Applicants' success in the ethics entrance exam: A cross-sectional study.

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

Ageing shift workers' sleep and working-hour characteristics after implementing ergonomic shift-scheduling rules.

We studied whether implementing binding ergonomic shift-scheduling rules change ageing (≥45 years) social and healthcare employees' (mean age 52.5 years, 95% women) working-hour characteristics (e.g. weekly working hours, number and length of night shifts, and short shift intervals) and sleep. We compared an intervention group (n = 253) to a control group (n = 1,234) by survey responses (baseline 2007/2008, follow-up 2012) and objective working-hour characteristics (intervention group n = 159, control group n = 379) from 91 days preceding the surveys. Changes in working-hour characteristics were analysed with repeated measures general linear models. The fully adjusted model (sociodemographics and full-/part-time work) showed that proportion of short shift intervals (<11 hr, p = .033) and weekend work (p = .01) decreased more in the intervention than in the control group. Changes in sleep outcomes were analysed with generalised logit model to binomial and multinomial variables. The fully adjusted model (sociodemographics, full-/part-time work, job strain, health behaviours, and perceived health) revealed higher odds in the intervention group for long sleep (≥9 hr; odds ratio [OR] 5.53, 95% confidence interval [CI] 2.21-13.80), and lower odds of short sleep (<6 hr; OR 0.72, 95% CI 0.57-0.92), having at least two sleep difficulties often (OR 0.55, 95% CI 0.43-0.70), and more specifically difficulties in falling asleep (OR 0.56, 95% CI 0.41-0.77), waking up several times per night (OR 0.43, 95% CI 0.34-0.55), difficulties in staying asleep (OR 0.64, 95% CI 0.49-0.82), and non-restorative sleep (OR 0.70, 95% CI 0.54-0.90) than the control group. In conclusion, implementation of ergonomic shift-scheduling rules resulted in minor changes in ageing employees' objective working hours and a consistent buffering effect against worsening of sleep.

Characteristics of SARS-CoV-2 positive cases beyond health-care professionals or social and health-care facilities.

BACKGROUND: During the outbreak of SARS-CoV-2 in Italy, infection among health-care professionals and in the context of welfare and health-care facilities was a significant concern. It is known that the elderly or those with concomitant pathologies are at greater risk of a serious evolution of the disease if affected by COVID-19 and that health workers are a category with greater exposure to SARS-CoV-2 infection. Until now, there has been little information on the epidemiological features and transmission dynamics of the COVID-19 outbreak which did not involve health-care professionals or social and health-care facilities. For this reason, this paper aims to describe the epidemiological characteristics of SARS-CoV-2 infection in the general population outside these semi-closed communities. METHODS: The study was designed by analyzing the data of the 1371 SARS-CoV-2 positive subjects observed in Sardinia up to 9 July, 2020 and whose data were available in the public health department. Statistical analysis and graphic representation were performed using STATA and Adobe Illustrator, respectively. RESULTS: Of the positive cases analyzed, 323 (23.5%) are health-care workers and 563 (41.1%) reside in social or health-care facilities. The number of positive cases among the general population (subjects who do not belong to these semi-closed communities), is 399 (29.1%), 208 females and 191 males. The estimated Case Fatality Rate stands at 5.0%, which is almost half the rate reported for all the SARS-CoV-2 positive cases (9.8%). The geographical distribution of positive cases differs considerably from the distribution of the totality of cases in Sardinia. CONCLUSIONS: This review provides an insight into the COVID-19 situation in the general community, ie not involving health-care professionals or social and health-care facilities. Understanding the evolving epidemiology and transmission dynamics of the outbreak outside of these semi-closed communities would provide appropriate information to guide intervention policy. The COVID-19 pandemic has exacerbated the vulnerability of our health-care system. Severe disruptions in care, medicine shortages and unequal access to health-care are but a few examples of the challenges faced by people living in Italy and Europe, highlighting the importance of evidence-based approaches in supporting the development of prevention and response strategies for future pandemics.

Continuing professional development among social- and health-care educators.

