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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]

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]

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: 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]

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]

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]

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]

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]

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]

Child welfare removals of children are among the most invasive decisions a state can make toward its citizens, and typically it is the courts that make these decisions. These interventions are regularly exposed to criticism. In this paper, we examine if and how care order proceedings could be improved in England, Finland, Norway, and California, USA. We have asked the judiciary decision‐makers about their view on what should be improved. Our findings show that the organization of the proceedings, including time and staff, are identified as issues in all four systems. Furthermore, the preparations by the child welfare agency are also mentioned as an issue, for English, Finnish, and Californian decision‐makers. Very few decision‐makers indicate features related to the individual, situational, and contextual dimensions, which is interesting since this would be expected from organization theory. The strong call for change in the way proceedings are organized indicates a need for modernization as well as better use of available competency from child development experts. The respondents focus on the elements that a decision‐maker has direct experience with and knowledge about, and this is indeed worth noting for policymakers in the four systems. [ABSTRACT FROM AUTHOR]

Aim: To test the psychometric properties of the Finnish version of the Dempster Practice Behaviour Scale and explore nurses' professional autonomy along with which characteristics are related to it. Design: An instrument validation and a descriptive cross‐sectional study. Methods: The web‐based survey was conducted in September 2021 at two university hospitals in Finland. Exploratory factor analysis (EFA) was used to explore the factor structure of the modified instrument, while Cronbach's α coefficients were calculated to determine the reliability of the scale. Descriptive univariate and multivariate analyses were conducted to examine Registered Nurses' professional autonomy. The study followed STROBE guidelines. Results: During the validation process, the 30 items of the Dempster Practice Behaviour Scale were reduced to 25 items. The S‐CVI/Ave for the translated scale was 0.94. When one additional item was omitted from the EFA, the results supported five factors, which explained 45.9% of the total variance. The mean overall autonomy score was 3.63 out of 5, with readiness and empowerment the subscales with the highest and lowest, respectively, mean values. The linear regression models showed that age, nursing experience, unit type, education, shift, and perceptions of the importance of professional autonomy were related to the subscales describing professional autonomy. Conclusion: The psychometric testing provided evidence that the translated instrument was reliable. Nurses assessed that they are skilled professionals who are accountable for their actions. However, they experienced rather low levels of professional autonomy in empowerment and valuation. Health care organizations should consider this through authentic leadership and, thus, possibly strengthen professional autonomy. [ABSTRACT FROM AUTHOR]

Background: The PROMISS randomised controlled trial showed that personalised dietary advice increased protein intake and improved 400‐m walk time and leg strength among community‐dwelling older adults with a low habitual protein intake. This secondary analysis describes and further evaluates the methods and feasibility of the model used to carry out dietary intervention in the PROMISS randomised controlled trial. Methods: In total, 185 participants (≥65 years, 54% women) with a habitual low protein intake (<1.0 g/kg adjusted body weight/day) in Finland and the Netherlands received personalised dietary advice and complimentary protein‐enriched food products for 6 months with two main objectives: (1) to increase protein intake to ≥1.2 g/kg adjusted body weight/day (energy‐neutral) and (2) to include each day a 'high‐protein meal' containing ≥ 30–35 g of protein. The feasibility of the model was evaluated by the adoption of the advice, feedback from the participants, and practical experiences by the nutritionists. Results: In all, 174 participants (93.5%) completed the intervention. At the 6‐month follow‐up, 41.8% reached both main objectives of the advice. The participants' general rating for the dietary advice was 8.6 (SD 1.0) (on a scale of 1–10; 10 indicating very good). Sticking to the advice was (very) easy for 79.2% of the participants. The nutritionists perceived the model feasible for the participants except for those with low food intake. Conclusions: The methods used in this model are mainly feasible, well‐received and effective in increasing protein intake among community‐dwelling older adults with low habitual protein intake. Key points: Personalised dietary advice is an effective and feasible way to increase protein intake among community‐dwelling older adults.Increasing the knowledge on the importance of protein intake among older adults is essential, and easier tools for self‐evaluation of protein intake are needed.Future research should focus on the older consumers' taste preferences to create protein‐enriched food products, as well as on finding feasible ways to increase protein intake among older adults with low food intake. [ABSTRACT FROM AUTHOR]

This study investigated the association between physical activity (PA) and midlife income. The population‐based data comprised employed members of the Northern Finland Birth Cohort 1966 (N = 2797). Using binned scatterplots and polynomial regressions, we evaluated the association between accelerometer‐measured moderate PA (MPA), vigorous PA (VPA), and moderate‐to‐vigorous PA (MVPA) at 46 years old and register‐based income at 50 years old. The models were adjusted for sex, marital status, number of children, education, adolescent PA, occupational physical strenuousness, and time preference. We found MPA (p < 0.001), VPA (p < 0.05), and MVPA (p < 0.001) to associate curvilinearly with income. In subgroup analyses, a curvilinear association was found between MPA (p < 0.01) and MVPA (p < 0.01) among those with physically strenuous work, VPA among all females (p < 0.01) and females with physically light work (p < 0.01), and MPA and MVPA among all males and males with physically strenuous work (p < 0.05; p < 0.01; p < 0.05; p < 0.05, respectively) and income. The highest income benefits occurred at PA volumes higher than current PA guidelines. Linear associations between PA and income were found among females for MPA (p < 0.05) and MVPA (p < 0.05), among those with physically light work for MPA (p < 0.05), VPA (p < 0.05), and MVPA (p < 0.05), and among females with physically strenuous work for VPA (p < 0.05). We conclude that PA up to the current recommended level is associated with income, but MPA exceeding 505.4 min/week, VPA exceeding 216.4 min/week, and MVPA exceeding 555.0 min/week might have a negative association with income. [ABSTRACT FROM AUTHOR]

Background: Knowledge of the experiences of coping in patients with incurable cancer is essential for high‐quality palliative and end‐of‐life care. Aim and Objective: To describe the coping experiences of patients with incurable cancer in hospice care to better develop patient‐centred care. Methods: The data for this qualitative study were collected through semi structured interviews, with patients with incurable cancer in hospice care (N = 20) and analysed with inductive content analysis. Ethical and organisational approvals were obtained, and the participants received both verbal and written information before consenting to participate. Results: The patients' coping was enhanced with their involvement in treatment‐related decisions. Valuing day‐to‐day living and coping with emotional stressors helped them accept their own life situations. Accepting their increasing fragility was enhanced by their self‐reappraisal. The patients found security in the possibility of receiving support when they needed it. Although the ordinariness of dying in hospice care settings was sometimes too much to bear, they understood dying to be a part of the natural cycle of life. They questioned the responsiveness of healthcare services because they felt that they were not always heard. Study Limitations: Because this study was limited to a specific population of cancer patients in hospice care, the results might not be generalised to other patient groups with chronic diseases or other palliative care settings. Conclusions: The experiences of patients in hospice care of coping with incurable cancer were reminiscent of the common coping process descriptions. Surprisingly, even though participants voiced that they had accepted their situation, dying itself was something they did not find crucial to discuss. The crucial aspects – without being in denial – dealt more with focusing on positive thinking and facing life. [ABSTRACT FROM AUTHOR]

