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This paper focuses on the uncertainty and resentment that many persons with disabilities feel concerning their disability services in the welfare state of Finland. This paper elaborates on the theme through the lived citizenship of persons with disabilities using the key theory of disability tax as an analytical tool. The empirical data were collected through an online survey (n = 541) and six group interviews (n = 41) of persons with disabilities in 2023. The disability tax experiences are elaborated through four aspects: (1) rejected applications, (2) uncertain realisation, (3) laborious complaint mechanisms, and (4) the psycho–emotional effect. The findings of this study establish collective experiences of multi-layered disability tax throughout the disability services process. It concludes that disability services, which were originally planned to specifically ensure equal opportunities to participate in society for persons with disabilities, are increasingly becoming the very sources of burden as austerity has silently grown deeper over recent years and has become the clear policy of the current government. [ABSTRACT FROM AUTHOR]

Background: During dental procedures, critical parameters, such as cooling condition, speed of the rotary dental turbine (handpiece), and distance and angle from pollution sources, were evaluated for transmission risk of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), simulated by spiking in a plasmid encoding a modified viral spike protein, HexaPro (S6P), in droplets and aerosols. Methods: To simulate routine operation in dental clinics, dental procedures were conducted on a dental manikin within a digital dental unit, incorporating different dental handpiece speeds and cooling conditions. The tooth model was immersed in Coomassie brilliant blue dye and was pre-coated with 100 μL water spiked-in with S6P-encoding plasmid. Furthermore, the manikin was surrounded by filter papers and Petri dishes positioned at different distances and angles. Subsequently, the filter papers and Petri dishes were collected to evaluate the aerosol splash points and the viral load of S6P-encoding plasmid in aerosols and splatters generated during the dental procedure. Results: Aerosol splashing generated a localized pollution area extended up to 60 cm, with heightened contamination risks concentrated within a 30 cm radius. Significant differences in aerosol splash points and viral load by different turbine handpiece speeds under any cooling condition (P < 0.05) were detected. The highest level of aerosol splash points and viral load were observed when the handpiece speed was set at 40,000 rpm. Conversely, the lowest level of aerosol splash point and viral load were found at a handpiece speed of 10,000 rpm. Moreover, the aerosol splash points with higher viral load were more prominent in the positions of the operator and assistant compared to other positions. Additionally, the position of the operator exhibited the highest viral load among all positions. Conclusions: To minimize the spread of aerosol and virus in clinics, dentists are supposed to adopt the minimal viable speed of a dental handpiece with limited cooling water during dental procedures. In addition, comprehensive personal protective equipment is necessary for both dental providers and dental assistants. [ABSTRACT FROM AUTHOR]

Unequal divisions of paid work and care among new parents contribute to increasing inequalities. One explanation for this is joint utility maximization and the benefits of partners (temporarily) specializing in paid work and care. This paper examines the (dis)advantages of specializing compared to dividing tasks more equally by studying whether differences in specialization between same-sex and different-sex couples lead to differences in household earnings after entering parenthood. Using register data from Norway, Finland, Denmark, and Sweden and examining first-time parents, we show that female couples have a more equal within-couple income development during the transition to parenthood than different-sex couples do. However, we find no differences in household income (including or excluding social transfers) between the two types of couples. Although a more equal task division may be preferred from an individual perspective, our results show no evidence of a "best strategy" when it comes to maximizing household income. [ABSTRACT FROM AUTHOR]

Purpose: This article aims to clarify the concepts used to understand, analyze and improve a patient's progress through a health service system. A patient pathway describes plans and intentions. Within it, we distinguish between the clinical pathway of decisions and interventions and the care pathway of supportive activities. As a patient pathway is implemented, it turns into a patient journey of what is done, what happens to a patient's medical condition and what is experienced and felt. We introduce "patient journey disruption" (PJD) as a concept describing the events that need to be prevented from happening to accomplish integrated, coordinated and seamless care. Design/methodology/approach: The method used in this paper is concept analysis. First, an expert steering group worked to refine the concept of PJDs; second, an analysis of similar concepts from related fields was done to root the concept into existing theories, and third, semi-structured interviews with professionals and patients were done to test the concept of PJDs in the home care context. Findings: PJDs are agency-based harmful events in the execution of the care pathway that deviate the patient journey from what can be reasonably expected. PJDs are management failures, which is why they should be studied by healthcare operations management (HOM) and service science scholars with the intention to find ways to prevent them from happening. Research limitations/implications: This study has limitations, including presenting conceptual ideas and preliminary results that are only indicative. Practical implications: We believe that the introduction of the concept of PJDs into the literature provides a new, systematic way of approaching the different shortcomings in our healthcare production systems. Moreover, by systematically identifying different PJDs, interventions can be designed and targeted more appropriately. Originality/value: Managerial challenges regarding healthcare processes have been studied but have not been well defined. The concept of PJDs is an original, well-thought-out definition. [ABSTRACT FROM AUTHOR]

Background: In everyday conversations, a person with aphasia (PWA) compensates for their language impairment by relying on multimodal and material resources, as well as on their conversation partners. However, some social actions people perform in authentic interaction, proposing a joint future activity, for example, ordinarily rely on a speaker producing a multi‐word utterance. Thus, the language impairment connected to aphasia may impede the production of such proposals, consequently hindering the participation of PWAs in the planning of future activities. Aims: To investigate (1) how people with post‐stroke chronic aphasia construct proposals of joint future activities in everyday conversations compared with their familiar conversation partners (FCPs); and (2) how aphasia severity impacts on such proposals and their uptake. Methods & Procedures: Ten hours of video‐recorded everyday conversations from seven persons with mild and severe aphasia of varying subtypes and their FCPs were explored using conversation analysis. We identified 59 instances where either party proposed a joint future activity and grouped such proposals according to their linguistic format and sequential position. Data are in Finnish. Outcomes & Results: People with mild aphasia made about the same number of proposals as their FCPs and used similar linguistic formats to their FCPs when proposing joint future activities. This included comparable patterns associated with producing a time reference, which was routinely used when a proposal initiated a planning activity. Mild aphasia manifested itself as within‐turn word searches that were typically self‐repaired. In contrast, people with severe aphasia made considerably fewer proposals compared with their FCPs, the proposal formats being linguistically unidentifiable. This resulted in delayed acknowledgement of the PWAs' talk as a proposal. Conclusions & Implications: Mild aphasia appears not to impede PWAs' ability to participate in the planning of joint future activities, whereas severe aphasia is a potential limitation. To address this possible participatory barrier, we discuss clinical implications for both therapist‐led aphasia treatment and conversation partner training. WHAT THIS PAPER ADDS: What is already known on the subject: PWAs use multimodal resources to compensate for their language impairment in everyday conversations. However, certain social actions, such as proposing a joint future activity, cannot ordinarily be accomplished without language. What this paper adds to existing knowledge: The study demonstrates that proposing joint future activities is a common social action in everyday conversations between PWAs and their family members. People with mild aphasia used typical linguistic proposal formats, and aphasic word‐finding problems did not prevent FCPs from understanding the talk as a proposal. People with severe aphasia constructed proposals infrequently using their remaining linguistic resources, a newspaper connecting the talk to the future and the support from FCPs. What are the potential or actual clinical implications of this work?: We suggest designing aphasia treatment with reference to the social action of proposing a joint future activity. Therapist‐led treatment could model typical linguistic proposal formats, whereas communication partner training could incorporate FCP strategies that scaffold PWAs' opportunities to construct proposals of joint future activities. This would enhance aphasia treatment's ecological validity, promote its generalization and ultimately enable PWAs to participate in everyday planning activities. [ABSTRACT FROM AUTHOR]

