universities to take notice of assessment procedures. However, little is known about the procedures taking place in individual academic departments as a result of this pan-European trend. This article describes how academics currently comprehend quality assessment, paying particular attention to self-evaluations and quality assurance systems. Altogether, the paper casts light on how academics are responding to the increasing university assessment activities. [ABSTRACT FROM AUTHOR]

In this article we explore a Finnish nationally representative self‐report survey (N = 155, 299) conducted in a school as a tool to advance the study of violence in alternative care. By analysing the survey, we were able to provide plausible prevalence and estimates of risk factors of violence in alternative care, suggesting that self‐report surveys conducted in schools are a useful and valid methodology for this type of research. Conducting the survey in a school setting enabled us to reach a nationally representative population of adolescents living in alternative care, which would be difficult to achieve in any other way. However, studying violence in alternative care with a school survey requires a large sample size. Even with quite a substantial dataset, detailed explanatory analyses were not possible due to the low number of observations. This emphasises the importance of other types of data in addition to survey data in explanatory analysis. Based on this study, we concluded that nationally representative self‐report surveys conducted in schools could provide a useful tool and possibilities for replicable research design, which could thereby develop the research field further. [ABSTRACT FROM AUTHOR]

This paper introduces a new way of assessing entrepreneurial learning in entrepreneurship education (EE) front the student perspective. We inductively study how self-assessment through a reflective task using video-clips can trigger and instill entrepreneurial thinking and learning about entrepreneurship among business and non-business students at higher education institutions (HEIs) in Finland and Denmark, after participating in a course with entrepreneurship as a part of the course content. We show that video-clip is a powerful self-assessment tool in EE as personal reflections trigger entrepreneurial skills. Furthermore, we show that no matter the study context students can assess their own entrepreneurial learning. [ABSTRACT FROM AUTHOR]

Aims: To assess anxiety, depression, perceived stress, couple satisfaction and life satisfaction of parents of healthy newborns in two cohorts in 2015 and in 2020 during the COVID‐19 pandemic. Design: A prospective follow‐up study. Methods: We enrolled 60 parents of healthy newborns (n = 30 dyads) in 2015 and 60 parents (n = 30 dyads) in 2020. Both parents completed six valid and reliable questionnaires independently 1–2 days and 12 months after delivery: Beck Anxiety Inventory, Beck Depression Inventory‐II, Edinburgh Postnatal Depression Scale, Perceived Stress Scale, Couple Satisfaction Index and Life Satisfaction Scale‐4. Results: Anxiety was more common but couple satisfaction better in both parents during the COVID‐19 pandemic than in 2015. Depressive symptoms and perceived stress were similarly low, and life satisfaction was similarly high in both cohorts, indicating ample parental resilience. There was a moderate positive association between previous mental health disorders and parental anxiety after delivery during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

BACKGROUND: About 20‐30% of children worldwide report depressive symptoms. This study examined associations between children's depressive symptoms, life events, and family factors. METHODS: Nationally representative data (n = 95,725) were drawn from the 2017 School Health Promotion Study in Finland. The respondents were 4th and 5th grade pupils (aged 10‐12) in primary schools and their parents/guardians (n = 33,726). Data were analyzed for child‐parent dyads (n = 32,181). Associations were studied using cross tabulation and logistic regression models. RESULTS: Children's reports of poor self‐rated health, problems with family interactions, and the accumulation of life events were statistically significantly associated with depressive symptoms, also when controlling for sociodemographic factors. Financial situation and parent's depressed mood, both reported by parents, were associated with children's depressive symptoms when both were included in the regression model. However, this association disappeared when other predictors were added to the model. CONCLUSION: The results make apparent the complex associations between children's depressive symptoms and family factors. Further research is needed on the discrepancies between parent and child experiences. [ABSTRACT FROM AUTHOR]