Adolescents growing up outside their birth homes are at major risk for multiple adversities in early adulthood, including low education and unemployment. The transition from out‐of‐home placement to independent living overlaps with the transition from school to work and higher education. However, the support during this critical phase is often inadequate. Adolescents ageing out of care are also more likely to have faced adversities in their birth families. Yet, the interplay between different risk factors and having aged out of care has gained little attention. This study aimed to assess known risk factors for low education and unstable employment and their interaction with ageing out of care, controlling for birth‐home‐related adversities. We assessed this topic using logistic and linear regression modelling based on the Finnish birth cohort 1987 (n = 59 476) registry. Our analysis showed that obtaining upper secondary and higher education was much less likely among those ageing out of care, and they had spent 52–80 fewer days annually in employment after graduation. Few interactions with other risk factors were, however, found. Efforts are needed to prevent inequalities in education and employment for those ageing out of care in the transition phase from school to work. [ABSTRACT FROM AUTHOR]

Background: Regulatory problems (RPs; excessive crying, sleeping, or feeding difficulties) that co‐occur (i.e., multiple) or are persistent have been associated with cognitive and behavioral problems in childhood. However, it remains unknown if multiple or persistent RPs are associated with cognitive and behavioral problems in adulthood. Methods: This large prospective longitudinal study (N = 759) was conducted in two cohorts in Germany (N = 342) and Finland (N = 417). RPs were assessed at 5, 20, and 56 months via the same standardized parental interviews and neurological examinations. In young adulthood, questionnaires were used to assess behavioral problems. Cognitive functioning was assessed with IQ tests. We examined the effects of multiple or persistent RPs on the outcomes via analysis of covariance tests and logistic regression controlled for the influence of cohort. Results: Of 163 participants with RPs, 89 had multiple and 77 had persistent RPs. Adults who had early multiple or persistent RPs (N = 151) reported more internalizing (p =.001), externalizing (p =.020), and total behavioral problems (p =.001), and, specifically, more depressive (p =.012), somatic (p =.005), avoidant personality (p <.001), and antisocial personality problems (p =.006) than those who never had RPs (N = 596). Participants with multiple or persistent RPs were more likely to receive any ADHD diagnoses (p =.017), particularly of hyperactive/impulsive subtype (p =.032). In contrast, there were no associations between multiple or persistent RPs and IQ scores in young adulthood. Conclusions: The results indicate long‐lasting associations between multiple or persistent RPs and behavioral problems. Thus, screening for early RPs could help to identify children who are at risk for later behavioral problems. [ABSTRACT FROM AUTHOR]

This study examined longitudinal associations between parenthood‐related factors and physical activity from young adulthood to midlife over a 19‐year follow‐up period. Participants (n = 761) at the ongoing Cardiovascular Risk in Young Finns Study responded to a self‐report questionnaire in their adulthood (in 1992, 2001, 2007, and 2011). Participants were classified as meeting or not meeting an aerobic physical activity recommendation. Parenthood‐related factors included the age of having their first child and the number and age of the children. Analyses of generalized estimation equations were performed and adjusted for several demographic and health‐related covariates. Both mothers and fathers with children under 6 years were less likely to be involved in physical activity than participants without children. However, meeting the aerobic physical activity recommendations did not differ between parents with a youngest child who was 6 years old or older as compared to the childless participants. The older the youngest child was, the more likely the parents were to be physically active. Participants who became a parent relatively late, at the age of 30 or older, seemed less likely to meet the aerobic physical activity recommendation during follow‐up than those who had their first child at the age of 26–29. The results indicate that parenthood does not seem to have a long‐lasting negative impact on adults' physical activity, and the individuals reached a similar level of physical activity in midlife than they had before parenthood. [ABSTRACT FROM AUTHOR]

Aim: To describe the clinical nurse specialist role and its outcomes and challenges. Design: Participatory Action Research conducted in Finland between the fall of 2017 and the end of 2018. Methods: A core participatory action research team (n = 10) led the design, implementation and evaluation of the research. Multiple data collection methods were used. The study is reported using the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) guidelines for participatory action research. Results: The clinical nurse specialist used most of the time in clinical patient care followed by clinical nursing leadership and scholarship activities. Outcomes of successful implementation led to increased visibility of nursing expertise, development, integration and quality assurance of nursing processes and practice, and promotion of knowledge translation and unit and collaborator cooperation. Furthermore, role challenges were also recognized. [ABSTRACT FROM AUTHOR]

Background: The role of medical emergency team (MET) in managing deteriorating patients and enhancing patient safety is greatly affected by teamwork. Aims: To identify teamwork‐related needs of the MET from MET nurses' perspectives. To assess the associations between MET nurses' perceptions of teamwork and their work experience and education. Study design: A quantitative, descriptive correlational design. Methods: Registered intensive care unit (ICU) nurses (n = 50) who were members of the MET in an acute tertiary care hospital answered a modified version of the team assessment questionnaire in 2017. Data were analysed using descriptive statistics, the Kruskal‐Wallis test, and the univariate analysis of variance method. The reporting of this study adheres to the strengthening the reporting of observational studies (STROBE) guidelines. Results: Participants showed least agreement with the items presenting leadership skills (mean = 2.6, SD = 0.68). Approximately 50% nurses disagreed that the MET had adequate resources, training, and skills. The majority of nurses (80%) felt that their responsibilities as a MET member interfered with taking care of their own ICU patients. Many nurses (64%) felt that they did not have a voice in MET's decision‐making process. Approximately 50% nurses felt that they were not recognized for their individual contribution, and they were uncertain regarding MET's policies for dealing with conflicts. The amounts of MET nurses' work experience and education were associated with MET skills and function, respectively. Conclusion: Key teamwork elements of the MET that need improvements include decision‐making and conflict resolution skills, valuing team members, and team leadership. Practicing shared mental models, implementing the TeamSTEPPS curricula at hospitals for training ICU nurses, and simulation‐based team‐training programmes may be beneficial in improving teamwork of MET members. Relevance to clinical practice: This study revealed key teamwork elements of the MET that need improvements. Our findings may contribute to improve teamwork, thereby optimizing MET function, and enhancing patient outcomes. [ABSTRACT FROM AUTHOR]