Aims: This study aims to measure any changes in the marital relationship during the first year after a diagnosis of prostate cancer, identify the demographic characteristics that influenced such changes, and measure changes related to health‐related quality of life (HRQoL). Background: Knowledge is limited on the impact of a diagnosis of prostate cancer on the marital relationship and HRQoL of patients and their spouses. Design: A 1‐year longitudinal study. Methods: Data were collected from five Finnish hospitals between October 2013 and January 2017. Of the 350 recruited couples (N = 700), 179 patients and 166 spouses completed the Marital Questionnaire and the RAND 36‐Item Health Survey 1 year after diagnosis. Results: No major changes were found in the marital relationship during the follow‐up period. The spouses reported statistically significant changes in their marital relationships, but the patients did not. Furthermore, changes in the marital relationship were not associated with the patients' HRQoL. Among spouses, emotional well‐being was associated with changes in the marital relationship. Conclusion: The marital relationship was relevant in terms of the spouses' HRQoL during the first year after a diagnosis of prostate cancer. Nurses and other healthcare providers should assess counselling and support provided to spouses individually. Summary statement: What is already known about this topic? Prostate cancer affects not only the individual but also the whole family's structure and hierarchy.Prostate cancer patients' quality of life is better if their spouses have positive beliefs about the disease's duration and treatment control. What does this paper add? Spouses reported statistically significant changes in the marital relationship, but the patients did not.Among spouses, emotional well‐being was associated with changes in the marital relationship. This paper's implications: By individually assessing counselling and support to spouses during prostate cancer care, nurses and other healthcare providers have the opportunity to use these findings. [ABSTRACT FROM AUTHOR]

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This article analyzes the current feelings of Finnish low-income working lone mothers and their views on what it means to be poor in the welfare state of Finland. This is done by analyzing written accounts of lone mothers through a qualitative content analysis. The data was collected in 2015 and 2021. The analysis reveals that mothers' feelings of poverty have similarities to those described in data collected in a different context over 20 years ago. The article is inspired by an article published in Affilia in the year 2003 by Lynn McIntyre, Suzanne Officer, and Lynne M. Robinson. In their paper, McIntyre et al. analyzed the feelings of poor Canadian lone mothers. While the welfare regime and services influence how life is organized, it is evident that self-sacrifice for the children caused by poverty is very much a part of the written accounts of Finnish mothers. We show that while there are a few cultural differences in the feelings that lone mothers undergo on account of their low-income status, feelings such as loneliness are persistent and often shared regardless of time or geographical location. Therefore, we suggest that low-income mothers should be given greater support by society and governments to be able to feel hopeful and empowered rather than poor and alone. [ABSTRACT FROM AUTHOR]

The aim of the study was to assess occupational exposure to bisphenol A in Finland. Five companies took part in the research project: two paint factories (liquid and powder paints), a composite product factory, a thermal paper factory, and a tractor factory. Exposure was assessed by measuring total bisphenol A excretion (free and conjugated) from urine samples, and its concentrations in the air. The results revealed the specific work tasks in two of five companies in which significant occupational exposure to bisphenol A may occur. In the manufacturing of liquid paint hardener, urine samples collected after the working day showed bisphenol A levels of up to 100-170 µg l-1. Workers in thermal paper manufacturing were also exposed to bisphenol A, especially those working in the manufacture of coating material and operating coating machines. Median concentrations of the post-shift urine samples of coating machine workers were in the range of 130-250 µg l-1. The highest bisphenol A concentrations were in the range of 1000-1500 µg l-1. Recommendations for more effective personal protection resulted in decreased exposure, particularly among coating machine operators. In the rest of the companies, urinary bisphenol A levels were typically in the range of those of the general population. Bisphenol A concentrations in air samples were typically low (<40 µg m-3), except in some short-term duties related to the handling of solid bisphenol A (maximum 17.6 mg m-3). Low air levels, even in the companies with high urinary levels, suggest exposure via dermal contact. According to the results, exposure to bisphenol A may occur particularly in work tasks that involve the use of pure bisphenol A. In these tasks, special attention should be paid to the prevention of skin exposure. Inhalation exposure may become relevant in dusty work tasks. Since skin exposure is of potential concern in these tasks, biomonitoring is recommended as the method for assessing occupational exposure to bisphenol A. [ABSTRACT FROM AUTHOR]

This paper examines populous perspectives of the government's responsibility to intervene in situations of possible parental neglect of children in England, Finland, Norway, and California (USA), and ask if institutional context, defined as child protection system and children´s wellbeing situation, are formative for people's perspectives on government responsibility for children in vulnerable situations and how they view children´s future. With representative samples of populations responses to a survey vignette using ordered logistic regression, findings indicate that the institutional context shed some light on differences on state responsibility. However, similarly to welfare state research, there are differences and contradictions in important dimensions that require further investigation, especially on citizens perceptions of neglect and on intrusive interventions. Citizens with a comparatively higher education are evidently much more supportive of state responsibility for children and child protection interventions than other citizens. This finding is similar to those of other studies of state responsibility. Overall, there is a high level of support in populations for the provision of public services to children and families in vulnerable situations. [ABSTRACT FROM AUTHOR]

Aims: This paper analyses the factors that influence home care employees' intention to introduce robots. Background: The introduction of different kinds of care robots is a topical issue in elderly care now and in the near future. Methods: Cross‐sectional research conducted through a questionnaire. The survey data (N = 162) were collected in five locations around Finland in 2019. The analysis was carried out by regression analysis, Sobel test and by Hayes' bootstrapping method. Results: The results show that self‐efficacy is pivotal in the willingness to introduce care robots. Employees' age increases the enthusiasm to introduce robots but reduces self‐efficacy. Work engagement does not correlate with self‐efficacy or behavioural intention related to the introduction of care robots. Conclusions: The present paper reveals the significance of attitudes, cognitive factors and age in the adoption of care robots in home care facilities. Practical implications: It is important to pay attention to supporting the employees' sense of technology management and the construction of a robot‐positive atmosphere when introducing care robots, and the development of skills of older employees and employees with a lower educational level should be supported. [ABSTRACT FROM AUTHOR]

Response to intervention (RTI) can be considered an everyday practice in many parts of the United States, whereas, in Finland, only recently has a new framework for support in learning taken shape. Choosing Finland as the comparative partner for this policy paper is justified as its educational system has been widely referenced on the basis of good Programme for International Student Assessment (PISA) results. The results of the present comparative article showed first, that the U.S. RTI was primarily intended for diagnosing and preventing learning disabilities whereas the Finnish RTI is mainly an administrative structure for support. Second, the U.S. RTI includes clear definitions regarding the intensity, duration, and content of support provided within each tier whereas the Finnish version contains no explicit guidelines for support. Third, the U.S. RTI assumes no special educational services in the first two tiers, but the Finnish framework includes special educational services from the onset of support. Implications for policy and practice are discussed. [ABSTRACT FROM AUTHOR]