Future social- and health-care educators will be required to have versatile competence in educating professionals that reflects both the constantly changing health-care environment and delivery of high-quality patient care. Continuing professional development can be defined as a process that aims to increase educators' competence and well-being, along with the effectiveness of an organisation. This study aimed to describe educators' continuing professional development and clarify the contribution of continuing education. The research applied a qualitative approach as only limited information about social- and health-care educators' professional development currently exists.' Data were collected by group interviews of 35 experienced social- and health-care educators from six institutions of higher education and two vocational schools across Finland. An inductive content analysis yielded 39 subcategories, 11 categories and three main categories, namely, educators' approaches for developing professional competence, barriers to continuing education, and educators' continuing education needs. The educators reported that they maintain and develop their competence in versatile ways; for example, continuing professional development takes place through both formal continuing education and informal collaboration at daily work. Regarding barriers to continuing education, the educators most often cited the lack of planning and a lack of resources, for example, scheduling and financial factors. The continuing education needs of social- and health-care educators are highly individual and should not only reflect organisational goals. The fact that this study only included experienced educators can be considered a limitation, as a sample that also included novice educators may have yielded different perceptions of continuing education and professional development. The results of the research can be utilised when designing the continuing professional development of educators at the individual, group or organisational level.

Perceptions and educational needs of social and healthcare professionals in the prevention of domestic violence - A focus group study.

OBJECTIVE: To explore and describe social and healthcare professionals' perceptions and educational needs in relation to domestic violence and its prevention. METHODS: A qualitative research was conducted in three European countries. Two multidisciplinary focus group interviews were conducted (in each country) among professionals and higher education teachers in the field of social and health care. Total number of participants were 32 (Finland n=12, Greece n=12, Portugal n=8). The transcribed data were analyzed by thematic analysis. RESULTS: Participants' perceptions of domestic violence and its prevention included: multidimensional phenomenon, consequences, and addressing concern. Domestic violence was seen as a multidimensional phenomenon, which has various consequences for several aspects of life. Professionals have difficulties addressing their concern due to lack of knowledge and tools. Solutions to prevent domestic violence that the participants shared were: education, intervention, and strategies. Education was seen as the key aspect for the prevention of domestic violence. Also, professionals' communication and situation management skills, as well as national and international strategies, were seen as valuable solutions. Educational needs for prevention of domestic violence were expressed based on content, methods, and practices, such as services system and legislation. CONCLUSION: The findings of the current study highlight the social- and healthcare professionals' need for education about domestic violence. It is essential that these professionals receive appropriate training to effectively identify and address domestic violence. The current study provides useful information for the development of relevant training/education for this group of professionals.

"DOMINO - Stop Domestic Violence". An Educational Mobile Application.

Domestic violence affects people of all socioeconomic backgrounds and education levels and can happen to anyone. It is a public health issue that needs to be addressed with health and social care professionals playing an essential role in prevention and early intervention. These professionals need to be prepared through proper education. A European funded project developed "DOMINO - Stop domestic violence" educational mobile application which was piloted among 99 social and/or health care students and professionals. Most of the participants (n= 59, 59.6%) indicated that the DOMINO mobile application was easy to install and over half of them (n=61, 61.6%) would recommend the app. They found it easy to use, and quick access to useful materials and tools. Participants found case studies and the checklist good and useful tools for them. The DOMINO educational mobile application is available open access, in English, Finnish, Greek, Latvian, Portuguese and Swedish, for any stakeholder worldwide who is interested to learn more about domestic violence prevention and intervention.

Individual-based and interactional resilience mechanisms in social and healthcare service NPOs during the COVID-19 pandemic: Handling a disruptive extreme context in Austria.

While Austrian social and healthcare service nonprofit organizations (NPOs) are key performers in the COVID-19 pandemic, we also notice their vulnerability in terms of struggling with this disruptive extreme context. The particularity of disruptive extreme contexts is that organizations commonly can neither anticipate them, nor prepare specific countermeasures or specialized resources for fighting against them. Thus, we regard organizational resilience based on non-specialized resources as an appropriate approach for dealing with (the struggles of) disruptive extreme contexts. Organizational resilience refers to an organization's ability to resist disruptive extreme contexts while maintaining and adapting functionality and ultimately learning from these extreme contexts by mobilizing and accessing the required resources, behaviors and capabilities. Based on 33 expert interviews with NPO top and middle managers we aim to explore individual-based and interactional resilience mechanisms of NPOs in the pandemic. The qualitative content analysis yielded to following results: Individual personality traits (e.g., pragmatisms, flexibility) and attitudes (serenity and optimism) constitute individual-based resilience mechanisms. Moreover, a shared (crisis) understanding (e.g., common sense of direction), social connectedness (e.g., team cohesion) and managerial staff orientation (e.g., a caring attitude) as interactional resilience mechanisms helped to maintain and adapt NPOs' functioning. Overall, this study reinforces the multilevel nature of resilience in terms of the crucial combination of individual and interactional resilience mechanisms for facing adversity. Moreover, it emphasizes the evolving nature of resilience in terms of the required time for, e.g., building trust.

