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

Aims: To describe nurse managers' perceptions of interventions to support nurses as second victims of patient safety incidents and to describe the management of interventions and ways to improve them. Design: A qualitative study using interviews. Methods: A purposive sample of nurse managers (n = 16) recruited from three hospital districts in Finland was interviewed in 2021. The data were analysed using elements of inductive and deductive content analysis. Results: The study identified three main categories: (1) Management of second victim support, which contained three sub‐categories related to the nurse manager's role, support received by the nurse manager and challenges of support management; (2) interventions to support second victims included existing interventions and operating models; and (3) improving second victim support, based on the sub‐categories developing practices and developing an open and non‐blaming patient safety culture. Conclusion: Nurse managers play a crucial role in supporting nurses as second victims of patient safety incidents and coordinating additional support. Operating models for managing interventions could facilitate nurse managers' work and ensure adequate support for second victims. The support could be improved by increasing the awareness of the second victim phenomenon. Implications for the Profession and Patient Care: Mitigating the harmful effects of patient safety incidents can improve nurses' well‐being, reduce burden and attrition risks and positively impact patient safety. Impact: Increasing awareness of the second victim phenomenon and coherent operation models would provide equal support for the nurses and facilitate nurse managers' work. Reporting Method: COREQ checklist was used. What does this paper contribute to the wider global clinical community? Nurse managers' role is significant in supporting the second victims and coordinating additional support.Awareness of the second victim phenomenon and coherent operating models can secure adequate support for the nurses and facilitate nurse managers' work. [ABSTRACT FROM AUTHOR]

A space, where the client feels safe, is necessary for therapeutic process. Its importance seems to be implicitly understood and agreed upon across different schools of psychotherapy. However, what it means and how it appears in therapy has not been clearly described before. This paper presents the findings from the first author's master thesis, which sought to answer the question 'Why is safe space important in dance therapy, and how do dance therapists define and create it in their practice?'. This phenomenological inquiry originated from a need to translate the experiential phenomenon of safe space into words. It is a first attempt to investigate safe space in depth and to provide a definition of its essence in dance movement therapy. Findings from this research describe working methods and interventions for safe space as well as qualities that therapists can embody to help their clients feel safe. [ABSTRACT FROM AUTHOR]

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

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

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

Aim This article describes the development and testing of an Excel-based scheduling solution for the flexible allocation and reallocation of nurses to cover sudden, unplanned absences among permanent nursing staff. Method A quasi-experimental, one group, pre- and post-test study design was used (Box 1) with total sampling. Participants (n=17) were selected purposefully by including all ward managers (n=8) and assistant ward managers (n=9) from one university hospital department. The number of sudden absences among the nursing staff was identified during two 4-week data collection periods (pre- and post-test). Results During the use of the paper-based scheduling system, 121 absences were identified; during the use of the Excel-based system, 106 were identified. The main reasons for the use of flexible 'floating' nurses were sick leave (n=66) and workload (n=31). Other reasons (n=29) included patient transfer to another hospital, scheduling errors and the start or end of employment. Conclusion The Excel-based scheduling solution offered better support in obtaining substitute labour inside the organisation, with smaller employment costs. It also reduced the number of tasks ward managers had to carry out during the process of reallocating staff. [ABSTRACT FROM AUTHOR]

Objective: Research and PhDs are relatively rare in family medicine and primary care. To promote research, regular one-year research courses for primary care professionals with a focus on clinical epidemiology were started. This study explores the academic outcomes of the first four cohorts of research courses and surveys the participants' perspectives on the research course. Design: An electronic survey was sent to the research course participants. All peer-reviewed scientific papers published by these students were retrieved by literature searches in PubMed. Setting: Primary care in Finland. Subjects: A total of 46 research course participants who had finished the research courses between 2007 and 2012. Results: Of the 46 participants 29 were physicians, eight nurses, three dentists, four physiotherapists, and two nutritionists. By the end of 2014, 28 of the 46 participants (61%) had published 79 papers indexed in PubMed and seven students (15%) had completed a PhD. The participants stated that the course taught them critical thinking, and provided basic research knowledge, inspiration, and fruitful networks for research. Conclusion: A one-year, multi-professional, clinical epidemiology based research course appeared to be successful in encouraging primary care research as measured by research publications and networking. Activating teaching methods, encouraging focus on own research planning, and support from peers and tutors helped the participants to embark on research projects that resulted in PhDs for 15% of the participants. [ABSTRACT FROM AUTHOR]