In this study, we examine the cross-cultural differences in human resource (HR) managers' beliefs in effective HR practices by surveying HR practitioners in Finland (N = 86), South Korea (N = 147), and Spain (N = 196). Similar to previous studies from the United States, the Netherlands, and Australia, there are large discrepancies between HR practitioner beliefs and research findings, particularly in the area of staffing. In addition, we find that interpersonal-oriented aspects of HR practices tend to be more culturally bound than technical-oriented aspects of HR practices. We interpret the differences using Hofstede's cultural dimensions (Power Distance, Individualism versus Collectivism, Masculinity versus Femininity, Long-Term Orientation versus Short-Term Orientation, and Uncertainty Avoidance). We discuss the overall nature of the science-practice gap in HR management, and the implications for evidence-based management. © 2014 Wiley Periodicals, Inc. [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]

Background: Consistent practice, an agreed clinical practice based on evidence, has been considered as a base for effective provision of quality and safety of care. As a result, patients have an equal quality of care regardless of the organisation or worker. However, despite the international guidelines, pressure ulcer prevention practices vary in long‐term older people care. Aim: To develop, implement and evaluate the impact of renewed, consistent practice for pressure ulcer prevention, in long‐term older people care. Design: A quasi‐experimental intervention study. Methods: Two long‐term older people care facilities chosen with convenience sampling were randomly allocated to intervention or comparison group. Registered and practical nurses, in total 141/112, participated in the study. The renewed consistent practice based on international guidelines for pressure ulcer prevention was developed and implemented using the Operational Model for Evidence‐Based Practices (OMEBP). Frequencies and agreement of PU prevention practices in line with international guidelines in the care facilities were measured using the PUPreP instrument. Results: In the intervention facility, improvement in line with international guidelines was seen in the frequency of PU prevention practices in risk assessment, nutrition, pressure‐relieving devices and documentation. Furthermore, improvement was seen in the intervention facility in all six areas of agreement on practices. Conclusions: The results of this study support the implementation of PU prevention guidelines in long‐term older people care (LOPC) and more widely in healthcare settings for older people to promote consistent practice, and safety and equal quality of care. [ABSTRACT FROM AUTHOR]

Aim: To develop the Nurse Managers' Work Content Questionnaire (NMWCQ) and to describe nurse managers' work content. Background: Restructuring within health care has expanded the nurse manager's role to include organisational, patient and staff demands. Methods: The pilot study employed a cross‐sectional study design. Based on a literature review, the NMWCQ with 102 items was developed and pretested for this study. Data were collected in 2017 from three Finnish acute care central hospitals that provide specialised health care. A total of 61 nurse managers participated, which represents a response rate of 59%. Principal component analysis was used to test the construct validity of the instrument. Cronbach's alpha values were used to analyse the internal consistency of the instrument. In addition, descriptive and nonparametric analysis was used. Results: Ultimately, 13 components with 87 items were identified in the questionnaire. The construct validity and internal consistency of the questionnaire were at acceptable levels. Cronbach's alpha rates of the components were 0.554 ‐ 0.890. The most frequently performed daily work of nurse managers was in the component of organising, and the most infrequently performed daily work was in the component of clinical nursing. Conclusions: The study shows that the Nurse Managers' Work Content Questionnaire (NMWCQ) is suitable for measuring the current content of nurse managers' work. However, the questionnaire is new and needs additional testing such as confirmatory factor analysis with larger amounts of data. [ABSTRACT FROM AUTHOR]

Seclusion and restraint are regularly used to manage patient aggression events in psychiatric inpatient care, despite occupational safety concerns. There is currently a lack of information on how nurses perceive the use of patient seclusion and restraint as a risk for occupational safety. The aim of this study is to describe the risks for occupational hazards in patient seclusion and mechanical restraint practices as well as ideas for improvement identified by nurses. A qualitative descriptive design was adopted, using focus groups comprising nurses (N = 32) working in psychiatric inpatient care. The data were analysed using inductive content analysis, and the results were reported using the consolidated criteria for reporting qualitative studies (COREQ). Four themes of risk for occupational hazards were identified: patient‐induced, staff‐induced, organization‐induced, and environment‐induced risks. One significant finding was that nurses described that their actions can strongly contribute to occupational hazards during seclusion and mechanical restraint practices. The nurses gave various ideas for how occupational safety could be improved during seclusion and mechanical restraint events, ideas involving staff, the organization, and environmental enhancements. [ABSTRACT FROM AUTHOR]

This study aimed to examine the association between breastfeeding and childhood obesity. A multinational cross‐sectional study of 4,740 children aged 9–11 years was conducted from 12 countries. Infant breastfeeding was recalled by parents or legal guardians. Height, weight, waist circumference, and body fat were obtained using standardized methods. The overall prevalence of obesity, central obesity, and high body fat were 12.3%, 9.9%, and 8.1%, respectively. After adjustment for maternal age at delivery, body mass index (BMI), highest maternal education, history of gestational diabetes, gestational age, and child's age, sex, birth weight, unhealthy diet pattern scores, moderate‐to‐vigorous physical activity, sleeping, and sedentary time, exclusive breastfeeding was associated with lower odds of obesity (odds ratio [OR] 0.76, 95% confidence interval, CI [0.57, 1.00]) and high body fat (OR 0.60, 95% CI [0.43, 0.84]) compared with exclusive formula feeding. The multivariable‐adjusted ORs based on different breastfeeding durations (none, 1–6, 6–12, and > 12 months) were 1.00, 0.74, 0.70, and 0.60 for obesity (Ptrend =.020) and 1.00, 0.64, 047, and 0.64 for high body fat (Ptrend =.012), respectively. These associations were no longer significant after adjustment for maternal BMI. Breastfeeding may be a protective factor for obesity and high body fat in 9‐ to 11‐year‐old children from 12 countries. [ABSTRACT FROM AUTHOR]