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]

Grounded in 'expectancy-value' theory, this paper reports on the psychometric properties of an instrument intended to measure students' motivation in mathematics. The participants were 2045 third-, fourth- and fifth-grade students from Estonia, Finland, Norway, Portugal, Serbia and Sweden. The Expectancy-Value Scale (EVS) was found to be suitable for early grades of primary education in measuring competence self-perceptions and subjective task values relative to the mathematics field. The results indicate a good model fit aligned with the expectancy-value theory. The EVS dimensions showed good reliability, and scalar invariance was established. However, findings also indicated high correlations between some of the EVS dimensions, which is well documented for students at this age. The findings are discussed relative to the 'expectancy-value' theory framework and students' age. [ABSTRACT FROM AUTHOR]

Background: The use of patient-reported outcome measures (PROM) and patient-reported experience measures (PREM) provide health providers with valuable feedback on how to improve clinical care and patient outcomes. This paper describes a qualitative study that was conducted to learn about factors influencing the well-being of people living with HIV (PLHIV) in Finland. The findings will be used to develop themes for HIV-specific PROM and PREM questions. Methods: PROMs and PREMs were developed by the Finnish Institute for Health (THL) as a part of a project to develop a national quality-of-care registry for HIV. The study aimed to identify issues and concerns among people living with HIV (PLHIV) that influence their well-being (PROMs) and their experiences in the healthcare system (PREMs). The data were collected through face-to-face in-depth interviews and focus group discussions based on open-ended and semi-structured questions. The data were analyzed using thematic analysis. Results: The assessment identified the following PROMs of concern: psychological well-being, concerns about stigma, physical health, social well-being, sexual well-being, medication uptake, managing other medications with antiretrovirals (ARVs), and growing old. The assessment identified the following PREMs: helping patients understand their own health status, proving an opportunity for patients to discuss physical health, psychological and sexual well-being, supporting the uptake of ARVs, assisting patients with medication use, showing compassion towards patients, and empowering patients against stigma. Conclusion: These findings of the study can be used to develop domain-specific PROM and PREM questions for the national HIV quality care register. [ABSTRACT FROM AUTHOR]

This article offers a theoretical and practical comparison between the special education systems for the deaf in Finland and Mexico. The theoretical approach of research perspectives in Chou et al. (2014) and Hellsten (2020) supports this study. We focus on how?the gaps in special education that are present as early as elementary school increase the difficulties of integrating Mexican pupils with special educational needs (SEN) at university. We review the experience in education of deaf students in Finland and the feedback of deaf teachers and researchers.?The aim of the paper is to contribute to improved access to comprehensive and high-quality bilingual education for the deaf in developing countries. [ABSTRACT FROM AUTHOR]

Lung cancer is the leading cause of cancer-related death in all Nordic countries which, though similar in demographics and healthcare systems, have noticeable differences in lung cancer survival. Historically, Denmark and Finland have had higher lung cancer incidences and lower survival than Norway and Sweden. All four countries have national cancer registries. Data in these registries are often compared, but their full potential as a source of learning across the Nordic countries is impeded by differences between the registries. In this paper, we describe and compare the Nordic registries on lung cancer–specific data and discuss how a more harmonized registration practice could increase their usefulness as a source for mutual learning and quality improvements. We describe and compare the characteristics of data on lung cancer cases from registries in Denmark, Finland, Norway and Sweden. Moreover, we compare the results from the latest annual reports and specify how data may be acquired from the registries for research. Denmark has a separate clinical lung cancer registry with more detailed data than the other Nordic countries. Finland and Norway report lung cancer survival as relative survival, whereas Denmark and Sweden report overall survival. The Danish Lung Cancer Registry and the Swedish Cancer Registry do not receive data from the Cause of Death registries in contrast to the Finnish Cancer Registry and the Cancer Registry of Norway. The lung cancer registries in Denmark, Finland, Norway and Sweden have high level of completeness. However, several important differences between the registries may bias comparative analyses. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this paper is to systematically and critically appraise the available scientific evidence concerning the prevalence of edentulism among diabetic patients compared to non‐diabetic people. Methods: MEDLINE‐PubMed and Cochrane‐CENTRAL databases were comprehensively searched up to April 2023 to identify appropriate studies. The inclusion criteria were observational studies conducted in human subjects ≥18 years of age with the primary aim of investigating the prevalence of edentulism among diabetic patients. Based on the extracted data, a meta‐analysis was performed. Recommendations based on the body of evidence were formulated using the GRADE approach. Results: Independent screening of 2085 unique titles and abstracts revealed seven publications that met the eligibility criteria. Study size ranged from 293 to 15,943 participants. Data from all seven studies were suitable for meta‐analysis. Overall, 8.3% of the studied population was edentulous. The weighted mean prevalence of edentulism among diabetic and non‐diabetics was 14.0% and 7.1%, respectively. The overall odds ratio for diabetic patients to be edentulous as compared to non‐diabetics was 2.39 (95% CI [1.73, 3.28], p < 0.00001). Conclusion: There appears to be moderate certainty that the risk of being edentulous for diabetic patients compared to non‐diabetic people is significant, but the odds ratio is estimated to be small. [ABSTRACT FROM AUTHOR]

Social work clients often face complex financial problems. We have developed a financial social work intervention, FinSoc, to increase financial literacy and economic self-efficacy and reduce financial anxiety among parents with financial problems in Finland. The aim of this pilot randomized controlled trial is to explore the feasibility, acceptability, and preliminary effectiveness of the intervention. This paper, a study protocol, describes the design and implementation of the trial. Study protocols are articles detailing a priori the research plan, rationale, proposed methods and plans for how a clinical trial will be conducted. This study is a pilot randomized controlled trial with a mixed methods approach applying both quantitative measures and qualitative interviews. Participating social work clients with children are randomly assigned to either the treatment or the waiting list control group at a ratio of 1:1. The treatment group receives the intervention and the control group receives services as usual. The quantitative data from social work clients are collected at three measurement points. Qualitative interviews are conducted post-intervention with both clients receiving, and professionals implementing the intervention. The feasibility is assessed through recruitment and retention rates and the interviews with social work professionals providing the intervention. Acceptability is assessed through feedback from participants on satisfaction with the intervention and usefulness of the specific intervention components. Potential effectiveness is measured by financial literacy, economic self-efficacy and financial anxiety. The intervention is hypothesized to increase financial literacy and economic self-efficacy and reduce financial anxiety among social work clients with children. The results of this pilot study will increase the evidence base of financial social work and offer new insights for developing interventions for clients experiencing financial difficulties. [ABSTRACT FROM AUTHOR]