We aimed to study the association between self-reported voice disorders among teachers and indoor air quality in school buildings. We performed a questionnaire study of 538 Finnish teachers working in 67 school buildings utilizing both perceived and technical evaluations; the agreement between these two assessments was also studied. The technical assessment was provided by technical experts. Teachers with voice disorders reported significantly more complaints from indoor air than those without voice disorders. The results also indicated a possible connection between the technical assessment and voice disorders. After adjustment for sex, stress and asthma, the prevalence of voice disorders was 47% higher in teachers working in renovated buildings compared to those working in the non-problem buildings (aRR1.47; CI 95% 1.11–1.95). The prevalence of voice disorders was 28% higher among teachers working in buildings with problems compared to those working in non-problem buildings (aRR 1.28; 95% CI 0.99–1.64). In our study, poor perceived indoor air was significantly associated with self-reported voice disorders in teachers and there was an agreement between the perceived and technical assessments. Our results also indicated a possible connection between the technical assessment and voice disorders. Our results imply the need for longitudinal research with technical assessment to study the effect of renovation on voice disorders. [ABSTRACT FROM AUTHOR]

Background: The prevalence of mental disorders is increased among people of low socioeconomic status or educational level, but it remains unclear whether their access to treatment matches their increased need. Aims: Our objective was to examine whether educational level as an indicator of socioeconomic status is associated with use of mental health services, psychotropic medication and psychotherapy in Finland. Method: Cross-sectional data from a follow-up survey of a longitudinal, population-based cohort study were used to form a sample of 3,053 men and women aged 24 to 68 with a current or previous physician diagnosed mental disorder. The prevalence of mental disorders, mental health service use and educational level were assessed with self-report questionnaire. Educational level was determined by the highest educational attainment and grouped into three levels: high, intermediate and low. The associations between educational level and mental health service -related outcomes were assessed with binary logistic regression. Covariates in the fully adjusted model were age, gender and number of somatic diseases. Results: Compared to high educational level, low educational level was associated with higher odds of using antidepressants (OR 1.35, 95% CI [1.09, 1.66]), hypnotics (OR 1.33, 95% CI [1.07, 1.66]) and sedatives (OR 2.17, 95% CI [1.69, 2.78]), and lower odds of using mental health services (OR 0.80, 95% CI [0.65, 0.98]). No associations were found between educational level and use of psychotherapy. Conclusions: The results do not suggest a general socioeconomic status related mismatch. A pharmacological emphasis was observed in the treatment of low educational background participants, whereas overall mental health service use was emphasized among high educational background participants. [ABSTRACT FROM AUTHOR]

Inspired by the caregiver stress process model emphasising the role of resources for caregiving outcomes, the aim of this study was to investigate the prevalence of subjective caregiver burden (SCB) and its associations with individual social, economic, and political resources among older spousal caregivers in a Nordic regional setting. Cross-sectional survey data collected in 2016 in the Bothnia region of Finland and Sweden were used, where 674 spousal caregivers were identified and included in the analyses. The descriptive results showed that about half of the respondents experienced SCB. SCB was more common among Finnish-speaking caregivers. Results from the multivariate logistic regression analysis showed that none of the assessed political resources were significantly associated with SCB when controlling for other variables. Experiencing financial strain was associated with SCB, while personal income was not. Frequent contact with family members was statistically significantly associated with SCB. Future research could use longitudinal data to determine causal relationships, and when data allow, test the full caregiver stress process model to investigate the role of mediating factors in different comparative settings. Accumulated evidence on risk factors for negative outcomes of informal caregiving can contribute to effective screening tools for identifying and supporting vulnerable caregivers, which is becoming increasingly important with the ageing population. [ABSTRACT FROM AUTHOR]