Background: In Finland, although families generally receive support from child health clinics, some need more help in dealing with their child's emotions, behaviour and psychosocial development. Public health nurses play a central role in providing vital psychosocial support for families, but they often lack the confidence and competence to tackle mental health problems. Aim: To describe how public health nurses used and experienced a working model that combined a psychosocial tool (Strengths and Difficulties Questionnaire, SDQ) to identify disruptive behaviour in four‐year‐old children and an Internet‐based parent training programme with telephone coaching. Methods: This is a descriptive, cross‐sectional survey study. The sample consists of public health nurses (n = 138) who were working in child health clinics in Finland that had used the working model. Statistical data were analysed using SPSS Statistics for Windows. The responses to an open‐ended question were analysed using inductive content analysis. Results: The experiences about the working model were mainly positive. The public health nurses felt that the psychosocial tool, the SDQ, was easy and suitable to use in child health clinics. The availability of an Internet‐based parent training programme provided greater support for parents by overcoming practical barriers. Overall, the working model helped nurses to develop their mental health competencies. Conclusion: Within primary care, the need to tackle psychosocial problems is increasing, and for this, public health nurses need extra support and tools. It seems that the working model, including the SDQ and the online and telephone coaching programme, worked well in child health clinics. This working model can be used to provide parental support and improve nurses' mental health competencies. [ABSTRACT FROM AUTHOR]

Background: First‐line managers are links between an organizations' administration and the workforce. They transmit information from higher managers to workers and vice versa. Their management skills and especially their interaction with staff are a key point in successful management. Aim: To describe how first‐line managers realized appreciative management in their everyday management practice in health and social care. Method: A quantitative descriptive study was conducted by means of an electronic survey among social and healthcare managers in Finland. Results: Based on the self‐evaluations of the managers, appreciative management is well realized. The most recognition was given to equality and the least to appreciative know‐how. Connections were seen between appreciative management and gender, education, education level and managers with higher education, and those with fewer work units below them tended to have a better realization of appreciative management. Conclusion: The education level of first‐line nurse managers is meaningful when realizing appreciative management in social and healthcare settings. Implications for nursing management: More advanced education levels of first‐line managers help to promote appreciative management in social and health care, together with the amount of work units (meaning outpatient and inpatient wards). A first‐line manager is responsible for the needs of their workforce and needs to be critically assessed so that they might have more time for managing in an appreciative way. Appreciative management should be given increased focus when educating nurse managers. [ABSTRACT FROM AUTHOR]

Background: Many children with neurodevelopmental disorders such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD) or developmental language disorder (DLD) have difficulty recognizing and understanding emotions. However, the reasons for these difficulties are currently not well understood. Aims: To compare the emotion recognition skills of children with neurodevelopmental disorders as well as those children's skills with the skills of their typically developing (TD) age peers. Also, to identify the role of underlying factors in predicting emotion recognition skills. Methods & Procedures: The 6–10‐year‐old children (n = 50) who participated in the study had either ASD, ADHD or DLD and difficulties recognizing emotions from face and/or in voice. TD age peers (n = 106) served as controls. Children's skills were tested using six forced‐choice tasks with emotional nonsense words, meaningful emotional sentences, the FEFA 2 test, photographs, video clips and a task in which facial expressions and tones of voice had to be matched. Expressive vocabulary, rapid serial naming, auditory and visual working memory and Theory of Mind skills were explored as possible explanatory factors of the emotion recognition difficulties of the diagnosed children. Outcomes & Results: Children with ASD, ADHD or DLD did not significantly differ from each other in their linguistic or cognitive skills. Moreover, there were only minor differences between children with these diagnoses in recognizing facial expressions and emotional tone of voice and matching the two. The only significant difference was that children with ADHD recognized facial expressions in photographs better than children with DLD. The participants with diagnoses scored significantly lower than the controls in all but one emotion recognition tasks presented. According to the linear regression analysis, first‐order Theory of Mind skills predicted the delay relative to typical development in the recognition of facial expressions in the FEFA 2 test, and expressive vocabulary and working memory skills together predicted the delay in the recognition of emotions in the matching task. Conclusions & Implications: Children with ASD, ADHD or DLD showed very similar emotion recognition skills and were also found to be significantly delayed in their development of these skills. Some predictive factors related to linguistic and cognitive skills were found for these difficulties. Information about impaired emotion recognition and underlying linguistic and cognitive skills helps to select intervention procedures. Without this information, therapy might unnecessarily focus on only symptoms. [ABSTRACT FROM AUTHOR]

Background: Localised prostate cancer affects patient's quality of life in many ways. The aim of this study was to explore factors related to self‐rated health and life satisfaction for patients treated for prostate cancer, and to compare the results of these generic quality‐of‐life measures to the prostate cancer‐specific quality‐of‐life measure (UCLA Prostate Cancer Index), which focuses on physical functioning. Material and methods: This cross‐sectional survey was carried out among 183 men who underwent radical prostatectomy in 2012–2015 at a university hospital in Finland and were seen 1 year postsurgery. Approval from an ethics committee and written consents from participants were received. A questionnaire was used to evaluate patients' perceived quality of life. Logistic regression model, Spearman's correlation, Kruskal–Wallis test and Mann–Whitney U‐test were used to analyse factors related to quality of life. Results: Of the 183 men in the study, 63% rated their health status as good, and 70% were satisfied with their lives after prostatectomy. Older age and better urinary function were the only factors that explained both better self‐rated health and better satisfaction with life. The patients seemed not to interpret problems with sexual function as health‐related problems. In our sample, sexual dysfunction was relatively severe, but patients considered them to be less harmful than urinary or bowel symptoms. Interestingly, 24% of the men with low sexual function did not find that dysfunction bothersome. Conclusions: Objectively measured physical functioning is not necessarily in line with patients' experienced satisfaction with life and their self‐ratings of health. More longitudinal and qualitative research is needed about the meanings that patients attach to physical treatment side effects and the extent to which they can adapt to them over time. With a bigger sample and longer follow‐up time, it would be possible to identify men who particularly benefited from pretreatment counselling. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: In‐hospital, family‐witnessed cardiopulmonary resuscitation of adults has been found to help patients' family members deal with the short‐ and long‐term emotional consequences of resuscitation. Because of its benefits, many national and international nursing and medical organizations officially recommend this practice. Research, however, shows that family‐witnessed resuscitation is not widely implemented in clinical practice, and health care professionals generally do not favour this recommendation. Aim: To describe and provide an initial basis for understanding health care professionals' views and perspectives regarding the implementation of an in‐hospital, family‐witnessed adult resuscitation practice in two European countries. Study design: An inductive qualitative approach was used in this study. Methods: Finnish (n = 93) and Polish (n = 75) emergency and intensive care nurses and physicians provided written responses to queries regarding their personal observations, concerns and comments about in‐hospital, family‐witnessed resuscitation of an adult. Data were analysed using inductive thematic analysis. Findings: The study analysis yielded five themes characterizing health care professionals' main concerns regarding family‐witnessed resuscitation: (1) family's horror, (2) disturbed workflow (3) no support for the family, (4) staff preparation and (5) situation‐based decision. Conclusion: Despite existing evidence revealing the positive influence of family‐witnessed resuscitation on patients, relatives and cardiopulmonary resuscitation process, Finnish and Polish health care providers cited a number of personal and organizational barriers against this practice. The results of this study begin to examine reasons why family‐witnessed resuscitation has not been widely implemented in practice. In order to successfully apply current evidence‐based resuscitation guidelines, provider concerns need to be addressed through educational and organizational changes. Relevance to clinical practice: This study identified important implementation barriers for allowing families in critical care settings to be present during resuscitation efforts. These results can be further used in developing and adjusting clinical practice policies, protocols and guidelines related to family‐witnessed resuscitation. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The objective of this study was to determine whether drugs with sedative properties are related to oral health behaviour—such as frequency of toothbrushing, using toothpaste and dental visits—and oral hygiene, measured by the number of teeth with dental plaque, among community‐dwelling older people. Methods: The study population consisted of 159 community‐dwelling, dentate, non‐smoking, older people from the Oral Health GeMS study (Geriatric Multidisciplinary Strategy for the Good Care of Older People study). The data were collected by interviews and clinical examinations during 2004‐2005. Sedative properties of drugs were assessed using the sedative load (SL) model. Logistic and Poisson regression models were used to estimate odds ratios/relative risks (OR/RR) and 95% confidence intervals (CI). Results: After adjusting for confounding factors, SL associated with infrequent toothbrushing (OR 1.72, CI: 0.61‐4.89), toothpaste use less than twice a day (OR 3.34, CI: 1.39‐8.12), non‐regular dental visits (OR 2.28 CI: 0.91‐5.30) and the number of teeth with dental plaque (RR 1.20 CI: 1.04‐1.39) compared to participants without a SL. Conclusions: The results of this study suggest that use of drugs with sedative properties indicates poor oral health behaviour among older people. [ABSTRACT FROM AUTHOR]

