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In Finland, Young people’s sexuality education has not been examined from a multicultural perspective, with the exception of a few policy-oriented papers. This paper examines how cultural diversity is addressed in chapters on sexuality and sexuality education in Finnish health education textbooks. The analysis is based on material contained in textbooks used in grades 7-9 and upper secondary schools. Findings suggest that cultural diversity is included in textbooks in one of two ways: either to demonstrate the uniqueness of liberal, emancipated and progressive ‘Finnish’ sexuality; or as a way of distancing Finland and Finnish values from the rest of the world. In these textbooks, culture is understood as belonging to non-Finnish ‘others’ and a culture that itself as not being Finnish. This somewhat tendentious treatment of cultural diversity leaves teachers with limited tools with which to promote anti-discriminatory education. The textbooks also overlook the diverse backgrounds of young people growing up in Finland today. [ABSTRACT FROM AUTHOR]

There are strong tendencies in urban segregation, not only according to social class, gender and ethnic lines but also according to age. This paper draws on the findings of three studies conducted in Lahti, Finland, to examine the intergenerational aspects of spatial practise. It is argued that people look at their environment through a generational gaze, such that different generations have different spatial preferences and practises. In this article, an age-friendly living environment refers to one that appeals not only to older people but to people ofallages. Age-friendly environments have no segregating borderlines, but rather enable the meeting and communication of different aged people and sustain age integration. As older and young people are most dependent on their living environments, the paper concentrates on their use of space and attachment to place. Our special focus is on recreational activities and places: How and where older and young people spend leisure time? What are their favourite places? What is the importance of nature and different kind of urban spots for them? On the basis of the differences and similarities found out in their spatial practises and preferences, our aim is to discuss age-friendly environments that appeal to different aged people. The study is based on qualitative and quantitative data and draws out implications for future age-diverse communities. [ABSTRACT FROM AUTHOR]

Congenital heart disease (CHD) is one of the most common congenital anomalies in children. Children with major CHD are at risk for developing endocarditis. Acute endocarditis may be life threatening and lead to heart failure. The purpose of this study was to explore parental perceptions and experiences of an early oral health promotion intervention (OHPI) targeting children with major CHD at risk for developing endocarditis later in life, and use this information to examine intervention feasibility. Nine parents (three fathers and six mothers) participating in a one and a half year OHPI were purposefully selected for qualitative evaluation of intervention feasibility using semi-structured interviews. The interviews were analysed with an inductive content analysis method. The analysis resulted in four main categories and 14 subcategories that describe parental perceptions and experiences of the OHPI. The four main categories were timing of first intervention contact, effortlessness of intervention process, individuality of support, and relevancy of support. Parents of children with CHD perceived the OHPI as important and feasible to be implemented in daily life in children with systemic diseases overall. Further studies on timing of first contact and use of additional Web-based support are needed. [ABSTRACT FROM AUTHOR]

An association between early drinking onset and subsequent heavy drinking has been established, but interpretation is problematic: is the onset of drinking or of intoxication important; is early onset a marker for vulnerability or a causal risk factor; what role does recall bias play? We (1) compare the associations of onset indicators with subsequent risky drinking, (2) assess whether drinking onset has a stronger association with subsequent risky drinking than relative onset (deviation from cohort's median), and (3) study recall bias by examining within-cohort temporal changes in reported ages of drinking onset. The Finnish Drinking Habits Survey, a cross-sectional general population survey of 15–79-year-old Finns collected in 2016. Additionally, the four previous survey waves from 1984 to 2008 were used. Risky drinking was defined using the Alcohol Use Disorders Identification Test (AUDIT), and the age of first drink (AFD) and of intoxication (AFI) were obtained by retrospective recall. All three indicators showed statistically significant associations with AUDIT, but AFI had the strongest association. Absolute age of onset had a slightly stronger association with AUDIT than relative age of onset. Recall bias of AFD was found for each birth cohort, as the reported AFD within each cohort increased over time. Onset of intoxication has stronger association with risky drinking than the onset of drinking. No gain was seen in measuring relative rather than absolute age of onset, which suggests that age of onset is not merely a marker of vulnerability to risky drinking. [ABSTRACT FROM AUTHOR]