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

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

Accessible summary: What is known on the subject?: There is a scarcity of studies concerning violence in psychiatric outpatient settings in the 2010s in spite of the deinstitutionalization of psychiatric services.Previous research on violence in psychiatric outpatient settings has failed to consider the association between the psychological consequences of violence, exposures to violence and background factors. What the paper adds to existing knowledge?: It has been known for some time that exposures to violence are harmful for psychiatric inpatient nurses; the paper demonstrates that psychiatric outpatient nurses are also at risk.The psychological consequences of exposure to violence are highly individualized and influenced by background factors.Nurses who face harassment have a greater risk of suffering psychological symptoms. What are the implications for practice?: De‐escalation interventions should be implemented in psychiatric outpatient settings.Organizations should consider the possibility of internal violence occurring when planning preventive interventions to manage and reduce workplace violence.Education targeted at violence prevention, management and debriefing should be organized systematically in psychiatric outpatient units and be taken into consideration in the mental health nursing curriculum. Introduction: There is a scarcity of studies concerning violence and its consequences in psychiatric outpatient setting. Aim: This study aimed to explore the occurrence of workplace violence and the psychological consequences of exposure to violence among nurses working in psychiatric outpatient settings. Method: Research followed a cross‐sectional survey design. Data were collected with the VIA‐Q instrument. Results: During the 12 months prior to the study, nurses (n = 181) had most often experienced psychological violence, with fatigue being the most common consequence. Harassment most often caused feelings of violated integrity, whereas physical violence most often caused insomnia. Significant relationships between exposure to violence and psychological consequences were identified. Discussion: Workplace violence can manifest in a broad array of psychological symptoms and be harmful for nurses in psychiatric outpatient settings. It is important to discuss the subject of workplace violence and its place in the nursing curriculum and to reflect on how nurses are educated and trained to face violence in psychiatric nursing. Implications for Practice: De‐escalation interventions should be implemented in psychiatric outpatient settings. Organizations should take steps to abolish internal violence. Nurses need appropriate education in order to prepare them to manage workplace violence. [ABSTRACT FROM AUTHOR]

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

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

Background: Health literacy (HL) is an important determinant for maintaining and improving health throughout the lifespan. This underlines the need to monitor HL, including among adolescents, and to understand the factors explaining HL, with a view to decreasing differences in HL. The aim of this study was to objectively measure HL, and the relationship between HL and socio-demographic factors (gender, language of instruction, pupils' educational aspirations, parents' educational background and pupils' school achievement) among pupils (n = 3652) at the end of basic education in Finland. Methods: A nationally representative assessment, which included 55 items on HL, was conducted as a traditional paper-and-pencil test in schools. The data were analysed via descriptive statistics and a two-level hierarchical linear model to determine how the socio-demographic factors affected HL. Results: The pupils' average score on the HL test items was 58.9%, indicating a satisfactory HL level. A two-level hierarchical linear model showed that the variables (gender, language of instruction, pupils' educational aspirations, parents' educational background and pupils' school achievement) predicting the HL level had statistically significant effects. Conclusions: Among ninth graders (15–16 years old), almost one third of the boys and 8% of the girls exhibited an unsatisfactory HL level. The study also confirmed the importance of school-related factors in explaining HL differences. Since low HL has been linked to several unfavourable health indicators and has been viewed as an underestimated problem in times of pandemic and other health crises, the findings suggest that the HL level of Finnish ninth graders is a clear public-health issue. [ABSTRACT FROM AUTHOR]