ABSTRACT: The purpose of this study was to determine how the health‐related quality of life (HRQoL) of patients with prostate cancer and their spouses change during the 6 months after diagnosis and which factors explain the changes. Patients with prostate cancer and their spouses have reported a decrease in HRQoL, but simultaneous follow‐up of the HRQoL of patients with prostate cancer and their spouses is rare. The sample consisted of 186 couples. The participants personally filled in the RAND‐36‐Item Health Survey, both at the time of diagnosis and 6 months later. Changes in the HRQoL were analysed statistically using descriptive statistics and non‐parametric tests. Linear regression models were used to identify the factors associated with the changes in HRQoL in the patients and their spouses. The HRQoL of patients with prostate cancer and their spouses did not change significantly during the first 6 months after diagnosis. Changes in the patients’ bodily pain and physical functioning were explained by their background variables. The spouses’ background variables did not explain the changes in HRQoL during the follow‐up period. In addition, the changes in the HRQoL of patients and their spouses are very similar. There is a need for long‐term assessment of changes in the HRQoL of patients with prostate cancer and their spouses. The findings indicate that attention should be paid to spouses with regard to the nursing of patients with prostate cancer, as spouses seem to be an important resource for patients with prostate cancer. [ABSTRACT FROM AUTHOR]

Background: Many women with vulvodynia are women of fertile age, and this syndrome may cause many physical and psychosexual functional disorders. Women with vulvodynia often find that healthcare professionals seem to demonstrate a lack of awareness about the syndrome and its care. These issues have not been previously studied among student healthcare staff. Aim: To investigate awareness and knowledge about vulvodynia and its care among staff in the student healthcare sector in Finland. Method: The study design was cross sectional. A survey instrument called ‘Awareness and knowledge of vulvodynia and its care’ was developed for this study and was used for data collection. The data were collected from a web‐based survey conducted with student healthcare professionals (N = 191, n = 79) in all 13 student healthcare units in Finland. Descriptive statistical methods were used to describe the connections between the factors associated with awareness of vulvodynia and its care. Ethical standards were followed throughout the study. Results: The primary results of the study indicated that the respondents had somewhat good awareness of how to identify vulvodynia and somewhat poor awareness of the treatments for vulvodynia. Participants' awareness of the meaning of encountering patients, as well as the information and support they provided, was good. Based on the knowledge test, knowledge of vulvodynia and its care was estimated to be poor. The respondents' experience‐based skills in treating vulvodynia and education about vulvodynia were mostly associated with better awareness and knowledge about vulvodynia and its care. Conclusion: The student healthcare staff who meet and care for women of fertile age have irregular awareness and knowledge of vulvodynia and its care. The creation of educational programs to develop such awareness and knowledge is recommended to obtain a standard quality of care for all women with vulvodynia. [ABSTRACT FROM AUTHOR]

Purpose/Design This cross-sectional descriptive study describes staff experiences of appreciative management. Methods Data were collected by way of e-survey from staff (n = 87) working in the institutional care of people with intellectual and developmental disabilities . The Appreciative Management Scale ( AMS 1.0) was used and data were analysed by statistical methods. Findings Overall, respondents experienced appreciative management as being well implemented, with equality as the best implemented dimension and systematic management the worst. The promotion of well-being at work was associated with age. Appreciation staff received from management had a positive correlation with systematic management, equality, appreciation of know-how and the promotion of well-being at work. Conclusions The knowledge of weak systematic management in this study may be utilised in developing management strategies. The managers should use the concept of appreciative management to help young and less experienced nurses to increase their competency and willingness to work in this field. [ABSTRACT FROM AUTHOR]

