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We assessed the distribution of SARS-CoV-2 at autopsy in 22 deceased persons with confirmed COVID-19. SARS-CoV-2 was found by PCR (2/22, 9.1%) and by culture (1/22, 4.5%) in skull sawdust, suggesting that live virus is present in tissues postmortem, including bone. Occupational exposure risk is low with appropriate personal protective equipment.
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Autopsia , COVID-19 , SARS-CoV-2 , Cráneo , Humanos , COVID-19/epidemiología , COVID-19/virología , COVID-19/patología , SARS-CoV-2/genética , SARS-CoV-2/aislamiento & purificación , Finlandia/epidemiología , Cráneo/patología , Cráneo/virología , Masculino , Femenino , Exposición Profesional , Persona de Mediana Edad , Anciano , Adulto , Equipo de Protección Personal , Anciano de 80 o más AñosRESUMEN
Childhood cancer treatments predispose to late health problems and premature death. Our aim was to use national registry data to study associations between cancer therapy exposures and late health outcomes in aging male childhood cancer survivors (CCS). The study comprised 200 male CCS (survival ≥5 years) treated with conventional cancer therapy at a single institution in 1964-2000 and 1000 matched population controls. Analyses involved registry-based data on prescription drug purchases, reimbursements for chronic conditions, hospital admissions, and deaths that occurred ≥5 years after the cancer diagnosis. Mean age of CCS was 45.4 years. Compared to population controls, CCS had a higher risk for hospital admissions due to cardiovascular diseases and late mortality, both of which increased after age 40 years. CCS also had a higher risk for purchases of antihypertensives and lipid-lowering drugs within the last year of the study. Heart radiation ≥10 Gy was associated with hospitalizations due to cardiovascular diseases (HR 4.14, 95%CI 1.81-9.48), purchases of antihypertensives (OR 3.05, 95%CI 1.32-7.36), and purchases of lipid-lowering drugs (OR 2.93, 95%CI 1.08-7.73). Testosterone deficiency developed typically during pediatric follow-up, and it was associated with testicular radiation ≥20 Gy (HR 41.2, 95%CI 15.4-110) but not with alkylating agents. Of patients treated with testicular radiation ≥20 Gy, 91% had purchased testosterone within the last year. Reassuringly, CCS had no excess risk for purchases of opioids, anxiolytics, antiepileptics, or antidepressants. These findings emphasize the need for risk-based follow-up. Middle-aged male CCS are at an increased risk of premature cardiovascular morbidity and excess mortality.
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STUDY QUESTION: What is the prospective risk of Type 2 diabetes (T2D) in Nordic women with polycystic ovary syndrome (PCOS) compared to controls? SUMMARY ANSWER: A diagnosis of PCOS and BMI ≥30 kg/m2 is a high-risk phenotype for a prospective risk of T2D diagnosis across Nordic countries. WHAT IS KNOWN ALREADY: The risk of T2D in women with PCOS is increased. The risk of T2D is related to BMI and the magnitude of risk in normal weight women with PCOS has been discussed. However, prospective data regarding risk of T2D in population-based cohorts of women with PCOS are limited. STUDY DESIGN, SIZE, DURATION: This national register-based study included women with PCOS and age-matched controls. The main study outcome was T2D diagnosis occurring after PCOS diagnosis. T2D was defined according to ICD-10 diagnosis codes and/or filled medicine prescriptions of anti-diabetic medication excluding metformin. PARTICIPANTS/MATERIALS, SETTING, METHODS: The study cohort included women originating from Denmark (PCOS Denmark, N = 27 016; controls, N = 133 994), Finland (PCOS Finland, N = 20 467; controls, N = 58 051), and Sweden (PCOS Sweden, N = 52 409; controls, N = 254 010). The median age at cohort entry was 28 years in PCOS Denmark, Finland, and Sweden with a median follow-up time (interquartile range) in women with PCOS of 8.5 (4.0-14.8), 9.8 (5.1-15.1), and 6.0 (2.0-10.0) years, respectively. Cox regression analyses were adjusted for BMI and length of education. MAIN RESULTS AND THE ROLE OF CHANCE: The crude