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

Background: Depressive mood is a common problem among children in Western countries. Professionals in school and other health services have an important role in identifying children at increased risk for depression. The Short Mood and Feelings Questionnaire (SMFQ) is a widely used screening tool, but its 13 items still make it quite time‐consuming to complete. There is an urgent need for a quick and easy‐to‐complete self‐report depressive mood scale for use in school health examinations. Aim: This paper aims to describe and validate a revised version of SMFQ: FsMFQ‐6 is intended as a short screening tool for the early identification of depressive symptoms in children. Methods: Nationally representative data (n = 95,725) were drawn from the 2017 School Health Promotion Study. The respondents were fourth‐ and fifth‐grade pupils (aged 10–12) in Finnish primary schools. The data were analysed separately by gender. The construct validity of the scale was studied by principal component analysis and confirmatory factor analysis (CFA), convergent validity by both receiver operating characteristic (ROC) analysis and Spearman's correlation coefficient. Reliability was tested by Cronbach's alpha coefficient. Results: Principal component analysis yielded a one‐component model: the Finnish Short Mood and Feelings Questionnaire 6 (FsMFQ‐6). CFA confirmed the validity of FsMFQ‐6. Compared with mood at home (AUC = 0.80) and mood at school (AUC = 0.85), overall sensitivity and specificity were optimal at cut‐off point 0. Cronbach's alpha coefficient was 0.73, indicating good internal consistency. The results for girls and boys were almost identical. Conclusion: The results confirmed the validity and reliability of FsMFQ‐6. FsMFQ‐6 recognises depressive mood in children and is suitable for screening depressive symptoms in fourth‐ and fifth‐grade pupils in Finland. However, it is important to pay close attention to children who choose the 'Sometimes' response option more than once, for that can be a sign of depressive symptoms. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Patient safety incident reporting has been recognized as a key process for organizational learning and safety culture; however, there is limited knowledge about patient safety in forensic psychiatric care.There are distinct patient safety issues in psychiatric nursing, associated (inter alia) with the self‐harm, violence, seclusion/restrain and restrictions.Many adverse events are preventable. What does this paper add to existing knowledge?: No harm was caused to patients in less than half (51%) of all reported incidents (in a Finnish forensic psychiatric hospital during a six‐year period) considered in this study.The most common location of violent incidents was corridors (31%), followed by day rooms (20%), and patient rooms (15%). The most common patient safety incidence type was violence against another patient (38%), which typically occurred in corridors (36%), dayrooms (25%) and patient rooms (15%), and was usually related to daily activities in the afternoon (1,400–1,600 hr) and evening (1,800–2,000 hr).Typically, recommendations for improving patient safety focus on human behaviours. What are the implications for practice?: There is a need to notify and report all patient safety incidents (following staff training), learn from previous incidents (also learn for success), prevent typical incidents, learn for success, promote patient participation in incident prevention, share development measures outside the ward to enable exploitation by others and strengthen safety culture.In forensic psychiatry, conversation with patients regarding safety measures is strongly recommended to prevent patient safety incidents related to violence.The perspective should be extended from patient‐specific factors to general factors such as patient treatment and general comfort and privacy. Introduction: Patient safety incident reporting has been recognized as a key process for organizational learning and safety culture, but there is limited knowledge about patient safety in forensic psychiatric care. Aims: To characterize the types and frequencies of incidents in forensic psychiatric care and assess the implications for practice. Methods: Data were collected from a patient safety incident reporting system (PSiRS) database of one forensic psychiatry hospital in Finland and analysed using descriptive statistics. Results: No harm was caused in more than half of the 2,521 reported incidents examined (51%, n = 1,260). The most frequently recorded incident type was violence (38%), which typically occurred in corridors (31%) or dayrooms (20%). The most frequently recommended action to prevent violent events was that potential risks should be discussed (77%). Discussion: Patient safety incidents related to violence are common in forensic psychiatric hospitals. Although very few adverse events were classified as causing serious harm to patients, many cases of violence could be prevented by identifying potential circumstances that lead to violence. Implications for Practice: Staff need encouragement and training to detect and report all patient safety incidents. Safety culture is strengthened by learning and sharing development measures to improve patient safety. [ABSTRACT FROM AUTHOR]