Sweden and Finland were the first countries to ban corporal punishment 30 years ago. Since then, the prevalence of attitudes supporting the use of corporal punishment and the practice itself have decreased. This study examines the current frequencies of corporal punishment and other humiliating upbringing practices in Finnish and Swedish families. The analysis is based on survey data among 3170 Finnish and 1358 Swedish parents with children from newborn to 12 years of age. Data were analysed using univariate tests (chi-square) and logistic regression. According to the analysis, a larger proportion of Finnish parents, and especially mothers, use humiliating upbringing practices compared to Swedish parents. This difference is not found with regard to corporal punishment. A larger proportion of Finnish parents push their children compared to Swedish parents, while a larger proportion of Swedish parents shake their children. In both countries, corporal punishment is more frequently used by fathers, boys are more often victimised than girls, toddlers are more often exposed to corporal punishment and school-age children are more often subjected to psychologically abusive practices. Corporal punishment and other humiliating upbringing practices are strongly correlated in both countries. The differences found between countries were not explained by socio-demographic factors. Key Practitioner Messages Use of corporal punishment is still quite common among Finnish and Swedish parents., Parents use corporal punishment more often towards children aged two to six years while other humiliating upbringing practices are used more often towards children above age six., The differences between Finland and Sweden in the use of corporal punishment and other humiliating upbringing practices are not explained by traditional socioeconomic characteristics, nor by the parents' own experiences. [ABSTRACT FROM AUTHOR]

Background Earlier research and clinical practice show that specific language impairment (SLI) is often associated with nonverbal cognitive deficits and weakened skills in executive functions (EFs). Executive deficits may have a remarkable influence on a child's everyday activities in the home and school environments. However, research information is still limited on EFs in school-aged children with SLI, mostly conducted among English- and Dutch-speaking children. Aims To study whether there are differences in EFs between Finnish-speaking children with SLI and typically developing (TD) peers at school age. EFs are compared between the groups with and without controlling for nonverbal intelligence. Methods & Procedures : Parents and teachers of children with SLI ( n = 22) and age- and gender-matched TD peers ( n = 22) completed The Behavior Rating Inventory of Executive Functions (BRIEF). The mean age of the children was 8,2 years. BRIEF ratings of parents and teachers were compared between the children with SLI and with TD peers by paired analysis using conditional logistic regression models with and without controlling for nonverbal IQ. Intellectual functioning was assessed with the Wechsler Intelligence Scale for Children. Outcomes & Results Children with SLI had weaker scores in all parent and teacher BRIEF scales compared with TD peers. Statistically significant differences between the groups were found in BRIEF scales Shift, Emotional Control, Initiate, Working Memory, Plan/Organize and Monitor. Differences between the groups were statistically significant also in intellectual functioning. On BRIEF scales some group differences remained statistically significant after controlling for nonverbal IQ. Conclusions & Implications This study provides additional evidence that also Finnish-speaking school-aged children with SLI are at risk of having deficits in EFs in daily life. EFs have been proposed to have an impact on developmental outcomes later in life. In clinical practice it is important to pay attention to EFs in school-aged children with SLI when making diagnostic evaluations and planning interventions for them. [ABSTRACT FROM AUTHOR]

Background Nonprofit cancer societies play an important role in providing social support for patients with cancer through nonprofit electronic counselling services ( ECS) provided by counselling nurses ( CNs) with experience in oncology nursing. To date, there exist only few studies addressing the facilitators and barriers for social support of patients with cancer as reported by CNs. Objective To describe the facilitators and barriers for electronic social support of patients with cancer received from the ECS in the nonprofit cancer societies as reported by CNs. Methods Qualitative design with three group interviews was conducted with 10 CNs in three nonprofit cancer societies in southern and western parts of Finland. Interviews were recorded, transcribed verbatim and content analysed inductively. Findings The facilitators were promotion of the access to ECS, functioning structures of ECS, utilisation of the strengths of an individual CN in ECS, promotion of the life management of patients, patient-centeredness as a basis of ECS and reliability of ECS. The barriers for electronic social support were the unmet paths between ECS and patients, nonfunctioning structures of ECS, inadequacy of mutual communication and lack of shared viewpoints between CNs and patients. Conclusions Facilitators and barriers for electronic social support of patients with cancer were related to organisation, individuals and counselling process. The counselling work in ECS as its best promotes the life management of patients with cancer but, alternatively, can lead to conflicts in communication and therefore be a barrier for electronic social support. Implications for practice To make the nonprofit ECS better known, the cooperation with hospitals is needed to enable social support for patients. To improve communication between CNs and patients, continuous communications skills training and functional working environments are needed. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Eating disorders and alcohol use disorders often co-occur, but few prospective studies have examined their relationship. Using a large population-based twin sample, we investigated how the drinking behaviors of women with lifetime eating disorders unfold from adolescence to adulthood. Method We identified 182 women with a lifetime eating disorder assessed at mean age 24, including 92 women with DSM-5 anorexia nervosa and 58 women with DSM-5 bulimia nervosa, from the 1975-1979 birth cohorts of Finnish twins ( N = 2,825 women). Frequency of drinking and intoxicating were assessed at ages 16, 24, and 34. Drinking problems were assessed at ages 24 and 34 by the Malmö-modified Michigan Alcohol Screening Test (Mm-Mast) and the Rutgers Alcohol Problem Index (RAPI). Results At age 16, proportionately more women with eating disorders reported being severely intoxicated when they last drank (25% vs.16%, P = 0.001), and at both surveys in adulthood, they reported more frequent intoxication and more alcohol-related problems than their unaffected peers. Those who had recovered from their eating disorder at age 24 still reported more alcohol-related problems in their 30s than did other women. The age of drinking onset, number of monthly drinking days, or frequency of intoxication in adolescence did not differ between women with lifetime eating disorders and unaffected women. Discussion Women with eating disorders scored higher than their unaffected peers on scales measuring alcohol dependence, alcohol-related problems, and intoxication. These differences persisted from mid-adolescence into young adulthood. Women with eating disorders should be assessed routinely for drinking behaviors. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:563-571) [ABSTRACT FROM AUTHOR]

Background and Aims Flaws in previous studies mean that findings of J-shaped risk curves for gambling should be disregarded. The current study aims to estimate the shape of risk curves for gambling losses and risk of gambling-related harm (a) for total gambling losses and (b) disaggregated by gambling activity. Design Four cross-sectional surveys. Setting Nationally representative surveys of adults in Australia (1999), Canada (2000), Finland (2011) and Norway (2002). Participants A total of 10 632 Australian adults, 3120 Canadian adults, 4484 people aged 15-74 years in Finland and 5235 people aged 15-74 years in Norway. Measurements Problem gambling risk was measured using the modified South Oaks Gambling Screen, the NORC DSM Screen for Gambling Problems and the Problem Gambling Severity Index. Findings Risk curves for total gambling losses were estimated to be r-shaped in Australia {β losses = 4.7 [95% confidence interval (CI) = 3.8, 6.5], β losses2 = -7.6 (95% CI = -17.5, -4.5)}, Canada [β losses = 2.0 (95% CI = 1.3, 3.9), β losses2 = -3.9 (95% CI = -15.4, -2.2)] and Finland [β losses = 3.6 (95% CI = 2.5, 7.5), β losses2 = -4.4 (95% CI = -34.9, -2.4)] and linear in Norway [β losses = 1.6 (95% CI = 0.6, 3.1), β losses2 = -2.6 (95% CI = -12.6, 1.4)]. Risk curves for different gambling activities showed either linear, r-shaped or non-significant relationships. Conclusions Player loss-risk curves for total gambling losses and for different gambling activities are likely to be linear or r-shaped. For total losses and electronic gaming machines, there is no evidence of a threshold below which increasing losses does not increase the risk of harm. [ABSTRACT FROM AUTHOR]

