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There is a clear need for highly competent health sciences experts. No instrument currently exists for assessing the generic competences of health sciences students. The aim of this study is to develop and psychometrically test the Health sciences Generic Competence (HealthGenericCom) instrument. The instrument development four step process has been conducted with a cross-sectional study design and according to the COSMIN guidelines. Face and content validity was tested by 13 experts, structural validity was tested with exploratory factor analysis, and internal consistency was evaluated by calculating Cronbach's alpha. The structural validity was tested using data from Finnish health sciences students (n=276). The content validity index of the whole HealthGenericCom instrument was 1 for relevance and for clarity. Using exploratory factor analysis a model of eight factors (with 88 items) was created: 1) competence in leadership, administration, and finance; 2) competence in people-centred guidance; 3) competence in health promotion; 4) competence in evidence-based practice; 5) digital competence; 6) competence in work well-being and self-management; 7) competence in collaboration and problem-solving; and 8) competence in societal interaction. The HealthGenericCom was shown to be valid and reliable and provides an evidence-based conceptual framework that can be used in developing curriculums and competence management.

The study's purpose was to describe the competence in well-being at work of social and health care educators and the factors influencing it. Cross-sectional study. Data were collected using a questionnaire from social and health care educators (n=243) working at ten randomly selected educational organizations. K-means clustering was used to identify three distinct educator profiles. Educators belonging to profiles 1 and 2 exhibited low competence in managing work wellbeing. All profiles exhibited intermediate competence in promoting work wellbeing. Competence in appreciating the work of educators was either intermediate or high in all three profiles. Managers working in educational organizations need to ensure and support educators' well-being.

An educator's competence influences the implementation of evidence-based education and the overall quality of social and health care. This study aimed to identify distinct competence profiles from Finnish social, health and rehabilitative care educators, as well as describe which personal and professional characteristics influenced belonging to a certain profile. Data were collected from 28 educational organizations located throughout Finland using the Health and Social Care Educators' Competence instrument. The survey was answered by 422 educators. The performed K-means cluster analysis identified three distinct educator competence profiles, which differed in terms of self-assessed expertise in various competence areas and certain background characteristics. The results highlight that educational institutions should concentrate on refining the digital competence of educators, which requires networking, collaboration, and work-related pedagogical competence. The differences in evaluation identified for the three profiles demonstrates that more experienced educators should mentor their less experienced counterparts to ensure a high quality of education.

Invasive predators are one of the leading causes of global biodiversity loss, threatening local ecosystems through predation and spreading diseases. In Europe, the most common and widespread invasive mesopredator is the raccoon dog (Nyctereutes procyonoides). Raccoon dog is an opportunistic omnivore listed as a species of European Union concern, as they are suspected of harming ground-nesting waterbird populations. However, the actual extent of risks caused by raccoon dog predation has been disputed, partly due to methodological constraints in detecting all prey in the diet. Here, we studied the animal components of raccoon dog diet using DNA metabarcoding, a powerful tool to detect even the smallest traces of ingested food items. We sequenced genes 12S rRNA and COI from raccoon dog scat samples collected during the breeding season of birds close to water bodies in southern Finland. We also examined whether the occurrence of different dietary items would depend on the habitat around the latrine. We found that frogs were the most common vertebrate food item in raccoon dog diet during spring. The proportion of detected bird material was not higher compared to earlier studies, despite the potential to detect DNA originating from eggs. The proportion of fish in the diet increased with increasing water area around the latrine, but no other relationships between diet and habitat were found. We conclude that even though raccoon dogs predate on waterbirds’ and other ground nesting birds’ nests, they do not seem to be specialized on it in our study areas. However, declining waterbird populations and, in particular, local amphibian populations could be negatively impacted by raccoon dog predation.

Abstract Aim To describe practical nursing students', mentors' and educators' perceptions of student learning and assessment of learning progress during work‐based learning. Design A qualitative descriptive study. Methods The research data were collected by interviewing eight practical nursing students, 12 mentors and eight educators (total n = 28) from three vocational institutions and four social‐ and health care organizations in Finland during November 2019–September 2020. The interviews were conducted as focus group interviews, after which the collected material was subjected to content analysis. The researchers had received appropriate research permits from the target organizations. Results Work‐based learning depends on the student, who must be goal‐oriented and responsible for their own learning. The mentor also plays a key role in the learning process as the supporter and enabler of a student's goal‐oriented learning process. The educator is responsible for instructing both students and mentors, and supporting a student's goal‐oriented learning process. The vocational institution also has a role in successful learning among practical nursing students as an enabler of students' individual learning process. The participants shared that the workplace is responsible for ensuring a secure learning environment.