Purpose: To identify different income trajectories after a rejected disability pension application and to analyze socio-demographic and disability process related determinants of these trajectories. Methods: Finnish residents aged 18–58 years with a first rejected disability pension application in 2010 (N = 3683) were followed for 48 months with register data. We performed a sequence analysis of six income sources (employment, unemployment benefit, sickness allowance, rehabilitation benefit, awarded disability pensions, other/unknown). Multinomial logistic regression was used in analyses. Results: Four clusters were identified, displaying unemployment, awarded disability pension, employment, or unknown source as the primary source of post-rejection income. Transitions between income sources were frequent, especially in the employment and unemployment clusters. Using the awarded pension cluster as the reference group, previous unemployment raised the odds of unemployment cluster membership the most. Similarly, previous employment raised the odds of employment cluster the most. A somatic rather than mental disorder and being under 50 years old raised the odds of being in the unemployment and employment clusters. Conclusions: After a rejected disability pension, main income paths include unemployment benefits, re-applied disability pension, and fragmented employment. Labor market and sickness history and age are associated with the probability of these paths. Rejected disability pension applicants should be offered medical or vocational rehabilitation, to enable sustained labor market participation. Partial disability pension, supported by rehabilitation is one solution when a full-time labor market participation is not a realistic option. [ABSTRACT FROM AUTHOR]

Objective: It is generally expected that the growth of the older population will lead to an increase in the use of health care services. The aim was to examine the changes in the number of visits made to general practitioners (GP) by the older age groups, and whether such changes were associated with changes in mortality rates. Design and setting: A register-based observational study in a Finnish city where a significant increase in the older population took place from 2003 to 2014. The number of GP visits made by the older population was calculated, the visits per person per year in two-year series, together with respective mortality rates. Subjects: The study population consisted of inhabitants aged 65 years and older (65+) in Vantaa that visited a GP in primary health care. Main outcome measures: The number of GP visits per person per year in the whole older population during the study years. Results: In 2009–2010, there was a sudden drop in GP visits per person in the younger (65–74 years) age groups examined. In the population aged 85+, use of GP visits remained at a fairly constant level. The mortality rate decreased until the year 2008. After that, the positive trend ended and the mortality rate plateaued. Conclusions: Simultaneously with the decline in GP visits per person in the older population, the mortality rate leveled off from its positive trend in 2009–2010. Factors identified being associated with the number of GP consultations were organizational changes in primary health care, economic recession causing retrenchment, and even vaccinations during the swine flu epidemic. Along with an increasingly ageing population, concern over the supply of publicly funded health care has become more pronounced. The amount of GP visits of 65+ decreased in primary health care, especially in the youngest groups. However, in the oldest age groups (85+), the use of GPs remained unchanged regardless of changes in service supply. As the rate of GP visits among the population of 65+ declined, the positive trend in the mortality rate ceased. [ABSTRACT FROM AUTHOR]

Based on an extensive Finnish data covering 1350 interviews the authors surveyed the end users' perceptions concerning improved energy efficiency, renewable energy integration and zero energy housing. The data has wide social coverage and it matches well with both age and gender distribution in Finland. The survey indicates that solar photovoltaic panels and heat pumps are among most familiar renewable energy technologies to the interviewed occupants while the panels also enjoy the most positive image among the interviewees. However, the interviewees' willingness to pay extra for energy efficient improvements was more munificent than that for the renewable energy installations. Zero energy buildings were only known to roughly half of the interviewees while 48.9% of the respondents did not even know whether there is an energy performance certificate for their house or not. [ABSTRACT FROM AUTHOR]