Objective: To assess the population prevalence and incidence of binge eating disorder (BED) among young women. Method: In a nationwide longitudinal study of Finnish twins born 1975-1979, the women participated in five surveys from age 16 until their mid-thirties. At Wave 4 (mean age 24 years), the women (N52,825) underwent a 2-stage screening for eating disorders. We assessed the lifetime prevalence, incidence, and clinical characteristics of DSM-5 BED. Results: We detected 16 women who met DSM-5 criteria for BED, yielding a lifetime prevalence of 0.7% (95% confidence interval [CI] 0.4-1.2%). The incidence of BED among women between 10 and 24 years of age was 35 (95% CI 20-60) per 100,000 person-years. The mean age of onset of BED was 19 years (range 13-27 years). Of the cases, 13/16 (81%) were currently ill. Duration of illness at the time of assessment ranged from less than a year to 13 years (median 6 years). Of women with BED, only two had a history of other eating disorders, but six had lifetime major depressive disorder. Two-thirds of the women with BED belonged to the highest weight quartile at age 16, and their mean BMI at age 22-27 year was 26.2 kg/m² (range 22.1-32.5 kg/m²). Discussion: Incident BED as defined by DSM-5 was relatively rare among younger women and was often preceded by relative overweight. BED often occurred without a history of other eating disorders, but comorbidity with major depressive disorder was common. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to describe nurses' perceptions of workplace culture, especially in regard to stress levels, job satisfaction and the practice environment in primary health care. Background: Health care is facing many challenges related to its attractiveness as a place of employment and the maintenance of a sufficient workforce supply. Previous studies report increasing rates of nurse job dissatisfaction and intentions to leave their current positions both in Finland and also globally. Improving workplace culture is thus vital in meeting the challenges related to recruitment and retention. Methods: A cross ‐ sectional descriptive design was used to describe nurses' perceptions of workplace culture. Data were collected by questionnaire from 22 units in nine primary healthcare organizations in Finland, and analysed using descriptive and inferential statistics. Results: Most of the respondents indicated that they were not certain whether their workplace culture was either positive or negative. Profession, age and work shift characteristics had an effect on the respondents' perceptions of workplace culture. Younger licensed practical and registered nurses assessed their workplace culture more positively, whereas older registered nurses and those working rotating rosters viewed workplace culture more negatively. Conclusions: The findings suggest that both unit and demographic characteristics affect workplace culture. This survey highlights that a positive workplace culture is one of the key factors in retaining and recruiting nurses, and provides an essential evidence that may be considered by other healthcare organizations. Implications for nursing and health policy: Nurse managers and healthcare leaders need to address workload management and take into account the related variables that affect a unit's workplace culture. [ABSTRACT FROM AUTHOR]

In the recovery process of arthroplasty patients, their family members play an important role due to short hospital stay and increased age of patients. Family members need to have knowledge to be able to support the patient. The aim of this study was to explore expected and received knowledge in family members of arthroplasty patients and describe the relationships between the differences in received and expected knowledge and background factors, country, information and control preferences and access to knowledge. The study was conducted in six European countries (Cyprus, Greece, Finland, Iceland, Spain and Sweden). The study design was cross-cultural, prospective and comparative with two measurement points: pre-operative and at discharge from hospital. Knowledge Expectations of significant other-scale and Krantz Health Opinion Survey were used before surgery and Received Knowledge of significant other-scale and Access to Knowledge at discharge. Patients undergoing elective hip or knee arthroplasty in seventeen hospitals were asked to identify one family member. The sample size was decided by power calculation. A total of 615 participants answered the questionnaires at both measurements. Family members perceived to receive less knowledge than they expected to have, most unfulfilled knowledge expectations were in the financial, social and experiential dimensions of knowledge. Seventy-four per cent of participants had unfulfilled knowledge expectations. Increased access to information from healthcare providers decreased the difference between received and expected knowledge. Compared to family members in southern Europe, those in the Nordic countries had more unfulfilled knowledge expectations and less access to information from healthcare providers. The evidence from this study highlights the need to involve the family members in the educational approach. [ABSTRACT FROM AUTHOR]

Our aim was to study the inter-correlations and developmental pathways of mothers' and fathers' social and emotional loneliness during pregnancy (20th pregnancy week), infancy (child aged 8 months), and early childhood (child aged 18 months). Moreover, we aimed to study whether mothers and fathers who have different developmental profiles (identified by latent growth curve mixture models) differ in their experiences of marital dissatisfaction ( RDAS), social phobia ( SPIN) and depression ( BDI) during pregnancy. Both mothers' social and emotional loneliness and fathers' social and emotional loneliness were highly stable, and within individuals these loneliness factors were strongly correlated. However, the correlations between mothers' loneliness experiences and fathers' loneliness experiences were weaker than expected. Separate latent growth curve groups were identified, which differed in feelings of marital dissatisfaction, social phobia, and depression. These groupings revealed that the higher the loneliness was, the more the parents experience these other psychosocial problems. [ABSTRACT FROM AUTHOR]

As pregnancy may trigger overweight in women, new means for its prevention are being sought. The aim here was to investigate the effect of individual dietary counselling during and after pregnancy on post‐partum weight and waist circumference up to 4 years post‐partum. A cohort of women (n = 256) were randomized to receive repeated individual dietary counselling by a nutritionist during and after pregnancy, or as controls not receiving dietary counselling, from the first trimester of pregnancy until 6 months after delivery. Counselling aimed to bring dietary intake into line with recommendations, with particular focus on the increase in the intake of unsaturated fatty acids instead of saturated. Pre‐pregnancy weight was taken from welfare clinic records. Weight and waist circumference were measured at 4 years after delivery. The proportion of overweight women increased from 26% prior to pregnancy to 30% at 4 years after delivery among women receiving dietary counselling, as against considerably more, from 32% to 57%, among controls. The prevalence of central adiposity was 31% in women receiving dietary counselling, 64% in controls. Likewise, both the risk of overweight (odds ratio: 0.23, 0.08–0.63, P = 0.005) and central adiposity (odds ratio: 0.18, 0.06–0.52, P = 0.002) were lower in women receiving dietary counselling compared with controls. Repeated dietary counselling initiated in early pregnancy can be beneficial in long‐term weight control after delivery. [ABSTRACT FROM AUTHOR]