This paper investigates different uses of the Journal Impact Factor (JIF) in national journal rankings and discusses the merits of supplementing metrics with expert assessment. Our focus is national journal rankings used as evidence to support decisions about the distribution of institutional funding or career advancement. The seven countries under comparison are China, Denmark, Finland, Italy, Norway, Poland, and Turkey—and the region of Flanders in Belgium. With the exception of Italy, top‐tier journals used in national rankings include those classified at the highest level, or according to tier, or points implemented. A total of 3,565 (75.8%) out of 4,701 unique top‐tier journals were identified as having a JIF, with 55.7% belonging to the first Journal Impact Factor quartile. Journal rankings in China, Flanders, Poland, and Turkey classify journals with a JIF as being top‐tier, but only when they are in the first quartile of the Average Journal Impact Factor Percentile. Journal rankings that result from expert assessment in Denmark, Finland, and Norway regularly classify journals as top‐tier outside the first quartile, particularly in the social sciences and humanities. We conclude that experts, when tasked with metric‐informed journal rankings, take into account quality dimensions that are not covered by JIFs. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe nursing staff's assessments of medication management process in the psychiatric and operative domains after introduction of an electronic medication chart. Background: The medication management process includes all structures and practices within the organisation that guide and support medication administration and related procedures. Design: A cross‐sectional survey. Methods: A Finnish version of the Medication Administration System – Nurses Assessment of Satisfaction (modified MAS‐NAS) paper‐based questionnaire was sent to all nursing staff (N = 855) working in operative (n = 498) and psychiatric (n = 357) domains in one central hospital. Data were analysed using statistical methods. Results: In total, 324 nursing staff members participated. More than half agreed that medication management is efficient (64%), safe for patients (76%), and that the current medication administration system provides the necessary medical treatment information (e.g. prescriptions by physicians, medication data) (64%). Respondents' overall satisfaction with medication management process was slightly above average on a scale from 1 to 10 (mean = 6.2; SD = 1.8; median = 7, range 2–9). Respondents who used electronic medication chart reported higher overall satisfaction with medication management process (median = 7, mean = 6.1, SD = 1.8 and range 2–9) than those not using it (median = 6.5, mean = 6.3, SD = 1.6 and range 2–9). No statistically significant difference was found (U = 8552.000, p = 0.33). Conclusions: This study revealed several problems in the medication management process. The results can be used in developing the medication management process. Relevance to clinical practice: Electronic medication chart should be used and developed further in terms of efficacy, safety and access. One year after the electronic medication chart was introduced, only half of the respondents had used it. That is why implementation of electronic systems or technological applications should be carefully considered as a whole. [ABSTRACT FROM AUTHOR]

Background: The PredictAD tool integrates heterogeneous data such as imaging, cerebrospinal fluid biomarkers and results from neuropsychological tests for compact visualization in an interactive user interface. This study investigated whether the software tool could assist physicians in the early diagnosis of Alzheimer's disease. Methods: Baseline data from 140 patients with mild cognitive impairment were selected from the Alzheimer's Disease Neuroimaging Study. Three clinical raters classified patients into 6 categories of confidence in the prediction of early Alzheimer's disease, in 4 phases of incremental data presentation using the software tool. A 5th phase was done with all available patient data presented on paper charts. Classifications by the clinical raters were compared to the clinical diagnoses made by the Alzheimer's Disease Neuroimaging Initiative investigators. Results: A statistical significant trend (p < 0.05) towards better classification accuracy (from 62.6 to 70.0%) was found when using the PredictAD tool during the stepwise procedure. When the same data were presented on paper, classification accuracy of the raters dropped significantly from 70.0 to 63.2%. Conclusion: Best classification accuracy was achieved by the clinical raters when using the tool for decision support, suggesting that the tool can add value in diagnostic classification when large amounts of heterogeneous data are presented. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

This study examines a range of factors associated with future citation and altmetric counts to a paper. The factors include journal impact factor, individual collaboration, international collaboration, institution prestige, country prestige, research funding, abstract readability, abstract length, title length, number of cited references, field size, and field type and will be modeled in association with citation counts, Mendeley readers, Twitter posts, Facebook posts, blog posts, and news posts. The results demonstrate that eight factors are important for increased citation counts, seven different factors are important for increased Mendeley readers, eight factors are important for increased Twitter posts, three factors are important for increased Facebook posts, six factors are important for increased blog posts, and five factors are important for increased news posts. Journal impact factor and international collaboration are the two factors that significantly associate with increased citation counts and with all altmetric scores. Moreover, it seems that the factors driving Mendeley readership are similar to those driving citation counts. However, the altmetric events differ from each other in terms of a small number of factors; for instance, institution prestige and country prestige associate with increased Mendeley readers and blog and news posts, but it is an insignificant factor for Twitter and Facebook posts. The findings contribute to the continued development of theoretical models and methodological developments associated with capturing, interpreting, and understanding altmetric events. [ABSTRACT FROM AUTHOR]

Purpose: This paper reports on research exploring the intersections between researchers and communication professionals' perspectives on the objectives, funders and organizational influences on their science communication practices. Design/methodology/approach: Examining one context, the inter-organizational BCDC Energy Research project based at five different research organizations in Finland, this paper presents data from semi-structured interviews with 17 researchers and 15 communication professionals. Findings: The results suggest that performance-based funding policies that drive the proliferation of large-scale research projects can create challenges. In particular, a challenge arises in generating a shared sense of identity and purpose amongst researchers and communication professionals. This may have unintended negative impacts on the quality and cohesiveness of the science communication which occurs. Research limitations/implications: The study was exploratory in nature and focuses on one organizational and institutional environment. Further research with a wider number of projects, as well as funders, would be conducive to a greater understanding of the issues involved. Practical implications: On a practical level, this research suggests that the creation of clearer communications awareness and guidance may be helpful in some large-scale projects, particularly involving broad numbers of organizations, individual researchers and funders. Originality/value: This is one of the first studies examining the perspectives of both researchers and communication professionals working over one project, drawing together a range of different institutional and disciplinary perspectives. The results highlight the importance of the influences of funding on science communication aims, assumptions, cultures and structures. The article articulates the need for further research in this area. [ABSTRACT FROM AUTHOR]

Aims: This paper describes the use of three governance tools for health in all policies utilised to facilitate implementation in the municipality of Kuopio, Finland: impact assessments, a city mandate (the Kuopio strategy), and shared budgets. Methods: An explanatory case study was used. Data sources included semistructured interviews with 10 government employees and scholarly literature. Realist scientific methods were used to reveal mechanisms underlying the use of tools in health in all policies. Results: Strong evidence was found supporting initial and new theory/hypotheses regarding the use of each tool in achieving positive implementation outcomes. Impact assessments facilitated health in all policies by enhancing understanding of health implications. The Kuopio strategy aided in implementation by giving credence to health in all policies work via formal authority. Shared budgets promoted intersectoral discussions and understanding, and a sense of ownership, in addition to allowing time to be spent on health in all policies work and not financial deliberation. Conclusions: Findings confirm the efficacious use of three governance tools in implementing health in all policies in Kuopio. Knowledge and evidence-based guidelines on local health in all policies implementation are needed as this policy approach continues to be recognised and adopted as a means to promote population health and health equity. [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]

In this paper, we compare two methodological approaches - Conversation Analysis (CA) and the Communication Deviance (CD) Scale - in detecting confusing family interaction, which is considered one of the risk factors for schizophrenia. CA is a method for identifying and describing actions in interaction, whereas the CD Scale presents the criteria for identifying communication defects in the field of schizophrenia research. Our aim is to determine whether the approaches resonate with and could complement each other in analysing the same interactional data - i.e., a total of 10.5 hours of audio-recorded Finnish family interaction in a psychological test in which the participants negotiate on mutual Rorschach inkblot interpretations. The data include 585 proposals by the family members. Here we focus on three types of proposal sequences (140 in all) where a proposal is not followed by an acceptance or a rejection. We have earlier shown that from the CA perspective, the family members orient to the discontinuity of these sequences by pursuing an explicit response to a proposal, but very rarely make the 'problematic' nature of the interaction visible to each other or the analyst. In the present paper, we will show that the CD Scale finds communication defects in the sequences under analysis but that the defects do not primarily involve the discontinuity of the sequence. Thus CA and the CD Scale look at interaction from different perspectives and disagree on what is considered an interactional problem. [ABSTRACT FROM AUTHOR]