Abstract Aims and objectives This study aims to provide insight into healthcare professionals' lived experiences of digital health competence with the objective of improving the knowledge of how digital health competence is perceived by healthcare professionals. Background Healthcare professionals need to adjust to the digital era to provide quality and ethical care. Previous research has rarely adopted a healthcare professional's standpoint to describe their perceptions of digital health competence, even though their perspective in how new care practices are designed and implemented is vital. Design A qualitative descriptive study. Methods Healthcare professionals (nurses and allied health professionals) from versatile healthcare settings were recruited for individual semi‐structured interviews in Sweden (n = 5) and Finland (n = 15) (spring 2019‐summer 2020). Purposive and convenience sampling was used. Participants' backgrounds were in the public and private sectors. The interviews were transcribed for inductive content analysis. The SRQR guideline guided the study process. Results Healthcare professionals' perceptions of digital health competence are connected to competence to provide patient‐centric care through digital channels, using technology and digital health systems, interacting with the patient through digital means, evaluating what digital health is and combining digital and traditional methods. Professionals' perceptions of their own digital health competence were divided, with the participants either reporting sufficient competence or perceiving a lack of skills in some specific areas. Conclusions Healthcare professionals' perceptions of digital health competence focus on the ability to provide patient‐centric care by evaluating the need and possibilities for using digital health services jointly with more traditional methods. This study provides a sound basis for digital health research, but future studies should focus on elucidating factors which affect digital health competence and competence development. Relevance to clinical practice The results of this study can guide healthcare practices and digital health implementation, as well as function as a basis for instrument or theory development. Health care and nursing leaders should enable the resources to hybrid practices in patient‐centric care provision.

Abstract Aims To describe the mentoring competence of clinical practice nurse mentors and identify different mentor profiles. Design Cross‐sectional research design, secondary analysis. Methods An international, cross‐sectional study design was performed in five European countries. A total of 1 604 mentors from 33 healthcare organizations participated in the study between 2016–2019. The Mentors' Competence Instrument (MCI), which includes seven sub‐dimensions and 44 items, was used to collect data. K‐means cluster and binary regression analyses were performed to detect mentor profiles and determine how various factors affect competence, respectively. Results The K‐means cluster analysis identified three distinct profiles: A (n = 926); B (n = 566); and C (n = 85). The profiles showed significantly different values (p

Abstract Aim The purpose of the study was to identify and describe the characteristic profiles of evidence‐based practice competence of educators in the social, health and rehabilitation sectors and to establish relevant background factors. Design This study was carried out as a descriptive cross‐sectional study. Methods Data were collected from social, health and rehabilitation sector educators working in the 21 Finnish universities of applied sciences and seven vocational colleges (n = 422; N = 2,330). A self‐assessment instrument measuring evidence‐based practice competence was used. Competence profiles were formed using a K‐cluster grouping analysis. Results Three distinct competence profiles were identified and delineated. Most educators feel that they can guide students' critical thinking and are able to seek and produce scientific knowledge. Evidence‐based practice competence was explained by background factors such as year of graduation (for higher degree), level of education, job title, current employer and current field of work.

Struvite (NH4MgPO4∗6H2O) is a slow-release fertilizer produced from phosphorus and nitrogen-containing wastewater in the presence of Mg salts. Commercial Mg salts are the single most significant cost of struvite precipitation. In this study, H2SO4 formed as an industrial sidestream was used to prepare MgSO4 solution from waste dolomite (DOL) and fly ash (FA). MgSO4 solution was then used to precipitate struvite from a synthetic (NH4)2HPO4 solution and from actual industrial process waters. The best results were obtained with real process waters where over 99% of phosphate and about 80% ammonium removals were achieved with both MgSO4 solutions after 30 min of reaction time. A higher molar ratio between Mg and P improved the phosphate removal efficiency, especially with DOL-based MgSO4 solutions; however, it had no practical effect on ammonium removal. The struvite content of precipitates was 75.49% with an FA-based chemical and 60.93% with a DOL-based chemical; other valuable nutrients (Ca, K, S, Fe, Mn, and Cl) were captured in the precipitates. The results indicate that both sidestream-based reagents perform well in struvite precipitation and that the formed precipitates could be used as fertilizers.