Clinical preception in practice plays a significant role in the education of both Registered Nurses and practical nurses. This study presents the evaluation of an interprofessional research and development project (2009-2103) on clinical preceptorship between two universities of applied sciences, two vocational institutes and four healthcare organisations in western Finland. The research question was as follows: How did the participants evaluate the process and outcomes of developing preceptorship through an action-research approach? The primary target group consisted of professionals within the healthcare sector and nursing teachers at the universities of applied sciences and the vocational institutes. The five units represented in the healthcare organisations functioned as clinical practice placements for both nursing and practical nursing students, with Registered Nurses and practical nurses acting as their preceptors. Each unit developed a unique preceptorship model to answer their specific needs. The models were implemented and tested during one academic year followed by a quantitative (a 4-point scale) and qualitative evaluation of the process. The models are presented in another article, and the evaluation results are presented in this article. The evaluation showed that preceptorship has become an important and accepted part of work, including the practice of starting any preception at a unit with a thorough introduction. The project's emphasis on critical thinking, reflection and focus on ethics were valued by the staff. Pedagogical further education should be arranged on a regular basis to strengthen the knowledge base of the preceptors. Furthermore, enough time for preceptorship should be allocated, as it is a pedagogical duty. The implication of this project is that more cooperation between different stake holders is needed, in order to narrow the gap between theory and praxis. [ABSTRACT FROM AUTHOR]

Contemporary evidence on the effectiveness of concrete and abstract representations in science education is based solely on studies conducted in college context. There it has been found that learning with abstract representations produces predominantly better outcomes than learning with concrete representations and combining the representations can be even more productive. In the present study, 52 elementary school students used a computer simulation to discover the basic principles of electric circuits. The perceptual concreteness of simulation elements either remained concrete or switched from concrete to abstract during the learning. In order to compare the relative effectiveness of the learning conditions and assess the changes in students' conceptual understanding, the students completed a subject knowledge assessment questionnaire before and after learning with the simulation. According to the results, the students gained a better understanding of the circuits by learning with constantly concrete simulation elements than switching from concrete to abstract elements during the learning. Constantly concrete elements also enhanced the learning process by reducing the learning times. The outcomes of the study suggest that the effects of concrete and abstract representations in science education are notably different in elementary school context as compared with college contexts. [ABSTRACT FROM AUTHOR]

Objectives In Finland, a major oral healthcare reform ( OHCR), implemented during 2001-2002, opened the public dental services ( PDS) and extended subsidies for private dental services to entire adult population. Before the reform, adults born earlier than 1956 were not entitled to use PDS nor did they receive any reimbursements for their private dental costs. We aimed to examine changes in the income-related inequality and inequity in the use of dental services among the adult Finns after the reform. Methods Representative data from Finnish adults born in 1970 or earlier were gathered from three identical postal surveys concerning the use of dental services and subjective perceptions of oral health. Those surveys were conducted before the OHCR in 2001 ( n = 1907) and after the OHCR in 2004 ( n = 1629) and 2007 ( n = 1509). We used concentration index and its decomposition to analyse income-related inequality and inequity in the use of dental services and factors associated with them. Results Results showed that pro-rich inequality and inequity in the overall use of dental services narrowed from 2001 to 2004. However, between 2004 and 2007, pro-rich inequality and inequity widened, so it returned to a rather similar level in 2007 as it had been in 2001. Most of the pro-rich inequality and inequity were related to regular dental visiting habit and income level. While there was pro-poor inequality and inequity in the use of PDS, there was pro-rich inequality and inequity in the use of private dental services throughout the study years. Conclusion It seems that income-related inequality and inequity in the use of dental services narrowed only temporarily after the reform. [ABSTRACT FROM AUTHOR]

We investigated the psychological adaptation of Ingrian-Finnish migrants from Russia to Finland between 2008 and 2013. Pre-migration data ( N = 225) were collected at the Finnish language courses that were part of the immigration training program. The three post-migration follow-ups were conducted half a year ( N = 155), and 2 ( N = 133) and 3 years ( N = 85) after migration. Well-being was assessed with measures of Life Satisfaction and Self-Esteem. Life Satisfaction increased from pre-migration to the first post-migration measurement point, after which it stabilized. Self-Esteem decreased throughout the study. Variables reflecting adjustment to the event of migration (e.g., acculturation stress, socio-cultural adaptation) were primarily associated with well-being at the first post-migration measurement point. More general determinants of well-being (e.g., social support and subjective economic situation) were more consistently associated with well-being throughout the study. The results suggest that migration can be beneficial to some but detrimental to other types of well-being. [ABSTRACT FROM AUTHOR]

Introduction Observing real situations in clinical practice can provide undetected information regarding problems in the medication process. Aims The aims of this study were to describe the frequency, types, and severity of medication errors in medical and surgical inpatients as well as to study the relationship between medication errors and associating factors. Methods A cross-sectional study using direct observations and medication record reviews was conducted to assess how 32 registered nurses administered 1058 medications to 122 inpatients in four medical and surgical wards at a university hospital in Finland between April and May 2012. Observations were recorded using a structured observation form and patients' medication record reviews (n = 122) before and after the observations were conducted. A multiprofessional team analysed and classified all of the detected errors and assessed their severity. A logistic regression was used to analyse the factors (work environment, team, person-specific, patient-specific or medication-related) associated with medication errors. Results At least one error was found in 22.2% (235/1058) of administered medications , 63.4% of which were medication administration errors and 18.3% of which were documentation errors. Of the medication administration errors, 59.1% involved an incorrect administration technique. 3.4% of errors caused harm to patients. Statistically significant factors that increased the risk of medication errors included every other weekday, except Sunday; morning shifts; increased rushes; nurses asking for help; and increased number of medications that patients used. Factors that decreased the risk of errors included administering medications through an oral route, double-checking the drugs, and additional people in the medication room at the same time. Conclusion Medication errors in inpatient care are frequent, and improvements to increase safety are vital. More attention to medication administration techniques, administration instructions and attitudes toward safety are needed to prevent problems. [ABSTRACT FROM AUTHOR]