This paper discusses youth and the significance of age in the lives of persons with profound intellectual and multiple disabilities. The analysis is based on an ethnographic research project that explores what makes a good life for this group of people. The findings indicate that whilst the meaning and significance of youth and age were discussed often by care workers and family members, age had very little significance in the lives of our research participants. Youth as a phase of life gets lost in the transition from children's services to adult services: age in the lives of persons with profound intellectual disabilities means merely a move from one service system to another. For the care workers, age provides a way to evaluate and criticize the service system and whether it caters for the individual needs of persons with profound intellectual disabilities. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to report on the seeking of deeply meaningful information, also including embodied information, connected to significant, intensely personal life changes having lifelong impacts. The concepts of "meaning‐making," "transitioning," and information seeking in "deeply meaningful and profoundly personal contexts" are used in order to understand transgender individuals' information seeking in the contexts of gender identity formation. Based on the literature, emotions and information seeking connected to a significant life change were divided into four phases to study how they could be identified in the 25 qualitative interviews with transgender individuals from Finland between the ages of 15 and 72. Based on the findings of this study, in significant life changes, an individual needs reliable, sensible and identifiable information. Serendipitous encounters and embodied experiences characterize information seeking during transitional stages. Peer communities are important for minorities in order to find places where interviewees feel safe to share information and experiences. These communities can also be found online. The concept of "deeply meaningful information" highlights the effect information has on information seekers. Deeply meaningful information can serve as a trigger for life change, helping people forward during the transitions. [ABSTRACT FROM AUTHOR]

The aim of this study is to describe the communicative strategies nurses and patients use on a micro level to ensure patient understanding during discharge discussions. The data of the study consist of 16 videotaped discharge encounters (total duration 1 h 40 mins) between nurses and patients in Finland, which were analyzed using conversation analysis. The findings reveal that patients express understanding or troubles in understanding by subtle means, such as response particles. Nurses monitor patients' reactions and adapt their subsequent actions to them, for instance by moving on to the next topic or by giving additional explanations. They also pursue expressions of understanding when needed, e.g., by prolonging the topic. This gives the patient time to react and more material to get a grip on the topic, thus facilitating displays of understanding. As a result, even if the discharge discussions consist mostly of information delivery that resembles a monological practice, the interaction is collaboratively constructed to secure patient understanding. A raised awareness of good practices already in use to secure understanding can contribute to further developing the guidelines for discharge education. [ABSTRACT FROM AUTHOR]

Purpose: Children are gradually attaining recognition as service users and their involvement in service development has been advanced in recent years. This study draws on empirical research in social and health-care services designed for children and families. The purpose of this paper is to analyse how professionals understand children's involvement as experts by experience. The focus is on professionals' views and intergenerational relations. Design/methodology/approach: The research data comprise 25 individual and 10 group interviews with managers and professionals working in social and health-care services in one Finnish province. The data were analysed using qualitative thematic analysis. Findings: The professionals recognised the value of children's service user involvement. However, they concentrated more on the challenges than the possibilities it presents. Health-care professionals emphasised parental needs and children's vulnerability. In turn, the professionals from social services and child welfare non-governmental organisations perceived children as partners, although with reservations, as they discussed ethical issues widely and foregrounded the responsibilities of adults in protecting children. In general, the professionals in both domains saw themselves as having ethical responsibility to support children's service user involvement while at the same time setting limits to it. Originality/value: This study confirmed the importance of taking intergenerational relations into account when developing children's service user involvement. The results indicate that professionals also need to reflect on the ethical challenges with children themselves as, largely owing to the generational position of children as minors, they rarely perceive them as partners in ethical reflection. [ABSTRACT FROM AUTHOR]

European countries have developed a range of long-term care (LTC) policy responses to support the increasing share of older people. However, little is known about the effectiveness of LTC services and benefits, particularly their impact on older peoples' quality of life (QoL). This paper investigates the role of personal, care service and environmental characteristics on the effects of home care services on QoL across England, Finland and Austria. We used data from surveys conducted in England, Finland and Austria. In total, 811 older adults were included in the analysis. OLS regression including main effects and country-specific interactions was used to explore variation in gains in long-term care service-related quality-of-life (LTC-QoL). Explanatory variables were derived from the production of welfare framework and comprised home care service user socio-demographics, needs indicators, social support and environmental variables and characteristics of home care service provision. In all three countries, LTC-QoL gains increased with needs, indicating that home care services perform well, with additional gains declining the higher the needs. Also, better process quality contributed to LTC-QoL improvements in all three countries. In addition, the availability of informal care, social contact, financial household situation and living alone, were associated with changes in LTC-QoL only in one or two of the countries. Home care services increased service users' QoL in all three European countries. The increase in QoL, however, varied across the countries. The results also provide insights into the benefits and limits of home care service provision and areas for future improvements. JEL: I31, I38, J14 [ABSTRACT FROM AUTHOR]

The Adult Social Care Outcomes Toolkit four response‐level interview schedule (ASCOT INT4) for service users was translated into Finnish. The aim of this paper was to investigate the construct validity and structural characteristics of the Finnish ASCOT. We used data from a face‐to‐face interview survey of older people receiving publicly funded home care services, which was conducted in 2016–2017 (n = 493), excluding missing values and proxy respondents (n = 334). Chi‐square tests, adjusted residuals and analyses of variance were used to examine hypothesised associations between each attribute and a number of relevant variables regarding health and well‐being, disabilities, living arrangements, social contact and support, experience of service use, and the nature of the locality and environment. Structural characteristics were explored using exploratory factor analysis and Cronbach's alpha test. The EQ‐5D‐3L and ASCOT were moderately correlated (r = 0.429; p < 0.001). The ASCOT attributes were statistically positively related to the overall quality of life. For other tested variables, we found a high number of significant associations with the control over daily life, occupation, social participation, and personal cleanliness attributes, but fewer significant associations with the other attributes. Cronbach's alpha was 0.697 and a single factor was extracted. This assessment provides evidence to support the construct validity of the Finnish ASCOT. The results support the introduction of the Finnish ASCOT into Finland for use in practical applications. Future research on its reliability would be useful. [ABSTRACT FROM AUTHOR]