hazard ratio (HR, 95% CI) for T2D diagnosis in women with PCOS was 4.28 (3.98-4.60) in Denmark, 3.40 (3.11-3.74) in Finland, and 5.68 (5.20-6.21) in Sweden. In adjusted regression analyses, BMI ≥30 vs <25 kg/m2 was associated with a 7.6- to 11.3-fold risk of T2D. In a combined meta-analysis (PCOS, N = 99 892; controls, N = 446 055), the crude HR for T2D in PCOS was 4.64 (3.40-5.87) and, after adjustment for BMI and education level, the HR was 2.92 (2.32-3.51). LIMITATIONS, REASONS FOR CAUTION: Inclusion of more severe cases of PCOS in the present study design could have lead to an overestimation of risk estimates in our exposed population. However, some women in the control group would have undiagnosed PCOS, which would lead to an underestimation of T2D risk in women with PCOS. BMI data were not available for all participants. The present study should be repeated in study cohorts with higher background risks of T2D, particularly in populations of other ethnicities. WIDER IMPLICATIONS OF THE FINDINGS: The prospective risk for diagnosis of T2D is increased in women with PCOS, and the risk is aggravated in women with BMI ≥30 kg/m2. STUDY FUNDING/COMPETING INTEREST(S): Funding in Denmark was from the Region of Southern Denmark, Overlægerådet, Odense University Hospital. Funding in Finland was from Novo Nordisk Foundation, Finnish Research Council and Sigrid Juselius Foundation, the National Regional Fund, Sakari Alhopuro Foundation and Finnish Diabetes Research Foundation. E.E. has received a research grant from Ferring Pharmaceuticals (payment to institution) and serves as medical advisor for Tilly AB, not related to this manuscript. The remaining authors declare no conflict of interest. TRIAL REGISTRATION NUMBER: N/A.
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Índice de Masa Corporal , Diabetes Mellitus Tipo 2 , Síndrome del Ovario Poliquístico , Humanos , Síndrome del Ovario Poliquístico/epidemiología , Síndrome del Ovario Poliquístico/complicaciones , Femenino , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/complicaciones , Adulto , Dinamarca/epidemiología , Suecia/epidemiología , Finlandia/epidemiología , Estudios Prospectivos , Factores de Riesgo , Estudios de Casos y Controles , Adulto Joven , Estudios de Cohortes , Sistema de Registros , Persona de Mediana EdadRESUMEN
OBJECTIVE: To evaluate whether a subgroup of men can be identified that would benefit more from screening than others. MATERIALS AND METHODS: This retrospective cohort study was based on three European Randomised Study of Screening for Prostate Cancer (ERSPC) centres, Finland, the Netherlands and Sweden. We identified 126 827 men aged 55-69 years in the study who were followed for maximum of 16 years after randomisation. The primary outcome was prostate cancer (PCa) mortality. We analysed three age groups 55-59, 60-64 and 65-69 years and PCa cases within four European Association of Urology (EAU) risk groups: low, intermediate, high risk, and advanced disease. RESULTS: The hazard ratio (HR) for PCa mortality in the screening arm relative to the control arm for men aged 55-59 years was 0.96 (95% confidence interval [CI] 0.75-1.24) in Finland, 0.70 (95% CI 0.44-1.12) in the Netherlands and 0.42 (95% CI 0.24-0.73) in Sweden. The HR for men aged 60-64 years was 1.03 (95% CI 0.77-1.37) in Finland, 0.76 (95% CI 0.50-1.16) in the Netherlands and 0.97 (95% CI 0.64-1.48) in Sweden. The HR for men aged 65-69 years was 0.80 (95% CI 0.62-1.03) in Finland and 0.57 (95% CI 0.38-0.83) in the Netherlands, and this age group was absent in Sweden. In the EAU risk group analysis, PCa mortality rates were materially lower for men with advanced disease at diagnosis in all three countries: 0.67 (95% CI 0.56-0.82) in Finland, 0.28 (95% CI 0.18-0.44) in the Netherlands, and 0.48 (95% CI 0.30-0.78) in Sweden. CONCLUSION: We were unable to unequivocally identify the optimal age group for screening, as mortality reduction differed among centres and age groups. Instead, the screening effect appears to depend on screening duration, and the number and frequency of screening rounds. PCa mortality reduction by screening is largely attributable to stage shift.