Effects of Home-Based Physical Exercise on Days at Home and Cost-Effectiveness in Pre-Frail and Frail Persons: Randomized Controlled Trial.

OBJECTIVES: Frailty increases the risks of hospitalization, institutionalization, and death. Our objective was to study the effects of home-based physical exercise on the number of days spent at home among pre-frail and frail persons, versus usual care. In addition, utilization and costs of health care and social services, cost-effectiveness, and health-related quality-of-life (HRQoL) were explored. DESIGN: Randomized controlled trial, with year-long supervised exercise for 60 minutes twice a week versus usual care. Follow-up for 24 months after randomization. SETTING AND PARTICIPANTS: A sample of 299 home-dwelling persons in South Karelia, Finland. Main inclusion criteria: ≥65 years, meeting at least 1 of the frailty phenotype criteria, Mini-Mental State Examination score ≥17. METHODS: Primary outcome, days spent at home over 24 months, was calculated deducting days in inpatient care, in nursing homes, and days after death. HRQoL was assessed (15D questionnaire) at baseline and at 3, 6, and 12 months. Utilization data were retrieved from medical records. RESULTS: The participants' mean age was 82.5 (SD 6.3), 75% were women, 61% were pre-frail and 39% frail. After 24 months, there was no difference between groups in days spent at home [incidence rate ratio 1.03; 95% confidence interval (CI) 0.98-1.09]. After 12 months, the costs per person-year were 1.60-fold in the exercise group (95% CI 1.23-1.98), and after 24 months, 1.23-fold (95% CI 0.95-1.50) versus usual care. Over 12 months, the exercise group gained 0.04 quality-adjusted life-years and maintained the baseline 15D level, while the score in the usual care group deteriorated (P for group <.001, time 0.002, interaction 0.004). CONCLUSIONS AND IMPLICATIONS: Physical exercise did not increase the number of days spent at home. Exercise prevented deterioration of HRQoL, and in the frail subgroup, all intervention costs were compensated with decreased utilization of other health care and social services over 24 months.

Social and health care educators' perceptions of competence in digital pedagogy: A qualitative descriptive study.

BACKGROUND: Digitalisation has made digital competence a necessity for those working in social and healthcare. A high degree of competence in digital pedagogy is required of educators to meet the challenge of educating future professionals who are themselves highly digitally competent. OBJECTIVES: The aim of this study was to describe the perceptions of competence in digital pedagogy that educators in social and healthcare have. DESIGN: A qualitative descriptive study. PARTICIPANTS: The participants were Finnish-speaking social and healthcare educators (n = 37) working at six Finnish universities of applied sciences (UAS). METHODS: Group interviews (n = 12) were conducted during spring 2018. Each group consisted of 2-5 educators, with a total of 37 educators. The data was analysed using an inductive content analysis. RESULTS: According to the interviewed educators, competence in digital pedagogy involved pedagogical, digital, and ethical skills and awareness. The educators were aware of the possibilities afforded by digital technology and had a positive view on how the technology could be utilised in education. However, the educators were concerned that technology might solely be utilised for the sake of digitalisation instead of being pedagogically preferable. CONCLUSIONS: In the future, the results of this study can be utilised while developing an instrument to evaluate the level of competence in digital pedagogy. Examining the perceptions of the educators will allows us to better understand the phenomena from the educators' point of view.

Sense of community and job satisfaction among social and health care managers.

PURPOSE: The purpose of this paper is to identify how the factors associated with sense of community at work are connected with job satisfaction among the front-line managers and middle managers in social and health-care services in Finland. DESIGN/METHODOLOGY/APPROACH: A questionnaire prepared for this study was sent to 241 social and health-care managers (front line and middle managers) in Finland. A total of 136 of managers responded to the survey (response rate was 56 per cent). Data were analyzed by using descriptive statistics, exploratory factor analysis and multiple linear regression analysis. FINDINGS: Alongside job meaningfulness, open communication and good flow of information within the organization, sense of security provided by close relationships at work and managers' own superiors' appreciation of their leadership skills all are related to managers' job satisfaction. ORIGINALITY/VALUE: The study adds to our understanding of factors which are connected to the job satisfaction among social and health-care managers'. The findings of this study can be used in the development of leadership to support managers in coping at work.