In this study, a technical scheme of an ammonium recovery process from diluted municipal or industrial wastewaters was developed, and the main operational parameters of adsorption/desorption and air-stripping/acid-scrubbing or membrane units were examined. The proposed approach combines the removal of ammonium nitrogen by an ion-exchange mechanism on metakaolin-based geopolymers (MKGPs) followed by adsorbent regeneration. A regeneration agent was purified by the air-stripping technique or membrane technology. A ready-to-use market-grade fertilizer or industrial-grade ammonia water could be obtained as the final product. The properties and regeneration ability of MKGP, prepared from activated kaolinite clay, were compared with new geopolymer adsorbents based on papermill sludge (FS MKGP). Adsorption fixed-bed column experiments with continuously circulated regeneration solution purified by air-stripping or the membrane approach were conducted to determine the limits of the regeneration solution’s application. Sodium and potassium salts were tested as regeneration agents, and the influence of regeneration solution composition on ammonium removal and recovery rates was investigated. Based on a breakthrough curve analysis, the removal rate of ammonium N by FS MKGP was found to be 3.2 times higher than that by MKGP for actual wastewater samples. Moreover, there were substantial differences in the regeneration regime between the two adsorbents. For the air-stripping technique, a liquid-phase temperature of 45°C was minimal and enough for efficient ammonia transfer to the gaseous phase. For the membrane technique, a feed-phase temperature of 40°C was enough for removing ammonia from the regeneration solution, while no heating of a receiving phase was required.

Terveydenhuollossa on käytössä entistä enemmän potilaiden omahoitoa tukevia sähköisiä terveyspalveluja, jotka mahdollistavat aktiivisen osallistumisen omaan hoitoon. Omahoitopalvelujen lisääntyessä uudet sähköiset terveydenhuollon palvelut ovat myös osa ammattilaisten arkea, mikä vaikuttaa työhön ja työn sisältöön muuttaen ammattilaisten toimintaprosesseja. Terveydenhuollon ammattilaisten toimintaprosesseja tarkastellaan ammattilaisen ja potilaan välisenä vuorovaikutuksena sekä asiantuntijatyönä. Tutkimuksen kohteena on erikoissairaanhoidon omahoitopalvelu, Terveyskylän digihoitopolut. Tutkimuksen tarkoituksena on kuvata digihoitopolkujen vaikutuksia terveydenhuollon ammattilaisten toimintaprosesseihin erikoissairaanhoidossa. Tutkimus toteutettiin teemahaastatteluina neljässä yliopistollisessa sairaalassa digihoitopolkuja käyttäville ammattilaisille (n=11). Aineisto kerättiin kesän 2019 ja kevään 2020 aikana. Tiedonantajista suurin osa oli sairaanhoitajia (n=8). Muut tutkimukseen osallistuneet (n=3) toimivat lääkärinä, kuntoutusohjaajana ja ravitsemusterapeuttina. Aineiston analyysimenetelmänä oli teoriaohjaava sisällönanalyysi. Tulokset osoittavat digihoitopolkujen vaikuttaneen terveydenhuollon ammattilaisten ja potilaiden väliseen yhteistyöhön muuttamalla potilaan ja ammattilaisen välistä vuorovaikutusta sekä lisäämällä potilaan osallistamista. Potilaiden tuottama tieto digihoitopoluilla mahdollisti uudella tavalla valmistelevan toiminnan ennen vuorovaikutustilannetta. Terveydenhuollon ammattilaisten tehtävien luonne muuttui. Toimintaprosessit monipuolistuivat ja työn tekeminen uudistui, kun työssä voitiin käyttää uusia menetelmiä. Tulosten perusteella ammattilaisten osaaminen kehittyi ja työtehtävien osaamistarpeet uudistuivat. Digihoitopolkujen arvioitiin lisäävän ajankäytön suunnitelmallisuutta, kun työnjako muuttui ja työajan käyttö tehostui. Johtopäätöksenä voidaan todeta, että digihoitopolut muuttivat terveydenhuollon ammattilaisten toimintaprosesseja. Toimintaprosesseissa muuttuivat ammattilaisen ja potilaan välinen vuorovaikutus ja toteutettavien tehtävien luonne. Työnjako ja työajan käyttö tehostuivat. Tuloksia voidaan hyödyntää sähköisiä terveyspalveluja suunniteltaessa.