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

The adoption of technology in teaching has been identified to relate to various factors from attitudes and self‐efficacy to subjective norms and digital references. The aim of this study is to broaden the perspective to hierarchical grouping effects. Multilevel modelling of the study utilizes the data of 2355 Finnish basic education teachers. The results show that, before the coronavirus pandemic, Finnish teachers used digital devices in teaching at least once a week, on average, and many times on a daily basis, varying according to the subject being taught. The variation in teachers' technology usage occurs mainly at the individual level, with a small proportion between schools; higher‐level hierarchies proved redundant in the context of Finland. At the teacher level, digital skills, age, and digital self‐efficacy increase technology usage in teaching. At the end, the significance and limitations of the research and the direction of future research in the post‐pandemic era are discussed. Lay Description: What is already known about the topicTechnology usage in teaching is related to teachers' attitudes, skills and self‐efficacy.The importance of subjective norms and digital referents has also been identified.There is a need for a multidimensional approach that goes beyond the individual level.What this paper addsBefore the pandemic, digital technology was adopted on a weekly basis among Finnish teachers.The subject taught by the teacher has an impact on the quantity of digital technology usage.The technology usage varies at individual‐level, rather than at the higher‐levels. Implications for practiceTeachers' digital maturity is expected to influence the experiences of the pandemic period.The dominance of the individual‐level impacts the implementation of education policy.Research needs to take into account the context and hierarchies of different education systems. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject: As‐needed medication is commonly used for psychiatric inpatients' acute psychiatric and physical symptoms. Both patients and staff can initiate such medication.Earlier studies have focused on what and how as‐needed medication has been used for psychiatric reasons. Little is known about how patients participate in planning, administration and evaluation of as‐needed medication and its alternatives. Nursing documentation provides an insight into these practices. What this paper adds to existing knowledge: Long‐term inpatients have an active role in initiating as‐needed medication. However, patients and staff may have divergent opinions on the need for medication.Alternatives to medication are mostly proposed by staff, and the feedback on as‐needed medication events is usually provided from nurses' point of view. What are the implications for practice: Patients' views on decision‐making and evaluation should be noticed and documented more.Patient participation can be promoted by planning as‐needed medication and its alternatives beforehand. Introduction: Pro re nata (PRN) medication is unscheduled and used for acute physical and psychiatric symptoms. Previous studies have focused on the what and how of psychotropic PRN administration. Initiators of PRN events and occasions in which PRN was denied have rarely been studied. Thus, knowledge of patient participation in PRN is fragmented. Aim: We aimed to describe and explain long‐term psychiatric inpatients' participation in relation to planning and initiation of, as well as decisions and feedback on their PRN medication treatment. Methods: We retrieved data from patients' (n = 67) nursing documentation in a Finnish forensic psychiatric hospital in 2018. Data were analysed using statistical methods. Results: All patients were prescribed PRN, and they initiated half of the 8,626 PRN events identified, in a 1‐year period. Non‐pharmacological strategies were rarely (6%) documented, and most of them were initiated by staff (76%). Feedback on PRN was usually from a nurse's viewpoint (71%). Nurses' feedback was positive (80%) more often than patients' (50%). Discussion: Patient participation needs to be recognized throughout the PRN process. Future research could continue to explore patient participation in planning and evaluating their PRN medication. Implications for practice: Patients participate in PRN by requesting medication. Their participation can be developed by supporting patients to communicate their choice of non‐pharmacological methods, take the initiative for medication when needed and disclose their viewpoint on the effects of PRN. [ABSTRACT FROM AUTHOR]

Aim: This paper aims to analyse perioperative nurses' views of teamwork through team membership, team functionality, team cohesion, and team members' professionalism. Design: A descriptive, cross-sectional study. Methods: A questionnaire was sent to perioperative nurses working in one hospital district in Finland (n = 96). Data was collected by the Teamwork Scale and statistically analysed. Results: Perioperative nurses experienced teamwork positively. Team membership was associated with primary operating room (OR) role, engagement in the workplace, and perceived work empowerment. Team functionality was associated with combined OR role, working experience in healthcare, working experience as a perioperative nurse, and working shift. Team cohesion was associated with working shift and engagement in the workplace. Team members' professionalism was associated with engagement in the workplace, employment, and perceived work empowerment. Conclusion: Perioperative nurses' primary OR role and working shift had several connections to teamwork. This should be taken into careful consideration by OR managers in their daily work. [ABSTRACT FROM AUTHOR]

This paper investigates the epidemiology and public health response of novel coronavirus infection (COVID-19) in the Nordic region. The data on cases and deaths due to COVID-19 were drawn from the European Centre for Disease Prevention and Control. The data on age- and sex-wise cases, deaths and intensive care unit (ICU) admissions, and public health interventions in the Nordic region through November 10, 2020, were obtained from respective countries' health ministries. Sweden accounted for 60.59% of cases (162 240 of 267 768 cases) and 81% of deaths (6057 of 7477 cases) in the Nordic region. The incidence rate for the Nordic region was 989.59 per 100 000, varying from 327.30 per 100 000 in Finland to 1616.51 per 100 000 in Sweden, and the mortality rate for the region was 27.63 per 100 000, ranging from 5.3 per 100 000 in Norway to 60.35 per 100 000 in Sweden. The case–fatality ratio of the Nordic region was 2.79%. Females were more susceptible to COVID-19 infection than males (52.30% vs 47.66%), while males had a greater proportion of deaths (54.7%) and ICU need (71.99%) than females. It is imperative to continue with social distancing, mandatory masks, testing, prohibition of mass gatherings, isolation of confirmed cases, and preventing the importation of cases from other countries to avoid the further resurgence of cases. [ABSTRACT FROM AUTHOR]