Previous studies on late-night digital media use and adolescent sleep have not considered how chronotype, a natural tendency to be awake or asleep at certain time, is associated with this relationship. Therefore, the nature of the relationship between late-night digital media use and sleep in different chronotypes remains still unknown. The sample consisted of 15–20-year-old Finnish adolescents (n = 1084, mean age = 16.9 years, SD = 0.93, 45.7% female). This study examined whether chronotype, measured as diurnal type and midpoint of sleep, was associated with the time of evening/night when digital media was used. Associations between the use of different forms of digital media and sleep quality, sleep duration and tiredness on school days were also investigated. Finally, the mediation effect of late-night digital media use to the relationship between chronotype and sleep was examined. Generalized linear models showed that evening chronotype, weekend midpoint of sleep, and the time of evening or night at which digital media was used were associated with more insufficient sleep and tiredness, lower sleep quality and shorter sleep duration on school days. The total use of all media forms, i.e., late-night digital media for music, movies/series, social media, and studying, were associated with shorter sleep duration and more insufficient sleep and daytime tiredness. Late-night social media use also mediated the association between diurnal type and sleep quality. Watching movies or listening to music late at night was the strongest mediator of the association between diurnal type and sleep and tiredness. The most prominent finding shows that of the all different media forms, watching movies or listening to music late at night were associated with increased daytime tiredness, whereas late social media use was associated with poor sleep quality. These interactions were pronounced especially for evening-types. The findings of the current study suggest that the negative effects of late-night media use are reflected especially in sleep quality and daytime tiredness among evening-types during adolescence. [ABSTRACT FROM AUTHOR]

Nurses need moral courage in their ethical decision-making. As a personal characteristic, moral courage varies between individuals. The aim of this study was to analyse nurses’ self-assessed moral courage, morally courageous acts and associated individual factors in older people care in one large city in Finland. The data of this cross-sectional study were collected with the ‘Nurses’ Moral Courage Scale’ (NMCS) and the main analyses were conducted with multi-way ANOVA. A total of 205 nurses responded. Respondents’ self-assessed moral courage was 4.16 on a Likert scale of 1 to 5. Higher moral courage was associated with a higher knowledge base in ethics, more frequent encountering of ethical conflicts and having several sources for knowledge of ethics, suggesting that providing ethics education for nurses in the care of older people is important. The STROBE checklist was used as the reporting guideline for the manuscript. [ABSTRACT FROM AUTHOR]

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Background: Reliable information on the use of health services is important for health care planning, monitoring and policy. It is critical to assess the validity of the sources used for this purpose, including register and survey-based data. Studies on foreign-born populations' health care use have usually implemented either survey or register data. The concordance of such data among groups of different cultural background remains largely unknown. In this study, we presented an approach to examine routinely how survey and register-related characteristics may explain disagreement found between the two information sources.Methods: We linked register- and survey-based data pertaining to the Finnish Register of Primary Health Care general physician visits and the Survey on Well-Being among Foreign Born Population (FinMonik, 2018-2019), a nationally representative survey. The sample comprised n = 5,800 informants for whom registered general physician visits were tracked in the 12-month period preceding their participation in the survey. Cohen's kappa was used as measure of multisource concordance, hierarchical loglinear models for the association between single predictors and multisource discrepancy, and a logistic regression model for examining source-related predictors of source discrepancy. Survey weights were used in all sample analyses.Results: Source concordance was poor. When dichotomizing general physician visits (zero vs one or more), 35% of informants had reported one or more visits while none were found from register. Both register- and informant-related predictors were associated to this discrepancy (i.e. catchment area, private health care use, inability to work, region of origin and reason for migration).Conclusions: We found high discrepancy between the reported and the registered physician visits among the foreign-born population in Finland, with a particularly high number of reported physician visits when none were found in the register. There was a strong association between the specific catchment area and mismatch, indicating that both register under-coverage and survey over-report are plausible and may coexist behind the discrepancy. However, associations of informant's characteristics and mismatch were less pronounced. Implications on the validity of medical information sources are discussed. [ABSTRACT FROM AUTHOR]