The rise of modern socio‐digital technologies has fundamentally changed the everyday environments in which young people communicate with each other and cultivate interests. To gain a more sophisticated understanding of this phenomenon, this study provides in‐depth, qualitative insights into adolescents' experiences of their socio‐digital developmental ecologies. The 15 interview participants were recruited based on a previously conducted questionnaire. The semi‐structured theme interview addressed the socio‐digital aspects of the participants' interest‐driven behaviours and related networks with the aid of participant‐generated egocentric maps. The data not only qualitatively enrich the picture on adolescents' friendship‐ and interest‐driven socio‐digital participation but also provide new perspectives on the phenomena through the added network‐layer of analysis. The youth seem to vary in their motivational profiles related to their participation and the potential relevant psychological background factors for this variation are considered. Educational implications of these results are discussed when it comes to effective student engagement and connected learning. Lay Description: What is already known about this topic: The developmental ecologies of our youth are being transformed through the socio‐digital revolution.Adolescents participate in their digital media ecologies inFriendship‐ (hanging out with friends) andInterest‐driven ways (messing around and geeking out related to interests). What this paper adds: We describe the fine‐grained variance in the genres of socio‐digital participation (SDP) with the added layer of self‐perceived egocentric networks.Within each of these genres, there is variation of socially connected socio‐digital participation and the socioemotional depth of different size networks also varies.The youth also seem to vary in their motivational profiles related to their participation.The potential relevant psychological background factors behind different genres of participation are discussed. Implications for practice and/or policy: Instructors can compete for the limited attention span of students' with the ubiquitous personal interests byIncluding central motivational elements of youth socio‐digital participation in learning.Utilizing school subjects as conceptual tools to solve students‐relevant problems in a connected manner. [ABSTRACT FROM AUTHOR]

Nurses play an important role in promoting public health. Traditionally, the focus of health promotion by nurses has been on disease prevention and changing the behaviour of individuals with respect to their health. However, their role as promoters of health is more complex, since they have multi-disciplinary knowledge and experience of health promotion in their nursing practice. This paper presents an integrative review aimed at examining the findings of existing research studies (1998–2011) of health promotion practice by nurses. Systematic computer searches were conducted of the Cochrane databases, Cinahl, PubMed, Web of Science, PsycINFO and Scopus databases, covering the period January 1998 to December 2011. Data were analysed and the results are presented using the concept map method of Novak and Gowin. The review found information on the theoretical basis of health promotion practice by nurses, the range of their expertise, health promotion competencies and the organizational culture associated with health promotion practice. Nurses consider health promotion important but a number of obstacles associated with organizational culture prevent effective delivery. [ABSTRACT FROM PUBLISHER]

We used a randomized controlled trial to investigate if a mobile game, GraphoLearn (GL), could effectively support the learning of first graders (N = 70), who have severe difficulties in reading and spelling. We studied the effects of two versions of the game: GL Reading, which focused on training letter‐sound correspondence and word reading; and GL Spelling, which included additional training in phonological skills and spelling. During the spring of first grade, the children trained with tablet computers which they could carry with them during the six‐week intervention. The average exposure time to training was 5 hr 44 min. The results revealed no differences in the development of reading or spelling skills between GL players and the control group. However, pre‐training self‐efficacy moderated the effect among GL Reading players: children with high self‐efficacy developed more than the control group in word reading fluency, whereas children with low self‐efficacy developed less than the control group in spelling. Lay Description: What is already known: Serious games can support children's reading achievement, but less is known about their effects in mobile learning.GraphoLearn (GL) is a serious game designed to support reading acquisition, but previous studies suggest its effect on word‐level reading is limited.Explicit training of phonological skills and spelling could facilitate transfer to word reading.Self‐efficacy predicts persistence and effort in achievement situations but its role in mobile game‐based learning is not well known. What this paper adds: A randomized controlled trial was used to study if mobile game‐based learning supports children with reading difficulties.A new GL version, training phonological and spelling skills, had no effect on the development of reading and spelling skills.Children with high self‐efficacy benefited from training with the standard GL. Implications for practitioners: When using mobile games as support tools, close attention should be paid to learner characteristics and game design.Children with high self‐efficacy may be better able to regulate their behaviour during independent training with mobile games, leading to better learning outcomes. [ABSTRACT FROM AUTHOR]

Critical discussions on the focus group method have highlighted the importance of considering the forms of interaction generated in groups. In this empirical paper we argue that these forms of interaction are intimately linked to the ways participants interpret the study setting, and these interpretations are likely to differ significantly depending on participants' social backgrounds. In the light of our data consisting of 18 focus groups with 15-year-old school pupils from both affluent and deprived neighbourhoods of Helsinki discussing film clips about young people drinking alcohol, we ask what kinds of modes of participation are mobilised in focus group discussions in order to mark the social position of participants. We further analyse these modes in relation to situated identity performances, arguing that contextual factors of the study setting become especially important to consider when researching vulnerable groups and heterogeneous populations. The analysis yields three modes of participation: these are active/engaged, resistant/passive and dominant/transformative. We argue that these modes can be viewed as actively taken positions that reveal what kinds of identities and competences participants are able and willing to mobilise in the study setting, and that recognising these modes is important in all interview settings. [ABSTRACT FROM AUTHOR]

Rural development refers to diverse attempts being made to address the problems of rural communities. In Finland, rural development leans heavily on entrepreneurship and small business development. Rural development processes have a strong social psychological component that entails that psychological knowledge is crucial for rural development agents. Nevertheless, psychological knowledge has also been criticised for simplifying highly complex development processes and overstating the role of internal psychological factors. In this paper, we argue that, regarding the relevance and utility of psychological knowledge, the question is not only how extensively different factors are taken into account but also how knowledge about psychological factors is read and interpreted. In this paper, we focus on Finnish rural business owners' values and demonstrate that value survey data can be read from two different social psychological perspectives: those of substantialism and relationalism. Although data and the conducted analyses are kept constant, the two readings produce differing types of knowledge of rural business owners' values; one reveals what business owners 'truly' are like and the other informs how to best communicate with business owners. Both readings are potentially useful for rural development work. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper studies the possible combined effect of occupational exposure and chronic airway disease to all-cause and respiratory related mortality in a longitudinal study setting. The results suggest that occupational airborne exposure increases mortality and is even more harmful for those with asthma and COPD coexistence. Objectives: Our objective was to study mortality related to different obstructive lung diseases, occupational exposure, and their potential joint effect in a large, randomized population-based cohort. Methods: We divided the participants based on the answers to asthma and chronic obstructive pulmonary disease (COPD) diagnoses and occupational exposure and used a combined effects model and compared the results to no asthma or COPD with no occupational exposure. Results: High exposure had a hazards ratio (HR) of 1.34 (1.11–1.62) and asthma and COPD coexistence of 1.58 (1.10–2.27). The combined effects of intermediate exposure and coexistence had an HR of 2.20 (1.18–4.09), high exposure with coexistence of 1.94 (1.10–3.42) for overall mortality, and sub-HR for respiratory-related mortality of 3.21 (1.87–5.50). Conclusions: High occupational exposure increased overall but not respiratory-related mortality hazards, while coexisting asthma and COPD overall and respiratory-related hazards of mortality. [ABSTRACT FROM AUTHOR]

The aim of the research was to analyse the experience of medical volunteers during World War II in the context of nursing history. Oral history data used in the study consisted of 30 interviews with Finnish wartime medical volunteers, known locally as Lottas. Interview data were analysed both thematically and by using the oral history method. Based on the analysis, the Lottas' experiences during wartime nursing became the leitmotif of this study. The main themes consisted of the following: 'taking care of wounded and ill patients', 'taking care of dying and deceased patients', 'taking care of mentally ill and psychoactive substance‐addicted patients' and 'confronting ethical and role dilemmas in nursing'. The interview results showed that the Lottas' duties were sometimes more demanding than basic nursing tasks and that their education was not adequate for the challenges that they faced. In this paper, the terms Lotta, medical Lotta or medical volunteer are used interchangeably and refer to people who were assigned to medical volunteer tasks, regardless of whether or not they were trained. It also includes junior members of the organisation who served as medical volunteers as minors, with special permission. [ABSTRACT FROM AUTHOR]