Work-related mental distress and its impact on employees' working life is a mounting issue among Finnish social workers. This article focuses on identifying the factors associated with child welfare social workers' occupational well-being. The occupational well-being of Finnish child welfare social workers (N = 364) and social workers whose duties do not include child protection work (N = 524) was explored and compared with each other using t-test statistics and logistic regression analysis. The data, collected in 2014/2015, were obtained from an ongoing longitudinal cohort study on work-related well-being among Finnish public sector employees. A multi-dimensional and holistic approach to occupational well-being was used as the outline for the analysis and comparison of the two groups. Child protection social workers reported higher levels of burnout and secondary traumatic stress than social workers without child protection duties. Despite these burdens, both groups showed a similar level of general health, compassion satisfaction and overall occupational well-being. Individual and organizational factors associated with high occupational well-being were identified. Supervision was found to be an important supporting element. This study identified multiple determinants related to social workers' occupational well-being, comprising positive and negative elements with regard to organizational and individual factors. [ABSTRACT FROM AUTHOR]

Objective. To study coping differences between young and experienced GPs in primary care who experience medical errors and uncertainty. Design. Questionnaire-based survey (self-assessment) conducted in 2011. Setting. Finnish primary practice offices in Southern Finland. Subjects. Finnish GPs engaged in primary health care from two different respondent groups: young (working experience ≤ 5years, n = 85) and experienced (working experience > 5 years, n = 80). Main outcome measures. Outcome measures included experiences and attitudes expressed by the included participants towards medical errors and tolerance of uncertainty, their coping strategies, and factors that may influence (positively or negatively) sources of errors. Results. In total, 165/244 GPs responded (response rate: 68%). Young GPs expressed significantly more often fear of committing a medical error (70.2% vs. 48.1%, p = 0.004) and admitted more often than experienced GPs that they had committed a medical error during the past year (83.5% vs. 68.8%, p = 0.026). Young GPs were less prone to apologize to a patient for an error (44.7% vs. 65.0%, p = 0.009) and found, more often than their more experienced colleagues, on-site consultations and electronic databases useful for avoiding mistakes. Conclusion. Experienced GPs seem to better tolerate uncertainty and also seem to fear medical errors less than their young colleagues. Young and more experienced GPs use different coping strategies for dealing with medical errors. Implications. When GPs become more experienced, they seem to get better at coping with medical errors. Means to support these skills should be studied in future research. [ABSTRACT FROM AUTHOR]

The present study analysed the development of gestures between 0;9-1;3 years, and the predictive value of this development for language skills at 2;0 in very-low-birth-weight (VLBW) children. Participants were 32 VLBW children and their 35 controls. The data on gestures was gathered using the Finnish version of the Communicative Development Inventory (FinCDI). At 2;0, the language skills of the children were assessed using the Reynell Developmental Language Scales (RDLS III) and the FinCDI. The number of acquired gestures was lower in the VLBW children than in the controls. The development of gestures correlated significantly with later expressive language in both groups, but significant correlations between the development of gestures and later receptive language development were detected only in the VLBW group. When the predictive value of gestures and early expressive and receptive lexicon with regard to later language skills were analysed, the development of gestures at 1;3 had good predictive value for poor language performance at 2;0. In addition, a small receptive lexicon size at 1;0 and at 1;3 was also a good predictor for later language performance. The development of gestures and receptive lexicon thus jointly provide clinically valuable information on the emerging language skills of VLBW children. [ABSTRACT FROM AUTHOR]

The purpose of this study is to help understand the meaning of age as experienced by older university graduates. The participants of this study were Finnish healthcare and social work professionals who earned master's degrees in their late 40s and 50s. They were all female, and their main purpose of study was to upgrade credentials. The analysis was informed by the sociology of age. The research questions were the following: What kind of meaning did these older graduates give to their age? How did the social category of “old” influence their reflections on age? As a result, age was meaningful for the participants at least in three different ways. First, when age was seen as a resource, it referred to the prior life history, especially to all those earlier working experiences which have made the person who she was. Second, when age was seen as a difference, it referred to all those social and cultural differences that divided older and younger students. Third, when age was seen as a limiting option, it referred to the time that one had left to fulfill different life plans. [ABSTRACT FROM PUBLISHER]