Illustrating the rising trend across education systems, the article examines the socio-historical constitution of the politics of pupil self-evaluation in the case of Finnish compulsory education assessment policy discourse. By studying self-evaluation as a 'politics', which, drawing on studies in governmentality, engages in the governing and shaping of educational practices, the conduct of teachers and pupils but also in the forming of pupils' selves, the article challenges the mainstream understanding of self-evaluation as an apolitical technology of learning in pursuit of better learning outcomes, 21th century competencies and lifelong learning. The study uses Finnish compulsory education curricular, legislative and policy documents from 1921 to 2020 as data. In the genealogical reading of data, the rise of the politics of pupil self-evaluation at the interface of discursive formations of assessment as a practice of discipline and truth about the pupil and the practice of self-disclosure and constitution was demonstrated. Consequently, pupil self-evaluation will be consolidated as a normal educational practice. Importantly, implying subjectifying power, a self-regulative and self-evaluative pupil subjectivity in compliance with the requirements of current globalized knowledge economy and evaluation society will be mobilized and called for. [ABSTRACT FROM AUTHOR]

Aim: To describe graduating nursing students' competence based on their knowledge in the nursing of a patient with acute coronary syndrome (ACS) and their self-assessed nurse competence. Design: A cross-sectional survey. Methods: The data were collected from 2018-2019 using an ACS test developed for this study and using the Nurse Competence Scale. The sample contained 47 graduating nursing students. The statistical analysis methods were used. Results: Only 48.9% (n = 23) of the students scored an accepted level of knowledge in the nursing of a patient with ACS, and a little over half (51.1%; n = 24) failed the ACS test. Graduating nursing students' self-assessed nurse competence was at a good level (69.7; VAS 0-100). No statistically significant differences in nurse competence assessments occurred between students who passed the ACS test and those who failed it. Conclusion: While graduating nursing students have a good level of nursing competence, their knowledge in the nursing of a patient with ACS was poor. It is important to emphasize the nursing of a patient with ACS in nursing education and to pay especially close attention to interpreting the patient's electrocardiogram findings. [ABSTRACT FROM AUTHOR]

BACKGROUND: Few multidisciplinary rehabilitation studies with a heterogeneous design have focused on individuals with multiple sclerosis (MS). This study compared subjective-reported changes in performance and satisfaction with daily activities among moderately and severely disabled individuals with MS during a 2-year, multidisciplinary, group-based, outpatient rehabilitation program comprising education in self-management and compensatory techniques, exercise, and guided peer support. METHODS: Thirty-eight adults with moderate disability (Expanded Disability Status Scale [EDSS] score of 4.0-5.5, 74% women, mean age of 48) and 41 individuals with severe disability (EDSS 6.0-8.5, 63% women, mean age of 48) were assessed at baseline and after 12 and 21 months of outpatient rehabilitation using the Canadian Occupational Performance Measure (COPM). Group x time interactions were analyzed using mixed analysis of variance. Participants' explanations of reasons for changes in activity performance were collected via semistructured interviews and analyzed content. RESULTS: Statistically significant improvements in COPM performance and satisfaction scores were reported in both groups from baseline to 21 months of rehabilitation. No significant between-group differences in improvement were observed. The self-reported reasons for improvement were mainly linked to environmental factors. CONCLUSIONS: The outpatient rehabilitation program, including 4 themes--cognition, mood, energy conservation, and body control--improved the self-reported performance of patients with MS with moderate and severe disabilities. Environmental factors warrant consideration during rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine whether physical activity, fitness, and motor skills have an indirect association with math performance via cognitive outcomes and if so, through which aspects of cognition? Methods: This study comprised 311 6th–9th grade adolescents (12–17 years [M age = 14.0 years], 59% girls) from seven schools throughout Finland in 2015. Math performance was measured via a teacher‐rated math achievement and the Basic Arithmetic test. Cognitive functions were measured by broad cognitive test battery. Physical activity was assessed with a self‐reported questionnaire and a hip‐worn accelerometer. Aerobic fitness was estimated using a maximal 20‐m shuttle run test, muscular fitness with curl‐up and push‐up tests, and motor skills with a 5‐leaps test and a throwing‐catching combination test. Structural equation modeling was applied to examine the associations. Results: In both boys and girls, motor skills had a positive indirect association with math outcomes through visuospatial working memory. Among girls, muscular fitness had a positive indirect association with math outcomes through visuospatial working memory. Aerobic fitness was positively associated with math achievement, but the indirect path via cognition was not observed. Self‐reported physical activity had a borderline indirect positive association with math outcomes through visuospatial working memory. Accelerometer‐based physical activity did not correlate with math performance. Conclusion: Motor skills and muscular fitness had indirect positive associations with math performance, mediated by visuospatial working memory. The results give support to the viewpoints that the connections between motor skills, fitness, and physical activity to academic skills are mediated via specific cognitive skills. [ABSTRACT FROM AUTHOR]