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Detección Precoz del Cáncer , Neoplasias de la Próstata , Humanos , Masculino , Neoplasias de la Próstata/mortalidad , Neoplasias de la Próstata/diagnóstico , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Finlandia/epidemiología , Europa (Continente)/epidemiología , Suecia/epidemiologíaRESUMEN
OBJECTIVE: This study aimed to (1) examine the clustering of energy balance-related behaviours (EBRB) and (2) investigate whether EBRB clusters, temperament and hair cortisol concentration (HCC) associate with overweight. DESIGN: We assessed food consumption using food records, screen time (ST) using sedentary behaviour diaries, sleep consistency and temperament (negative affectivity, surgency, effortful control) using questionnaires and HCC using hair samples. Accelerometers were used to assess physical activity (PA) intensities, sleep duration and sleep efficiency. Researchers measured each child's weight and height. We used finite mixture models to identify EBRB clusters and multilevel logistic regression models to examine the associations between EBRB clusters, temperament, HCC and overweight. SETTING: The cross-sectional DAGIS survey, data collected in 2015-2016. PARTICIPANTS: Finnish 3-6-year-olds (n 864) recruited through preschools. RESULTS: One-third of the participants were categorised into the cluster labelled 'Unhealthy diet, excessive screen time', characterised by unhealthy dietary choices (e.g. greater consumption of high-fat, high-sugar dairy products) and longer ST. Two-thirds were categorised into the second cluster, labelled 'Healthy diet, moderate screen time'. PA and sleep were irrelevant for clustering. Higher negative affectivity and lower effortful control associated with the 'Unhealthy diet, excessive screen time' cluster. EBRB clusters and HCC did not associate with overweight, but surgency was positively associated with overweight (OR = 1·63, 95 % CI 1·17, 2·25). CONCLUSIONS: Of the EBRB, food consumption and ST seem to associate. As temperament associates with EBRB clusters and overweight, tailored support acknowledging the child's temperament could be profitable in maintaining a healthy weight.
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Sobrepeso , Temperamento , Niño , Preescolar , Humanos , Sobrepeso/epidemiología , Estudios Transversales , Finlandia/epidemiología , DietaRESUMEN
Cats with a distinctive white hair pattern of unknown molecular cause have been discovered in the Finnish domestic cat population. Based on the unique appearance of these cats, we have named this phenotype salmiak ("salty licorice"). The use of a commercially available panel test to genotype four salmiak-colored cats revealed the absence of all known variants associated with white-haired phenotypic loci: full White (W), Spotting (Ws) and the Birman white Gloves associated (wg) allele of the KIT proto-oncogene (KIT) gene. Whole-genome sequencing on two salmiak-colored cats was conducted to search for candidate causal variants in the KIT gene. Despite a lack of coding variants, visual inspection of the short read alignments revealed a large ~95 kb deletion located ~65 kb downstream of the KIT gene in the salmiak cats. Additional PCR genotyping of 180 domestic cats and three salmiak-colored cats confirmed the homozygous derived variant genotype fully concordant with the salmiak phenotype. We suggest the newly identified variant be designated as wsal for "w salmiak".
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Color del Cabello , Proteínas Proto-Oncogénicas c-kit , Animales , Gatos/genética , Color del Cabello/genética , Proteínas Proto-Oncogénicas c-kit/genética , Fenotipo , Eliminación de Secuencia , Finlandia , Genotipo , Secuenciación Completa del Genoma/veterinariaRESUMEN
AIMS: Large differences exist in the risk of disability retirement between Finnish municipalities. This study examined whether individual-level and municipality-level characteristics explain these differences and which municipality-level characteristics are particularly important for the risk of disability retirement. METHODS: Individual-level register data were supplemented with 10 municipality-level characteristics from various databases. A 20% sample of the Finnish population (N=626,391) was followed for transition to disability retirement from 2016 to 2019 using multilevel Weibull models. RESULTS: Of the total variation in the risk of disability retirement, 4.3% was attributed to the municipal-level and decreased to 1.8% when individual-level characteristics (gender, age, education level and entitlement to special reimbursement for medical expenses, reflecting morbidity) were controlled for. Further adjustment for municipality-level characteristics fully erased the differences between municipalities. The proportion of municipality-level variation was larger for disability retirement due to somatic illnesses than mental disorders. Of the municipality-level characteristics, socioeconomic structure, unemployment rate, poverty, net migration between municipalities, dependency ratio, the amount of tax revenue per capita and morbidity were associated with the risk of disability retirement. CONCLUSIONS: The municipality-level variation in the risk of disability retirement is largely explained by the individual characteristics of the inhabitants. However, various characteristics of the municipalities show associations with the risk of disability retirement. Recognizing such factors is essential for shaping policies that mitigate disability retirement risk.