Health care professionals need continuous education to maintain the competencies required to provide high-quality care; in today’s world, this means an understanding of digital health services. Insight into health care professionals’ experiences of which aspects influence their digital health competence development is therefore highly relevant. The objective of the study was to examine which aspects influence the digital health competence development of health care professionals (nursing workforce and allied health professionals). In-depth, semi-structured interviews were conducted with 20 health care professionals (Finland n=15, Sweden n=5) from various health care settings between May 2019 and July 2020. Interviews were audio-recorded, translated verbatim and analysed with inductive content analysis. Health care professionals perceive that digital health competence development is influenced by aspects related to digital health adoption, co-workers and the work community, their manager, and opportunities for continuous education and orientation. The participants agreed that digital health competence is an important part of a health care professional’s overall clinical competence. Continuous education geared towards digital health competence should be systematically designed, and potentially integrate the resources available on social media platforms. Additionally, managers and supervisors should take a stronger stance towards learning about digital health services so they can serve as role models to their employees and genuinely promote digital health competence development.

Five alkali-activated analcime (ANA) sorbents (ANA-MK 1, ANA 2, ANA 3, ANA-MK 4, and ANA-MK 5) were developed for ammonium (NH4+) ion removal. Acid treatment and calcination were used as pre-treatments for analcime, and metakaolin (MK) was used as a blending agent in three sorbents. Sorption experiments were performed to evaluate the effects of sorbent dosage (1–20 g L−1), initial NH4+ ion concentration (5–1000 g L−1), and contact time (1 min–24 h). ANA-MK 1, ANA 2, and ANA-MK 4 were the most efficient sorbents for NH4+ ion removal, with a maximum experimental sorption uptake of 29.79, 26.00, and 22.24 mg g−1, respectively. ANA 3 and ANA-MK 5 demonstrated lower sorption capacities at 7.18 and 12.65 mg g−1, respectively. The results for the sorption of NH4+ ions onto the alkali-activated analcime surfaces were modeled using several isotherms. The Langmuir, Freundlich, Sips, and Bi-Langmuir isotherms were the best isotherm models to represent the studied systems. The results of the kinetic studies showed the maximum NH4+ ion removal percentage of the sorbents was ~80%, except for ANA-MK 5, which had a ~70% removal. Moreover, the pseudo-first-order, pseudo-second-order, and Elovich models were applied to the experimental data. The results showed that the sorption process for ANA-MK 1, ANA 2, ANA 3, and ANA-MK 4 followed the Elovich model, whereas the pseudo-second-order model provided the best correlation for ANA-MK 5.