Innovative assistive technology in Finnish public elderly-care services: a focus on productivity.

OBJECTIVE: The study investigates ways in which technology use may help municipalities improve productivity in elderly-care services. A case study of Finnish elderly-care services provides responses concerning impacts, decisions and options in technology use. METHODS: The research data were collected during a 'smart home pilot' implemented in four housing service units. Over 60 assistive devices were introduced in the smart homes used during short-term housing periods. PARTICIPANTS: Both customers and care staff's experiences as well as processes related to the use of assistive devices were investigated on the basis of survey questionnaires, interviews and feedback. RESULTS: Assistive device-related operational processes were investigated with the help of concepts of 'resource focus', 'lost motion' and 'intermediate storage'. Four central operational processes were identified. Design and desirability as well as costs, such as opportunity costs of assistive devices were also a focus. Significant factors related to productivity were disclosed in this way. CONCLUSIONS: Technology use versus productivity needs to be 'circled' from the points of view of individual users, workplaces, service processes, and larger technology options. There must be long-term patience to introduce technology properly into use to produce positive impacts on productivity. Customers and care staff have an interlinked, vital role to play as decision-makers' informants.

Diabetes tipo I y depresión en púberes y adolescentes / Type 1 Diabetes and depression in pubertal children and adolescents

La diabetes es una enfermedad crónica con alto impacto sociosanitario, no solo por su alta prevalencia, sino también por sus complicaciones crónicas y su elevada tasa de mortalidad. Según la OMS, la diabetes tipo 1, que afecta predominantemente a la juventud, está aumentando alarmantemente en todo el mundo a un ritmo del 3% anual. Unos 70.000 niños menores de 14 años desarrollan cada año diabetes tipo 1. Se ha documentado una prevalencia de depresión entre los jóvenes con diabetes tipo 1 entre dos a tres veces mayor que en la población general. La combinación de depresión y diabetes tiene graves consecuencias, entre las que se destacan mal control metabólico, dificultades en la adherencia al tratamiento, mayor frecuencia de tentativas de suicidio, mayor duración de cuadros depresivos, con mas recaídas. El objetivo del trabajo es: evaluar la presencia de depresión en púberes y adolescentes con DBT tipo 1 derivados al Servicio de Salud Mental del Hospital Garrahan, con dificultades en la adherencia al tratamiento, en el periodo 2/2011 al 12/2012. Resultados: el 68% de los pacientes evaluados presentaron depresión. Fueron 34 pacientes, 27 de ellos mujeres y varones. El 92% de los pacientes estudiados presentaba al menos 1 comorbilidad. Un 42% tenía asociado TCA, encontrando que la proporción de pacientes con TCA como comorbilidad fue significativamente mayor entre los que tenían depresión. 46 pacientes presentaron comorbilidades, el 92% de la población, TCA: 42% trastorno de...

Diabetes is a chronic disease with a high social and health care burden not only due to its high prevalence, but also because of its chronic complications and high death rate. According to the WHO, type 1 diabetes( DBT1), which mostly affects children and young adults, is alarmingly increasing at 3% rate a year throughout the world. Around 70,000 children under the age of 14 years develop DBT1 each year. It has been documented that depression among youth with DBT1 is three-fold that found in the general population. The association of depression and diabetes has severe consequences, such as poor metabolic control, difficulties with treatment compliance, increased rate of suicide intent, and longer duration of epi-sodes of depression with more relapses. The aim of this study was to assess the presence of depression in pubertal children and adolescents with DBT1 and poor treatment compliance referred to the department of Mental Health of the Garrahan Hospital in the period from 2/2011 to 12/2011. Results: Of all patients evaluated, 34 (68%) presented with depression, of whom 27 were girls and 7 boys. Of all the patients studied, 92% had at least one comorbidity. DBT1 was associated with eating disorders (ED) in 42%. The number of patients who had ED as a comorbidity was significantly higher among those who suffered from depression than among those who did not (94.4% vs. 53.6%, p= 0. 003). Comorbidities...