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

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

The 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]

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

Copyright of Child & Family Social Work is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and aims: Stage II cancer of the tongue is mostly managed surgically both locally and regionally. However, indications for postoperative radiotherapy and reconstructive options vary between centers. This paper aims to describe differences in treatment in a geographically homogenous cohort. Methods: A retrospective comparison was made between two cohorts of clinical T2N0 tongue cancer from Finland and Sweden. The Finnish cohort included 75 patients and the Swedish 54. All patients had curative intent of treatment and no previous head and neck cancer. Data analyzed consisted of pathological stage, size and thickness of tumor, frequency of reconstruction, radiotherapy delivered, and survival. Results: The Finnish cohort included a higher proportion of patients managed with reconstructive surgery (67%) than the Swedish cohort (0%), p < .00001. More patients were treated with postoperative radiotherapy (84%) in the Swedish cohort than in the Finnish (54%), p < .0002. The Finnish cohort had a higher level of survival and included more frequent downstaging (cTNM to pTNM). Conclusions and significance: Our data indicate a major difference in the management of T2N0 oral tongue cancer. The optimal cut-off size and growth pattern of the tumor warranting reconstruction should be further evaluated in a prospective manner considering both survival and quality of life. [ABSTRACT FROM AUTHOR]

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

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

Purpose: The purpose of this paper is to describe how frequent attenders (FAs), divided into different profiles, use of primary care, emergency care and specialised medical care and which social services have been granted to them. Design/methodology/approach: The present study utilises previous research of FAs and their identification of four profiles. The data were acquired from three data registries in Finland. Analysis of the FAs (n = 56) data was undertaken using descriptive statistics methods and qualitative analysis. Findings: Patients with multiple problems used primary care, emergency care and specialized medical care frequently, and they had the highest number of appointments with doctors and nurses. Social services were required mostly social work. Visits made by patients with an impaired capacity caused by substance abuse were mainly targeted at appointments and mental health care services to a nurse in primary care. The required types of social services were often rehabilitative work experience. For mothers requiring support, the most frequently used services in primary were the child health and maternity clinic. The social services granted were mostly social work. Children and adolescents who are burdened by everyday concerns visits were mainly focused on primary to the child health and maternity clinic. Use of social services often entailed the supervision of contact sessions between parents and children's. Research limitations/implications: The study confirmed that there is a need for increase knowledge of FAs. The service needs of FAs should be understood multi-dimensionally and the research results justify the individualised integration of social and health services for FAs. Originality/value: The research results justify the individualised integration of social and health services for FAs. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to investigate positive mental health (PMH) and factors related to it among those living alone in the sparsely populated area of the Lapland region. Design/methodology/approach: The study utilises data from the Mental Health Survey of the Lapland region in Finland, covering 12 municipalities. The scores of short Warwick–Edinburgh Mental Well-Being Scale (sWEMWBS) were categorised into three levels of PMH. Logistic regression models were used to separately estimate the odds ratios for the high level of PMH compared with the moderate level of PMH and the low level of PMH compared with the moderate level. Findings: Social support seemed to be very strongly associated with both low and high levels of PMH among people living alone. Participating in activities provided by organisations or societies decreased the odds of having low PMH. Among men, young age predicted low PMH. Originality/value: The number of people living alone in Finland and other parts of Europe is increasing, yet there are few studies focusing on their positive mental health (PMH). Using scales such as sWEMWBS adds to the authors' knowledge about the positive mental well-being of those living alone, especially in rural areas, thus making it possible to utilise mental health promotion interventions effectively and accordingly. [ABSTRACT FROM AUTHOR]