The aim of this study was, first, to identify long-term patterns of effort-reward imbalance (ERI) and over-commitment (OVC), and, second, to examine how occupational well-being (burnout, work engagement) and recovery experiences (psychological detachment, relaxation, mastery and control) differ in these patterns. The study was based on follow-up data with three measurement points (2006, 2008, 2010) collected from Finnish managers (N=298). Latent Profile Analysis resulted in five long-term ERI-OVC patterns: a high-risk pattern (high ERI, high OVC), found in 20% of the participants; a low-risk pattern (low ERI, low OVC), found in 24% of participants; a relatively low-risk pattern (low ERI, moderate OVC), found in 47% of participants; a favourable change pattern (decreasing ERI and OVC), in 7%; and an unfavourable change pattern (high ERI with increasing linear trend, OVC with curvilinear trend) in 2%. The results showed, in line with the ERI model, that managers in the high-risk pattern showed higher burnout scores and poorer recovery experiences compared to those in the low-risk patterns. However, no differences were found in work engagement between the high and low-risk patterns. Thus, the ERI model seemed better to explain stress-related indicators of occupational well-being than motivational indicators. [ABSTRACT FROM AUTHOR]

In this study we explore the link between household expenditures and wealth across the age distribution by examining the elasticity of consumption spending from different types of wealth. We use a new source of harmonized wealth micro data for five countries: Canada, Finland, Italy, Germany and the US. Our results indicate that the effect of housing wealth dominates the effect of financial wealth in Finland, Italy, Germany, the US, and also in Canada for certain age groups. We find consumption responsiveness to housing wealth to be statistically significantly lower for younger households. The analysis also confirms the existence of between-country differences. [ABSTRACT FROM PUBLISHER]

Conclusions: Upper airway symptoms were common in subjects referred for sleep study. In particular, nasal stuffiness and airway dryness already seemed to bother snorers before development of obstructive sleep apnea syndrome (OSAS). Mouth dryness increased with severity of obstructive sleep apnea (OSA). Objectives: Upper airway symptoms are common in patients with OSAS. However, prevalence of these symptoms is unknown in primary snoring and mild OSA. We evaluated frequency of upper airway symptoms in a large group of patients referred for diagnostic sleep studies. Methods: We examined 524 consecutive subjects (69% men, mean ± SD age 51 ± 12 years, apnea-hypopnea index (AHI) 15 ± 21, body mass index 31 ± 6) by a questionnaire-based survey. The subjects filled in a questionnaire enquiring about current upper airway symptoms and history of nasal and pharyngeal disorders before the sleep study. Results: Frequent upper airway symptoms among study subjects were common: 56% of the patients reported throat dryness, 55% mouth dryness, 54% nasal stuffiness, 52% nose dryness, 33% sneezing, 33% postnasal drip, and 24% rhinorrhea. The patients with moderate or severe OSAS (AHI ≥15 and Epworth sleepiness score ≥10) suffered from mouth dryness more often (71% vs 40%, p < 0.01) than those with mild or no OSAS. [ABSTRACT FROM AUTHOR]

Conclusion: This study shows a persistent trend of an increase in the incidence of carcinoma of the tongue into the twenty-first century for both sexes and all age groups except for young males. Objectives: During the last decades increased incidence of squamous cell carcinoma (SCC) of the tongue in young adults has been reported. We previously showed an increased incidence in SCC of the tongue in Scandinavia in 1960-1994, most pronounced in patients aged 20-39 years. The aim of this study was to investigate whether the trend of increased incidence of tongue cancer continued into the twenty-first century in a population-based study in the Nordic countries. Methods: Data for all reported SCCs of the tongue and base of tongue in patients aged 20-79 years during 1960-2008 were extracted from the NORDCAN registry, based on the National Cancer registries in the Nordic countries. Data from Sweden, Norway, Finland, Denmark, and Iceland were analyzed. The age groups 20-39, 40-64, and 65-79 years were studied separately as well as male and female figures. Results: In all, 12 280 cases were reported, of which 673 were diagnosed in patients aged 20-39 years. The trend of an increase persisted after 1994 in both sexes and all three age groups except in young males. [ABSTRACT FROM AUTHOR]