Objectives: This study provides a Finnish replication of a recent Swiss experiment (Walser and Killias: J Exp Criminol 8:17-28, ) on the supervision mode effects in computerized delinquency surveys in schools. This study supplements the Swiss study by using individual level randomization and two additional outcome variables: meta-questions of response integrity and incidence-counting heuristics. Methods: A total of 924 ninth grade students (15-16 years old) in southern Finland were randomly assigned (at the level of individuals) to supervision either by their teachers or by an external research assistant. Students then responded to an online self-report delinquency survey. Chi-square and t tests were used to compare prevalence levels and means. Results: In both last year and lifetime recall periods, only one offence type (unspecified theft) showed significantly different outcomes, with external supervision yielding a higher prevalence figure. For other offences, no supervision effects were found. When females and males were separately examined, limited evidence of gender-specific supervision effects emerged. Thus, females appear to report more thefts in external supervision while males report more violence in teacher supervision. No statistically significant supervision effects were found in questions probing response integrity and counting heuristics. Conclusion: Using teacher supervision in online self-report delinquency surveys does not appear to compromise the validity of the survey results. The findings thus largely corroborate the results of the earlier Swiss test. How supervision condition interacts with respondent characteristics apart from gender calls for further scrutiny. [ABSTRACT FROM AUTHOR]

The aim is to analyse political participation among senior citizens in the West-Finnish region Osterbotten/Pohjanmaa by using data from the 2005 GERDA (gerontological regional database) survey. The first research question related to patterns of political participation and the extent to which older people in this region engage in voting and non-institutionalised forms of participation. Secondly, the driving forces behind different dimensions of participation were assessed on an individual level by using a modified variant of the civic voluntarism model as suggested by Verba and colleagues. The results show a high propensity to vote among elders in this region, but they also suggest that so-called non-institutionalised participation is likely to become more common in the future. Moreover, even though the results support the so-called resource theory of political participation, the fit of the multivariate models were modest, which necessitates further research in order to understand fully the driving forces behind political participation of older people in this specific region. [ABSTRACT FROM AUTHOR]

Salonen P, Tarkka M-T, Kellokumpu-Lehtinen P-L, Koivisto A-M, Åstedt-Kurki P, Kaunonen M. International Journal of Nursing Practice 2011; 17: 396-410 Individual face-to-face support and quality of life in patients with breast cancer Living with breast cancer significantly affects women's quality of life (QOL) creating a need for support that might persist throughout the breast cancer experience. The aim of this study was to assess the effect of individual face-to-face support on women's QOL and identify factors associated with their QOL. A two-group quasi-experimental design was used with a sample of 204 women who was assigned to the intervention ( n = 112) or the control group ( n = 92) in hospital after breast cancer surgery. Data of this study were collected 6 months after the surgery by structured questionnaires and analysed statistically using descriptive statistics and non-parametric tests. Factors predicting poor QOL were investigated using logistic regression models with enter-method. Women in the intervention group reported less arm symptoms and clinically better sexual functioning. Factors related to QOL were age, education, employment status, lymph node status, type of surgery, type of axillary surgery, received chemotherapy, hormonal therapy and ongoing therapy. Factors, predictive of poor QOL, included control group, age, education, type of surgery, type of axillary surgery, chemotherapy and ongoing therapy. Short-term face-to-face education and support intervention might have decreased arm symptoms and increased sexual functioning. Women with breast cancer should be offered systematic support and education, which is tailored to women's individual needs. [ABSTRACT FROM AUTHOR]