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

The Finnmark North Sámi is a variety of North Sámi language, an indigenous, endangered minority language spoken in the northernmost parts of Norway and Finland. The speakers of this language are bilingual, and regularly speak the majority language (Finnish or Norwegian) as well as their own North Sámi variety. In this paper we investigate possible influences of these majority languages on prosodic characteristics of Finnmark North Sámi, and associate them with prosodic patterns prevalent in the majority languages. We present a novel methodology that: (a) automatically finds the portions of speech (words) where the prosodic differences based on majority languages are most robustly manifested; and (b) analyzes the nature of these differences in terms of intonational patterns. For the first step, we trained convolutional WaveNet speech synthesis models on North Sámi speech material, modified to contain purely prosodic information, and used conditioning embeddings to find words with the greatest differences between the varieties. The subsequent exploratory analysis suggests that the differences in intonational patterns between the two Finnmark North Sámi varieties are not manifested uniformly across word types (based on part-of-speech category). Instead, we argue that the differences reflect phrase-level prosodic characteristics of the majority languages. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess the incidence, treatment and outcome of vascular trauma in a well-defined geographical region in Finland. Methods: A retrospective analysis was conducted of patients admitted to Tampere University Hospital (TAUH), Pirkanmaa, Finland, due to vascular trauma between January 2006 and December 2010. Data regarding trauma mechanism, anatomical location, treatment, and short-term outcome were collected from patients' files and vascular register. Results: Altogether, 143 non-iatrogenic vascular traumas occurred during the study period resulting in an annual trauma incidence of 5.8/100,000/year in the TAUH region. The majority of the injuries were located in the upper extremities ( N = 83, 58 %). Penetrating injuries comprised 58 % (83 patients) of all vascular trauma admissions and were significantly more common among men compared to women (83 and 17 %, respectively). The majority ( N = 93, 65 %) of the injuries were treated surgically, while in 15 (11 %) patients the trauma was resolved by endovascular means. The remaining 35 (24 %) patients were successfully managed conservatively, i.e., by observation or wound exploration only without the need for later (30-day) vascular repair. Two out of 17 patients (12 %) with lower extremity vascular trauma required major amputation. Procedure-related complications occurred in five patients. In-hospital and 30-day mortality was zero. Conclusions: This paper demonstrates that the incidence of non-iatrogenic civilian vascular trauma in the Pirkanmaa region is low and mainly caused by penetrating injury. Further, the majority of vascular traumas are still treated surgically. In general, the short-term survival of patients who survive the initial trauma is good. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

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]

Aim and objective: To analyse trends in incident reporting over the last 5 years and determine how many reports led to recommendations? Background: Patient safety incident reporting systems have been used in health care for years. However, they have a significant weakness in that reports often do not lead to any visible action. Design: The study is a retrospective register study. STROBE checklist was applied in the preparation of the paper. Methods: Data were collected from a web‐based incident reporting database (HaiPro) for a social‐ and healthcare organisation in Finland, covering the period from 2011–2015. Results: In total, 16,019 incident reports were analysed. In 2.7% (n = 426) of all reports, there was written recommendation to develop action that such incidents would not happen again. Those reports were classified into seven categories: education, introduction and information, introduction to work, patient care, guidelines, instruments and IT programmes, and the physical environment. Conclusions: Managers get major amount incident reports. There should be (a) a definition what kind of events should be reported, (b) a definition for how serious events managers have to make a recommendation and (c) control that recommendations are implemented. Relevance to clinical practice: There is a need for more action to promote patient safety based on incident reports. [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]

Purpose The purpose of this paper is to improve understanding of how different kinds of power influence trust and motivation in hospitals.Design/methodology/approach To analyze the links between power, trust and motivation, a framework of social power is tested on measures of trust in managers and motivation. Quantitative data from 137 respondents were collected. Partial least square is used to evaluate the theoretical model.Findings Legitimate, referent and reward power has a positive influence on trust, while coercive power has a negative influence on trust. In total, 41.8 per cent of the variation in trust in managers was explained by power. Trust, reward power and expert power explained 30.9 per cent of the variation in motivation.Practical implications The research indicates that in knowledge organizations such as hospitals, leaders should be careful in using coercive power. Expert power seems to influence motivation but not trust, while legitimate power seems to influence trust directly and motivation only through trust. Referent power seems to have a weak influence on trust and no direct influence on motivation. Reward power has a very strong influence both on trust and motivation.Originality/value It is important for leaders to consider how power can influence trust, motivation and the performance of a health organization. Although this study was conducted in Norway and Finland, the findings may have relevance on a broader scale. [ABSTRACT FROM AUTHOR]