In many developed countries lone parent families face high rates of child poverty. Among those lone parents who do get child maintenance there is a hidden problem. States may retain all, or a proportion, of the maintenance that is paid in order to offset other fiscal costs. Thus, the potential of child maintenance to alleviate poverty among lone parent families may not be fully realized, especially if the families are also in receipt of social assistance benefits. This paper provides an original comparative analysis exploring the effectiveness of child maintenance to reduce child poverty among lone parent families in receipt of social assistance. It addresses the question of whether effectiveness is compromised once interaction effects (such as the operation of a child maintenance disregard) are taken into account in four countries Australia, Finland, Germany and the UK using the LIS dataset (2013). It raises important policy considerations and provides evidence to show that if policy makers are serious about reducing child poverty, they must understand how hidden mechanisms within interactions between child maintenance and social security systems can work as effective cost recovery tools for the state, but have no poverty reduction impact. [ABSTRACT FROM AUTHOR]

Finland's 2022 Para Report Card on Physical Activity for Children and Adolescents With Disabilities includes a summary of results and grades for 10 physical activity indicators and highlights how these grades are interpreted by stakeholders. The disability classification was based on the UNICEF/Washington Group on Disability Statistics measure, Generalized Anxiety Disorder (GAD7) measure, or education status. Data between 2017 and 2021 were reviewed by 24 physical activity specialists using benchmarks adapted for data on disabilities from the Active Healthy Kids Global Alliance. The grades were assigned as follows: Overall Physical Activity, C+; Organized Sport, C; Active Play, D; Active Transportation, B; Family and Peers, C+; School, B; Community and Environment, C−; Government, A−; sedentary behavior and physical fitness were graded as incomplete. Stakeholder focus-group discussions highlighted the need for multidisciplinary cooperation and increasing competence of specialists working with children to promote a physically active lifestyle for all children. [ABSTRACT FROM AUTHOR]

This study aimed to identify differences among body mass index (BMI) categories of older family caregivers (=60 years) and their care recipients (=65 years). Secondly, this study aimed to examine group differences and factors associated with weight change during a nutrition and oral health intervention. This secondary analysis of a randomized controlled trial (ClinicalTrial.gov (NCT04003493)) involved individually tailored nutritional guidance from a clinical nutritionist and oral health guidance from a dental hygienist. Baseline BMI differences were analyzed, followed by further analyses of group differences and associated factors of weight change over a 6-month period using generalized estimating equations. Among the participants (113 family caregivers and 107 care recipients), 36.3% and 35.1% were overweight (BMI >29 kg/m²), while 18.6% and 21.6% were underweight (BMI <24 kg/m²) at baseline, respectively. For family caregivers differences in BMI categories included age, mid-arm and calf circumferences, and plasma prealbumin concentration. For care recipients differences were observed in medication use, mid-arm and calf circumferences, Mini Nutritional Assessment scores, physical function, and number of teeth. During the 6-month intervention, there were no differences in weight change between intervention and control groups for both caregivers and care recipients. Factors significantly associated (p < 0.05) with weight loss included female sex for both caregivers and care recipients, and frailty for caregivers. Family caregivers' characteristics were not significantly associated with weight change in their care recipients. In conclusion, being overweight is a prevalent among older family caregivers and care recipients. Factors such as age, medication use, physical function, number of teeth, and Mini Nutritional Assessment scores varied across BMI categories. Female sex was associated with weight loss in both older family caregivers and care recipients, and frailty was associated with weight loss in caregivers. However, the characteristics of family caregivers did not explain the weight loss of their care recipients. [ABSTRACT FROM AUTHOR]

Background: Neovascular age-related macular degeneration (nAMD) is a common cause of visual impairment and blindness in the elderly with globally increasing prevalence. Vascular endothelial growth factor inhibitor (anti-VEGF) treatment has improved visual prognosis of nAMD, but continuous treatment may cause anxiety and stress, although increase in visual acuity (VA) may also have positive effects on patients' quality of life. The health care burden due to frequent treatment and monitoring is apparent, but the effect of anti-VEGF treatment on patients' quality of life is not fully understood. We evaluated the overall impact of nAMD and its treatment on newly diagnosed patients' health-related quality of life (HRQoL) in real-world setting. Methods: The present prospective cohort study included newly diagnosed nAMD patients treated with anti-VEGF injections at Oulu University Hospital during 2019–2020. Data included parameters from comprehensive ophthalmic examination and fundus imaging, age at diagnosis, sex, comorbidities, visual acuity, and frequency of anti-VEGF injections. HRQoL was assessed by 15D questionnaire at diagnosis, 6 months, and 12 months. Results: 95 nAMD patients were included. They were 78 ± 8 years old, 56 (59%) were female, and 74 (78%) had more than one comorbidity. The patients received 8 ± 3 anti-VEGF-injections. Visual acuity (VA) improved from 56 ± 18 to 61 ± 24 Early treatment diabetic retinopathy study (ETDRS) letters in 12 months. VA improved > 5 ETDRS letters in 45 (47%), remained stable in 30 (32%) and decreased > 5 letters in 17 (18%) eyes. The mean total 15D score reflecting overall HRQoL decreased from 0.850 ± 0.104 to 0.834 ± 0.103 in 12 months. Decreased HRQoL was associated with baseline best-corrected VA (BCVA) ≥ 70 ETDRS letters (p = 0.023) and more than one comorbidity (p = 0.034). HRQoL regarding visual function increased from 0.765 ± 0.194 to 0.789 ± 0.184 during the 12-month follow-up. Conclusions: In real world setting, HRQoL regarding visual function improved in anti-VEGF-treated nAMD patients during the first 12 months after the diagnosis and treatment initiation. Good baseline VA or several comorbidities were associated with decreased overall HRQoL during the follow-up. Despite the effectiveness of anti-VEGF treatment on visual function, several other aspects affecting elderly patients' everyday life should be considered when nAMD treatment is implemented. [ABSTRACT FROM AUTHOR]