• Previous research into the competence of healthcare professionals in the stroke care pathway does not offer a complete picture of the relevant issues. • The overall level of competence of healthcare professionals in the stroke care pathway was good. Multiprofessional and collaboration competence were the strongest areas of competence. In contrast, competence to use evidence-based information was rated as the weakest area of competence. The competence profiles were found to be influenced by healthcare professionals' occupation, and their participation in their organization's expert network. • The results of the study can be used to inform competence development, competence management, and the design of continuing education. Nursing managers can use the results of this study to identify staff competencies and skills gaps. To describe healthcare professionals' self-assessed competence in stroke care pathways based on their self-evaluation and identify the factors associated with competence. A cross-sectional, descriptive explorative study design was used. The data were collected during May and September 2021 through a survey sent to healthcare professionals (N= 1200, n= 215) working in neurological care. Competence in stroke care pathways was measured using the RN-STROKE, PT-STROKE and OT-STROKE instruments defined by four-factor model. The instruments' validity and reliability were confirmed through exploratory factor analysis and Cronbach's alpha. K-means clustering, one-way ANOVA, Chi Square, Mann Whitney U and Kruskal-Wallis were used to analyze the data. The results were reported as frequencies, percentages, mean and standard deviation. The results were reported according to STROBE guidelines. Four main areas of healthcare professionals' competence in stroke care pathways were identified: (1) counseling and interaction competence (2) competence to use evidence-based information, (3) self-management and development competence, and (4) multiprofessional and collaboration competence. The study then identified three competence profiles of healthcare professionals working in the stroke care pathway. Professionals in Profile A evaluated their competence at the highest level, those in Profile B at the average level, and those in Profile C at the lowest level. Healthcare professionals' occupation and participation in their organisation's expert network were found to be associated with competence profiles. The overall competence of healthcare professionals in the stroke care pathway was rated as good, but competence to use evidence-based information in clinical practice, in particular, should be improved. Organisations should, therefore, increase education and training in this area and provide adequate resources to enable the use of evidence-based information in clinical work. The study identifies three profiles relating to healthcare professionals' competence in the stroke care pathway, which can be used to create continuous education and ensure better patient care according to participants' profiles. The study was reported using the STROBE Statement checklist. No patient or public contribution. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the removal of ammonium ions from a synthetic model solution by using Na-zeolite-based geopolymers. Na-zeolite (=analcime) is a residue from mining industry. Three adsorbents were prepared from Na-zeolite using different production steps and metakaolin as a blending agent. These novel adsorbents were investigated in a fixed-bed column system where the effects of different flow rates with the initial ammonium concentration of 40 mg/L were studied. The Thomas, Bohart–Adams and Yoon–Nelson breakthrough curve models fitted well with the experimental data with a high R2 value. After adsorption experiments, adsorbents were regenerated using a mixture of 0.2 M NaCl and 0.1 M NaOH as a regeneration agent; after that, adsorbents were reutilised for ammonium ion adsorption for three adsorption–regeneration cycles. The results of the experiment indicate that all the prepared analcime-based geopolymers are suitable adsorbents for the removal of ammonium ions and that capacity remains nearly constant for two of them during two adsorption–regeneration cycles.

• High-quality stroke care requires both in-depth and wide-ranging professional competences. • Competence in stroke care require interaction skills as well as multiprofessional collaboration. • Clinical competence relies on strong theoretical understanding of stroke as a disease. • Multidisciplinary emotional support competency is required to aid patients and families in stroke recovery. • High-quality stroke care requires competence in self-management and continuous development. To describe healthcare professionals' experience of needed competence in patient stroke care within specialist and primary healthcare. Healthcare professionals who provide stroke care need multifaceted, multi-professional skills; ongoing training is important for competent stroke care. A descriptive qualitative study. Six focus group interviews with semi-structured interviews were conducted in October and November 2020. Healthcare professionals (n = 25) working in stroke care units in both specialist and primary healthcare settings were interviewed. The interviews were recorded, transcribed and analyzed inductively by content analysis. The study was conducted, and results were reported according to the Consolidated Criteria for Reporting Qualitative Research. Five main categories were identified: clinical competence; multiprofessional networking competence; competence in interaction skills; emotional and psychoeducational support competence; and self-management and development competence. Competence in stroke care includes both in-depth and wide-ranging professional competences that require ongoing development. Utilizing various education models and collaborative learning approaches can help meet the requirements for developing competence in stroke care. No patient or public contribution [ABSTRACT FROM AUTHOR]

Abstract Radiation‐associated sarcoma (RAS) is a rare complication of radiation therapy (RT) to breast cancer (BC). This study explored RAS after RT to BC in a nationwide population‐based material. The Finnish Cancer Registry was queried for patients with BC treated during 1953‐2014 who were later diagnosed with a secondary sarcoma in 1953‐2014. Registry data, patient files, and sarcoma specimens were analyzed to confirm diagnosis and location of RAS at or close to the RT target volume. A total of 132 512 patients were diagnosed with invasive BC during the study period. A subsequent sarcoma was diagnosed in 355 patients. After exclusion, 96 RAS were identified. Angiosarcoma (AS) was the most prevalent histology in 50 (52%) of 96 patients. However, the first radiation‐associated AS was diagnosed in a patient treated for BC with breast‐conserving surgery in 1984, and thereafter, the proportion of AS continuously increased. The 5‐year sarcoma‐specific survival was 75.1% for RAS treated with a curative intent. The distribution of histologic subtypes of RAS has changed during the 60 years of this registry study. The first radiation‐associated AS was diagnosed in 1989, and presently, AS is the most common histologic subtype of RAS. It is possible that changes in BC treatment strategies are influencing the characteristics of RAS.