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AIMS: This study examined the incidence of attention-deficit/hyperactivity disorder medication among children and adolescents by sex and age group in Finland during 2008-2019. METHODS: The data on children and adolescents aged 6-18 years receiving reimbursement for any attention-deficit/hyperactivity disorder medication was collected from the nationwide register on reimbursed purchases. The incidence was calculated as a ratio of the number of new users and the number of age and sex-matched population at risk. Negative binomial models were used to calculate rate ratios (RRs). RESULTS: In 2019, the incidence of attention-deficit/hyperactivity disorder medication was 13.4 per 1000 boys and 4.8 per 1000 girls. Among boys, the incidence became 3.7 times greater during the observed years (RR 95% confidence interval (CI) 2.0, 6.5, P<0.0001), whereas in girls it was 7.6 times greater (RR 95% CI 2.1, 27.4, P=0.0019). The boys had 2.8 times the incidence rate compared with the girls (RR 95% CI 2.2, 3.6, P<0.0001). The increase was associated with age only among boys (P=0.0001). The highest incidence rate 23.4 per 1000 individuals (95% CI 22.5, 24.4) was found in 2019 among 6-8-year-old boys. CONCLUSIONS: The incidence of attention-deficit/hyperactivity disorder medication use among children and adolescents increased significantly in Finland during the study period. Incidence was higher among boys, but the increase was greater among girls. The most common group to start attention-deficit/hyperactivity disorder medication was 6-8-year-old boys. These findings warrant critical evaluation of the diagnostic and treatment policies currently available in Finland for the treatment of attention-deficit/hyperactivity disorder and related symptoms.
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BACKGROUND: Gambling causes important harms in societies. According to the public health approach, the most effective policies to reduce harms target full populations. Availability restrictions and mandatory precommitment are among the most effective measures. However, restrictions on the availability of some gambling products or channels may also be offset by increased consumption in other products. Substitution effects can have negative public health impacts due to differing harm potential across different gambling products. This paper uses longitudinal sales data (2019-2022) from the Finnish gambling monopoly Veikkaus. During the observation period, the availability of gambling was restricted in Finland due to subsequent waves of Covid-19-related restrictions. In addition, the gambling monopoly introduced mandatory precommitment to land-based EGMs. We focus on how these restrictive policy changes impacted the total consumption of gambling and possible substitution effects. METHODS: The Finnish gambling monopoly provided weekly theoretical loss data per gambling product category and gambling channel (online, land-based) for the period of January 2019 - July 2022 based on a statutory obligation. We analysed the effects of availability restrictions and other public health measures on the consumption of different products using descriptive time series and regression analyses. We compared the sale of land-based products to online equivalents at product category level and included main policy change periods in the models. RESULTS: Total consumption of gambling declined during 2019-2022 mainly due to reduced land-based electronic gambling machine (EGM) consumption. Declines in land-based EGM sales were not offset by online alternatives or other close substitutes in the long term. However, during the first wave of Covid-19, there was an observable substitution of land-based table games by online alternatives and land-based horse betting and possibly sports betting by online horse betting. Overall, the results also show that Covid-19 functioned as a boost to an already existing trend of increasing digitalisation of gambling. CONCLUSIONS: The study provides empirical support for the effectiveness of public health-oriented policies in reducing the total consumption of gambling. Availability restrictions and mandatory precommitment are therefore likely to also reduce the burden of harms of gambling to individuals and societies.