Montin L, Suominen T, Haaranen E, Katajisto J, Lepistö J, Leino-Kilpi H. International Journal of Nursing Practice 2011; : 19-26 This study was carried out to measure changes in health-related quality of life (HRQOL) in patients ( n = 100) undergoing total hip arthoplasty. The Sickness Impact Profile was used to measure patients' dysfunctions in 12 different categories post surgery. Improvement was observed in each category and dimension already at 3 months and at 6 months. Preoperative pain showed a statistically significant although declining correlation both with total, and with Physical and the Psychosocial dimensions of HRQOL. The greatest improvements were found in the categories Body Care and Movement, Ambulation, Alertness Behaviour, Social Interaction, Recreation and Pastimes and in Sleep and Rest. Patients' pain decreased, and 72% reported no pain at 6 months post the surgery. Patients' perceptions of their pain should be gathered carefully when deciding the need and timing for the surgery in order to minimize impairments into HRQOL. [ABSTRACT FROM AUTHOR]

The intake of some micronutrients is still a public health challenge for pregnant women in Finland. This study examined the effects of dietary counselling on micronutrient intakes among pregnant women at increased risk of gestational diabetes mellitus in Finland. This study utilised data from was a cluster‐randomised controlled trial (n = 399), which aimed to prevent gestational diabetes. In the intervention group, the dietary counselling was carried out at four routine visits to maternity care and focused on dietary fat, fibre and saccharose intake. A validated 181‐item food frequency questionnaire was used for evaluating the participants' food consumption and nutrient intakes. The differences in changes in micronutrient intakes from baseline (pre‐pregnancy) to 36–37 weeks' gestation were compared between the intervention and the usual care groups using multilevel mixed‐effects linear regression models, adjusted for confounders. Based on the multiple‐adjusted model, the counselling increased the intake of niacin equivalent (coefficient 0.50, 95% confidence interval [CI] 0.03–0.97), vitamin D (0.24, CI 0.05–0.43), vitamin E (0.46, CI 0.26–0.66) and magnesium (5.05, CI 0.39–9.70) and maintained the intake of folate (6.50, CI 1.44–11.56), from early pregnancy to 36 to 37 weeks' gestation. Except for folate and vitamin D, the mean intake of the micronutrients from food was adequate in both groups at baseline and the follow‐up. In conclusion, the dietary counselling improved the intake of several vitamins and minerals from food during pregnancy. Supplementation on folate and vitamin D is still needed during pregnancy. [ABSTRACT FROM AUTHOR]

Our objective with this study was to investigate students' metacognitive awareness (MA) and its association with course grades in general upper secondary foreign languages, to foster reflective practices. A total of 267 foreign language students at Finnish schools answered an online survey, and the data were analysed quantitatively. Based on the results, the students' levels of MA were high in foreign languages, students at urban schools had higher levels than students at rural schools, and students with high course grades had higher levels of MA. Knowledge of cognition and attitudes about the language predicted the course grade the most. The results indicate that more emphasis should be put on the enhancement of MA at rural schools and with low-achieving students, to enhance their reflective practices. [ABSTRACT FROM AUTHOR]

This study examined the role of temperament type and gender of adolescents and teachers in adolescents' well‐being in school. The sample consisted of 677 Finnish students and 56 classroom teachers. Parents rated adolescent temperament and teachers rated their own temperament in autumn of Grade 6. Self‐reports of school well‐being among adolescents were obtained in autumn and the fall of Grade 6. The results showed that being a girl and having resilient temperament type predicted higher school well‐being. In turn, boys with undercontrolled temperament, who were otherwise at risk for decreased school well‐being, particularly benefited from having a female teacher with resilient temperament. Overall, the results suggest that both adolescent temperament type and gender play important roles in adolescents' well‐being in school. [ABSTRACT FROM AUTHOR]