In the field of electrocoagulation (EC), various studies on pollutant removal and on the use of different EC technologies have already been made. An EC process generates sludge, which is considered waste, resulting in increased operational costs that come from waste disposal. Sludge contains valuable materials, such as the nutrients or metals removed during water purification, along with metals, such as aluminum or iron, which come from the electrodes used in an EC system. Based on the principles of circular economy or based on existing legislations, reducing the production of valuable wastes, and increasing the valorization rate of as many materials as possible are important endeavors. This study is mainly a review of the existing sludge valorization studies. This review highlights the valorization of sludge as a fertilizer (mainly as struvite), pigment, construction material (mainly as blocks), adsorbent, and catalyst. While it has already been found that EC sludge is valorizable, more studies on EC sludge valorization and on the quality of sludge produced from the effluent of EC processes are warranted.

Alkali-activated adsorbents were synthesized by mixing three different slags from the steel industry: blast furnace slag (BFS), ladle slag (LS), and Lintz–Donawitz converter slag (LD). These powdered slag-based geopolymers (GP) were used to remove nickel(II) from aqueous solutions in fixed-bed column studies. The experiments were conducted in pH 6 using a phosphate buffer with initial nickel(II) concentration of 50 mg/L. Samples were taken at time intervals of between 5 and 90 min. Three adsorption–desorption cycles were implemented with a flow rate of 5 mL/min. The geopolymers were characterized by Fourier-Transform Infrared Spectroscopy (FTIR), X-ray powder diffraction (XRD), Field Emission Scanning Electron Microscopy (FESEM), X-ray fluorescence (XRF), specific surface area measurements, and a leaching test. The data were found to describe the Thomas, Adams–Bohart, and Yoon–Nelson models well. For GP (BFS, LS), experimental adsorption capacity was 2.92 mg/g, and for GP (LD, BFS, LS), it was 1.34 mg/g. The results indicated that the produced adsorbents have the potential to be used as adsorbents for the removal of nickel(II).

New carbonized biomass–metakaolin (PSD/MK_Fe) granular composite catalyst materials were manufactured for the catalytic wet air oxidation (CWAO) of bisphenol A (BPA). These catalysts were characterized using different analytical and spectroscopic techniques, and results showed that the catalysts’ final properties were influenced by the addition of metakaolin (MK), polyvinyl alcohol, boric acid, and iron. Under the optimal CWAO experimental conditions (p: 20 bar, T: 160 °C, initial pH: 5–6, c[catalyst]: 1.0 g/L), nearly complete BPA conversion (>98%) and total organic carbon (TOC) conversion of 70% were reached. A key factor behind the enhanced catalytic activity was high specific surface area, although catalytic activity was also affected by surface acidity. These results confirmed the high efficiency of the current BPA conversion process involving the use of the easily separable and reusable PSD/MK_Fe catalyst. Therefore, biomass composite catalysts can be regarded as efficient catalysts for the oxidation of BPA during the CWAO process.

Sulphate removal from mine water is a problem because traditional chemical precipitation does not remove all sulphates. In addition, it creates lime sediment as a secondary waste. Therefore, an inexpensive and environmental-friendly sulphate removal method is needed in addition to precipitation. In this study, carbon residues from a wood gasification process were repurposed as precursors to a suitable sorbent for SO42- ion removal. The raw material was modified using ZnCl2, BaCl2, CaCl2, FeCl3, or FeCl2. Carbon residues modified with FeCl3 were selected for further consideration because the removal efficiency toward sulphate was the highest. Batch sorption experiments were performed to evaluate the effects of the initial pH, initial SO42- ion concentration, and contact time on sulphate removal. The removal of SO42- ions using Fe-modified carbon residue was notably higher compared with unmodified carbon residue and commercially available activated carbon. The sorption data exhibited pseudo-second-order kinetics. The isotherm analysis indicated that the sorption data of Fe-modified carbon residues can be represented by the bi-Langmuir isotherm model.

Sawdust was used as a precursor for the production of biomass-based activated carbon. Carbonization and activation are single-stage processes, and steam was used as a physical activation agent at 800 °C. The adsorption capacity towards zinc was tested, and the produced activated carbon proved effective and selectively adsorbent. The effects of pH, initial concentration, adsorbent dosage, time, temperature, and regeneration cycles were tested. The adsorption capacity obtained in this study was compared favorably to that of the materials reported in the literature. Several isotherms were applied to describe the experimental results, with the Sips isotherm having the best fit. Kinetic studies showed that the adsorption follows the Elovich kinetic model.