Background The Nordic countries represent a unique case study for the COVID-19 pandemic due to socioeconomic and cultural similarities, high-quality comparable administrative register data and notable differences in mitigation policies during the pandemic. We aimed to compare weekly excess mortality in the Nordic countries across the three full pandemic years 2020–2022. Methods Using data on weekly all-cause mortality from official administrative registers in Denmark, Finland, Norway and Sweden, we employed time series regression models to assess mortality developments within each pandemic year, with the period 2010–2019 used as reference period. We then compared excess mortality across the countries in 2020–2022, taking differences in population size and age- and sex-distribution into account. Results were age- and sex-standardized to the Danish population of 2020. Robustness was examined with a variety of sensitivity analyses. Results While Sweden experienced excess mortality in 2020 [75 excess deaths per 100 000 population (95% prediction interval 29–122)], Denmark, Finland and Norway experienced excess mortality in 2022 [52 (14–90), 130 (83–177) and 88 (48–128), respectively]. Weekly death data reveal how mortality started to increase in mid-2021 in Denmark, Finland and Norway, and continued above the expected level through 2022. Conclusion Although the Nordic countries experienced relatively low pandemic excess mortality, the impact and timing of excess mortality differed substantially. These estimates—arguably the most accurate available for any region in capturing pandemic-related excess deaths—may inform future research and policy regarding the complex mortality dynamics in times of a health crisis such as the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Student selection is the first step in recruiting future social and healthcare professionals. Ethically competent professionals are needed in social and healthcare. It is important to select applicants who have the best possible abilities to develop their ethical competence in the future. Values-based recruitment has been used to inform the recruitment and selection of higher education applicants. However, objective and valid tests in student selection are needed. Aim: To assess social and healthcare applicants' success and related factors in the ethics section of the universities of applied sciences digital entrance examination (UAS Exam) to undergraduate degree programmes. Research design: A cross-sectional design was used. Participants and research context: Social and healthcare applicants needed to identify ethical situations in the ethics section of a national digital entrance examination (UAS Exam) in autumn 2019 (between 29 October and 1 November) in 20 Finnish universities of applied sciences. Ethical considerations: The process for the responsible conduct of research was followed in the study. Ethics committee approval was obtained from the Human Sciences Ethics Committee in the Satakunta region (27 September 2019). Approval to undertake the study was obtained from the participating universities of applied sciences. Participation to the study was voluntary and based on informed consent. Results: The applicants' (n = 8971) mean scores were 7.1/20 (standard deviation 6.5), and 22.7% of the applicants failed the ethics section. Age, previous education, and place of birth (own/parent) explained the applicants' success in the ethics section (total score and failed exam results). Conclusion(s): Applicants' success in the ethics section varied indicating that future students may have a different basis to develop their ethical competence. This may impact on (new) students' learning, especially in practical studies. [ABSTRACT FROM AUTHOR]

Aim: To describe the childhood experiences of patients with polio from the acute phase of the disease during post‐war Finland in the 1950s and 1960s. Design: Qualitative empirical study based on self‐reported history of nursing rooted in the past, a history of experiences. Methodology: Interview materials were gathered in the form of themes (45) and written interviews (4) (29 September 2018 to 30 June 2019). Data were analysed by reflexive thematic analysis to highlight hidden and latent experiences. This approach generated the study's main theme, themes and subthemes. Results: The main theme, 'shattered childhood', generated from the study results and was then divided into two themes, both of which were influenced in part by the loss of a familiar childhood, the changed environment, the breakdown of the body and the absence of control. Through their childhood memories, polio survivors described their broken childhoods using the following themes: 'betrayal by their bodies' and 'isolation'. In the narratives, the theme 'betrayal by one's own body' was generated by the following subthemes: 'suddenness of the affliction', 'paralysis' and 'being moved to the hospital'. The 'isolation' theme developed from the subthemes 'isolation from the body and surroundings' and 'emotional and social loneliness'. Conclusion: Polio survivors' experiences during the acute stage of the disease were traumatic and demonstrated children's inferior nursing position in Finland in the 1950s and 1960s. Impact: The study increases our understanding of the history of caring for children and families who were affected and disabled by polio and the importance of their experiences in society and healthcare settings. Patient or Public Contribution: The authors collaborated with the Finnish Polio Association to recruit study participants and plan the study. Patients with polio during childhood underwent interviews, and their experiences formulated the data, which were analysed and the basis of the results. Reporting Method: Consolidated criteria for reporting qualitative research (COREQ), a 32‐item checklist for interviews and focus groups, have been used as a reporting and checklist tool. All authors have agreed on the final version and the use of the COREQ criteria, relationship with participants, theoretical framework, setting, data collection and data analysis and report. [ABSTRACT FROM AUTHOR]

The review explored how serious games are utilized for preventing adolescents' social exclusion. Four original articles were retrieved using six databases. The use of serious games to prevent adolescents' social exclusion was rare, but there are potential areas where serious games could be utilized. Serious games may be a promising new intervention to use in adolescents' social rehabilitation and social work, preventing social exclusion, reducing the risk of unemployment, lack of education and training. These early findings suggest using serious games as a part of adolescents' social work and social rehabilitation to prevent social exclusion among adolescents, along with other methods. [ABSTRACT FROM AUTHOR]

In recent decades, disappointing poverty trends and welfare state limitations in many European countries – including constraints on minimum income benefits – have paved the way for a larger role of the third sector. An interesting but controversial form of third-sector in-kind support is food aid provision. In Europe, food aid is, so far, a non-rights-based practice displaying worrisome discretionary and stigmatizing characteristics. Yet, the phenomenon of food aid in Europe has spread, professionalized, and penetrated the institutions of the welfare state. This raises the question if, how and to what extent food aid plays a role in bypassing structural constraints on minimum income protection. This article applies an exploratory case study approach to estimate the monetary value of food aid in relation to statutory minimum incomes in four EU-countries. We use cross-nationally comparable food reference budgets to price food aid packages in Belgium, Finland, Hungary and Spain. The results show that food aid, although not sufficient to close the at-risk-of-poverty gap, is non-trivial for some European households. In Spain and Belgium food aid packages can reach up to €100 a month (expressing 7% to 11% of respective minimum income benefit levels). Importantly, we perceive (formalized) cooperation and interaction between local welfare agencies and food charities in all countries, suggesting that welfare state actors use non-rights-based food aid for filling gaps in the social safety net. The large between- and within-country variation of the monetary values of food aid packages points, however, to food aid as a problematic discretionary practice. [ABSTRACT FROM AUTHOR]

The aim of this study is to outline the development and changes in pre‐service teachers' technological pedagogical content knowledge (TPACK) assessments during the first 3 years in teacher education. Specifically, research was conducted at three measurement points over a 3‐year teacher education period. The target group consisted of pre‐service teachers (N = 148) from three Finnish universities. Results indicate a growth in confidence related to all TPACK areas during the research period. The strongest gains were in pedagogical content knowledge. In addition, the gains were larger in other areas related to pedagogical knowledge than areas related to technology or content knowledge. In areas without pedagogical knowledge, the changes were more moderate. In the discussion section, recommendations are provided on the potential of longitudinal use of the TPACK model to study and improve the development of pre‐service teachers' TPACK. Lay Description: What is already known about this topic: There are several studies focusing on pre‐service teachers' self‐perceived technological pedagogical content knowledge (TPACK) areasThere are differences amongst pre‐service teachers based on their confidence with different TPACK areasThere is a lack of longitudinal studies focusing on changes in pre‐service teachers' TPACK profiles during teacher educationWhat this paper adds: This research provides 3 years perspective for changes in pre‐service teachers' TPACK during teacher educationConfidence for different TPACK areas evolve at different paces during teacher educationHighest gains were for TPACK areas related to pedagogyThe relation of TPACK areas change during teacher education, that is, how differently or similarly TPACK areas are assessed compared with each otherImplications for practice and/or policy: There is a need for better support for pre‐service teachers' technological content knowledge and technological knowledge in teacher educationIn future studies, it is important to outline factors affecting the changes in TPACK profilesProfiling of pre‐service teachers' TPACK is needed for targeting appropriate support. [ABSTRACT FROM AUTHOR]