Aim: To conduct a construct validity test on a clinical nurse specialist core competency scale. Background: Clinical nurse specialists' competency development dates back to the late 20th century; however, there is scarcity of competency descriptions from outside of North America. Furthermore, little knowledge is available on the previous research‐driven efforts to develop and validate clinical nurse specialist core competencies. Design: A descriptive study, using an online self‐report questionnaire, was conducted from May to September 2019 in three Nordic countries. Methods: An exploratory factor analysis using principal axis factoring and rotation method oblimin with Kaiser normalisation was undertaken to examine factors in the 50‐item scale. Parallel analysis with eigenvalue Monte Carlo simulation and scree plot was used to determine the number of factors to extract. Psychometric properties of the scale were evaluated, and subjective interpretation was used to modify the tool in line with the statistical analysis. The STROBE checklist was used as the reporting guideline for this study. Results: One hundred and eighty‐four responses were obtained (Finland n = 52, Denmark n = 95, Iceland n = 37) with an overall response rate of 45%. The results provided construct validity evidence of the underlying theoretical structures of the four competency spheres of patient, nursing, organisation and scholarship. Cronbach's alpha coefficient for the original overall scale was 0.94, thus indicating adequate reliability of the scale. Conclusions: Based on the analysis and subjective interpretation, we suggest a 47‐item clinical nurse specialist core competency scale. Further study should be conducted to validate the core competency content and construct in other contexts beyond the present study. Relevance to clinical practice: The scale may be used to guide clinical nurse specialist practice and identify areas for professional development, develop graduate‐level programme curricula and inform future competency research. [ABSTRACT FROM AUTHOR]

Background: Reliable and valid measurement is the foundation of evidence-based practice. The self-administered Foot Health Assessment Instrument (S-FHAI) was recently developed to measure patients' evaluations of their own foot health. Evidence regarding the psychometric properties of the S-FHAI is limited. The aim of this study was to investigate those properties by using a Rasch analysis. Methods: This methodological study analysed secondary data that was collected from nurses (n = 411) in 2015. The psychometric properties of the S-FHAI were evaluated using the Rasch model. Unidimensionality was analysed first, followed by item functioning, person misfit and differential item functioning (DIF). Results: The S-FHAI demonstrated evidence of unidimensionality, with an acceptable item fit according to the Rasch model. Person fit and person separation were low, however, indicating restricted separation among different respondents. Item separation was high, demonstrating clear discrimination between the items. No DIF was detected in relation to gender, but significant DIF was demonstrated in relation to age for 6 of the 25 items. Conclusions: The S-FHAI has potential for use in investigating self-reported foot health. The Rasch analysis revealed that the psychometric properties of the instrument were acceptable, although some issues should be addressed to improve the scale. In future, it may be beneficial to analyse the sensitivity of the items and to test the S-FHAI in more diverse patient populations. [ABSTRACT FROM AUTHOR]

To meet both current and future competence needs, improved and updated understanding of nurses' scope of practice when working in remote communities is needed. The aim was to describe and analyze the characteristics of nursing encounters in primary healthcare in remote areas. The setting for the study was an island community in Finland. Nurses' patient record documentation and self-reports on patient encounters were surveyed (n = 1062). Patients aged ≥65 years accounted for most encounters. Great variety in the encounters was seen, though some nursing tasks and patient conditions were overrepresented. For patient safety reasons, it is important to review how nurses maintain competence regarding those tasks and conditions encountered less often. Primary healthcare services should focus on the broader determinants of health. However, a more disease-oriented focus was seen. To ensure quality of care in primary healthcare in remote areas, there is a need for standardized routines for monitoring patients and documenting findings and performed interventions. [ABSTRACT FROM AUTHOR]