Background Medical problems are described in a population of persons with Down syndrome. Health surveillance is compared to the recommendations of national guidelines. Method Case records from the specialised and primary healthcare and disability services were analysed. Results A wide spectrum of age-specific medical and surgical problems was described. Congenital heart defects and middle ear infections were mostly experienced by younger people, while thyroid disease, epilepsy, and Alzheimer's disease were frequent among older people. Psychiatric disorders and behavioural problems were frequent in all age groups. Conclusions Health surveillance remained insufficient, despite the guidelines available. A joint effort by healthcare and disability service providers is required to ensure that the medical needs of people with Down syndrome are adequately met across their entire lifespan. An active provision of healthcare and monitoring for this vulnerable group is needed. [ABSTRACT FROM AUTHOR]

Background. Previous studies show conflicting results on the role of weak sense of coherence (SOC) as a risk factor for depression. Aims. The aim of this work was to study whether a weak SOC predicts depressive symptoms in a non-depressive population sample in the short or long perspective. Method. Participants without depressive symptoms ( n == 1645) in the Finnish sample of the Outcomes of Depression International Network (ODIN) study were assessed at 1-year and 9-year follow-up. Depressive symptoms were assessed by the Beck Depression Inventory (BDI), and SOC by the 13-item Orientation to Life Questionnaire (SOC-13). Logistic regression analysis was used to test the association between baseline SOC and depressive symptoms measured at the follow-ups. Results. In univariate analysis, there was a significant inverse association between baseline SOC and depressive symptoms at 1 year ( p == 0.000) and at 9 years ( p == 0.000). In multivariate analysis, weak SOC continued to predict depressive symptoms at 1 year ( p == 0.022) and 9 years ( p == 0.015). Conclusions. Weak SOC predicted depressive symptoms in the short and long perspective. It seems likely that a strong SOC represents a protective function, not only absence of current depression. [ABSTRACT FROM AUTHOR]

Objective. To ascertain the age and gender distribution of patients receiving anticoagulant (AC) treatment with warfarin, and to establish the prevalence of AC treatment and its indications among the Finnish population. Design. A cross-sectional study in which the patients were identified from the patient records of health centres. Setting. Primary health care in the Hospital District of South Ostrobothnia in Finland. Patients. Those inhabitants of 15 municipalities in the study area who received AC treatment with warfarin on 1 April 2004. The total number of inhabitants was 132 621 at the end of 2003. Main outcome measures. Patient age and gender distributions, the prevalence of AC treatment in the study area, and indications for AC treatment. Results. Altogether 2389 patients were identified, 51.4% of them men. The mean age of the patients was 72.4 years. The prevalence of AC treatment was 1.8%; when age-adjusted to match the Finnish population it was 1.64%. The proportion of men receiving AC treatment was higher than that of women in all age groups. Atrial fibrillation (AF) was the most common main (60.2%) and second (7.2%) indication for AC treatment. Conclusion. Compared with Finnish figures 12 years earlier the prevalence of AC treatment has more than doubled, and the proportion of AF among indications has increased from 47% to 67%. New current care guidelines on AF and the increasing proportion of the elderly among the population are probable explanations. [ABSTRACT FROM AUTHOR]

Attitudinal climate can be seen as a central factor influencing drinking habits; the level of consumption has been claimed to depend on how many adverse consequences of drinking a society tolerates. In the past few decades, however, only a few studies have looked at normative aspects of drinking in the general population. This article investigates changes in attitudes and norms around drinking in Finland by reviewing existing research and presenting new results. We ask whether men and women's views on alcohol differ and are there differences between age groups. The focus is on identifying long-term changes in the attitudinal climate of alcohol use. The main data is based on six national drinking habits surveys of 15–69-year olds conducted in 1968, 1976, 1984, 1992, 2000 and 2008. Data from the Scandinavian drinking survey in 1979 and the Finnish alcohol panel survey in 2003 are also used. Since the 1960s, attitudes towards one's own use of alcohol have become progressively more permissive and gender differences have converged. Results on situational norms showed that the acceptance of drinking increased in a leisure context, while there were no substantial changes in everyday and work situations. However, attitudes around alcohol policy varied through the studied time frame. In the 1970s, new liberalizations in alcohol policy induced great concerns, which settled down through the 1980s until the early 1990s. Since the end of 1990s, greater calls have been made for stricter alcohol policies, even though views on personal use of alcohol have become more permissive than ever. [ABSTRACT FROM AUTHOR]