Phosphorus as phosphate and nitrogen as ammonium or nitrate are the main nutrients in wastewaters and agricultural sludges. They runoff easily to waterways and cause eutrophication in water bodies. However, ammonium and phosphate could be precipitated simultaneously and used as recycled nutrients. In this research, dolomite calcined at 650 °C, 750 °C, or 950 °C and commercial MgO were used as precipitants in simultaneous phosphate and ammonium removal from synthetic (NH4)2HPO4 solution and agricultural sludge. Calcination at 750 °C was the preferred option as dolomite was decomposed to MgO and CaCO3 for optimal struvite precipitation. Molar ratios of 1.1–1.6:1–2:2 (Mg:P:N) were employed in the experiments. Very robust ammonium removal was obtained with MgO (57%), dolomite 650 °C and dolomite 750 °C (75%). MgO removed almost all phosphate, while dolomite 650 °C removed 65%, and dolomite 750 °C removed 60% (70% from agricultural sludge). Some part of the phosphate was adsorbed, most likely by CaCO3, during dolomite precipitation. Struvite was the only identified reaction product in all samples after 24 h of precipitation. Calcined dolomite had great potential in ammonium and phosphate precipitation from both synthetic waters and agricultural sludges and the precipitates could be used as recycled fertilizers.

Evidence-based practice (EBP) has been shown to improve patient safety as well as quality of care. Advanced practice nurses (APNs) have a vital role in the implementation of EBP. This study aimed to describe APNs' experiences of EBP implementation. The study was a descriptive qualitative study and data were collected between May and August 2019 through interviews with APNs (n = 12). The data were analyzed using inductive content analysis. The study was reported according to COREQ guidelines. The responses were divided into four main categories: EBP in clinical nursing; EBP leadership; implementation of supporting structures for EBP; and EBP in APNs' work. APNs experienced: that the realization of EBP varied in clinical nursing, that there was a need for development in the leadership of EBP, variation in nurse leaders' competence in EBP leadership, and a lack of resources for EBP. [ABSTRACT FROM AUTHOR]

Sex-related physiological differences result in different expressions of diseases for men and women. Data are contradicting regarding the increase in the female risk for cardiovascular disease (CVD) at mid-life. Thus, we studied possible sex differences in age-adjusted mortality for CVD and non-vascular diseases stratifying our findings by specific age groups.Over one million deaths (1 080 910) reported to the Finnish nationwide Causes of Death Register in 1986-2009 were analyzed. A total of 247 942 male deaths and 278 752 female deaths were of CVD origin, the remaining deaths were non-vascular. The annual mortality rates were calculated per 100 000 mid-year population, separately for men and women in 5-year age categories.The age-standardized risk of death from CVD was 80% higher for men (442/100 000) than for women (246/100 000). After age 45-54 the male CVD mortality rate elevated parallel to the non-vascular mortality, whereas in women the CVD mortality elevated considerably more rapidly than the non-vascular mortality from age 60 years onwards.Heart disease mortality in men accelerates at a relatively young age, but in women the risk shows a steep increase at approximately 60 years of age. These data emphasize the need to identify and prevent risk factors for CVD, especially in women in their mid-life years.

During clinical practice, students become acquainted with the key work tasks associated with their professions. Students need more support from healthcare educators during clinical practice learning, particularly in challenging situations. This study aimed to describe healthcare educators' experiences of challenging situations during clinical practice placements. A qualitative study design was used to collect data through interviews with ten healthcare educators from two higher education institutions. The data were analyzed with inductive content analysis. The SRQR reporting guidelines were used to improve the transparency of the study. Educator reactions commonly involved emotional, goal-oriented and pedagogical support towards their students. The interviewed educators felt that mentors – when facing a challenging situation during clinical practice – are tasked with creating an atmosphere that supports student learning. Students faced challenges that were related to self-evaluation, goal-oriented activities, and their attitudes towards feedback. The building of a safe clinical learning environment involves collaboration between students, their clinical mentors and educators. [ABSTRACT FROM AUTHOR]