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COVID-19 , Juego de Azar , Humanos , Comercio , COVID-19/epidemiología , COVID-19/prevención & control , Finlandia/epidemiología , Juego de Azar/epidemiología , Política PúblicaRESUMEN
Listeria monocytogenes (Lm) is a bacterium widely distributed in the environment. Listeriosis is a severe disease associated with high hospitalisation and mortality rates. In April 2019, listeriosis was diagnosed in two hospital patients in Finland. We conducted a descriptive study to identify the source of the infection and defined a case as a person with a laboratory-confirmed Lm serogroup IIa sequence type (ST) 37. Six cases with Lm ST 37 were notified to the Finnish Infectious Diseases Registry between 2015 and 2019. Patient interviews and hospital menus were used to target traceback investigation of the implicated foods. In 2021 and 2022, similar Lm ST 37 was detected from samples of a ready-to-eat plant-based food product including fava beans. Inspections by the manufacturer and the local food control authority indicated that the food products were contaminated with Lm after pasteurisation. Our investigation highlights the importance that companies producing plant-based food are subject to similar controls as those producing food of animal origin. Hospital menus can be a useful source of information that is not dependent on patient recall.
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Brotes de Enfermedades , Microbiología de Alimentos , Listeria monocytogenes , Listeriosis , Humanos , Listeria monocytogenes/aislamiento & purificación , Listeria monocytogenes/genética , Listeriosis/epidemiología , Listeriosis/microbiología , Finlandia/epidemiología , Femenino , Masculino , Enfermedades Transmitidas por los Alimentos/epidemiología , Enfermedades Transmitidas por los Alimentos/microbiología , Persona de Mediana Edad , Anciano , Contaminación de Alimentos , Adulto , Fabaceae/microbiologíaRESUMEN
BackgroundLong-term effectiveness data on bivalent COVID-19 boosters are limited.AimWe evaluated the long-term protection of bivalent boosters against severe COVID-19 among ≥ 65-year-olds in Finland.MethodsIn this register-based cohort analysis, we compared the risk of three severe COVID-19 outcomes among ≥ 65-year-olds who received a bivalent booster (Original/Omicron BA.1 or Original/BA.4-5; exposed group) between 1/9/2022 and 31/8/2023 to those who did not (unexposed). We included individuals vaccinated with at least two monovalent COVID-19 vaccine doses before 1/9/2022 and ≥ 3 months ago. The analysis was divided into two periods: 1/9/2022-28/2/2023 (BA.5 and BQ.1.X predominating) and 1/3/2023-31/8/2023 (XBB predominating). The hazards for the outcomes between exposed and unexposed individuals were compared with Cox regression.ResultsWe included 1,191,871 individuals. From 1/9/2022 to 28/2/2023, bivalent boosters were associated with a reduced risk of hospitalisation due to COVID-19 (hazard ratio (HR): 0.45; 95% confidence interval (CI): 0.37-0.55), death due to COVID-19 (HR: 0.49; 95% CI: 0.38-0.62), and death in which COVID-19 was a contributing factor (HR: 0.40; 95% CI: 0.31-0.51) during 14-60 days since vaccination. From 1/3/2023 to 31/8/2023, bivalent boosters were associated with lower risks of all three severe COVID-19 outcomes during 61-120 days since a bivalent booster (e.g. HR: 0.53; 95% CI: 0.39-0.71 for hospitalisation due to COVID-19); thereafter no notable risk reduction was observed. No difference was found between Original/Omicron BA.1 and Original/BA.4-5 boosters.ConclusionBivalent boosters initially reduced the risk of severe COVID-19 outcomes by ca 50% among ≥ 65-year-olds, but protection waned over time. These findings help guide vaccine development and vaccination programmes.
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Vacunas contra la COVID-19 , COVID-19 , Inmunización Secundaria , SARS-CoV-2 , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Anciano , Masculino , Femenino , Finlandia/epidemiología , Vacunas contra la COVID-19/administración & dosificación , Hospitalización/estadística & datos numéricos , Anciano de 80 o más Años , Vacunación/estadística & datos numéricos , Estudios de Cohortes , Eficacia de las Vacunas/estadística & datos numéricosRESUMEN
Highly pathogenic avian influenza (HPAI) has caused widespread mortality in both wild and domestic birds in Europe 2020-2023. In July 2023, HPAI A(H5N1) was detected on 27 fur farms in Finland. In total, infections in silver and blue foxes, American minks and raccoon dogs were confirmed by RT-PCR. The pathological findings in the animals include widespread inflammatory lesions in the lungs, brain and liver, indicating efficient systemic dissemination of the virus. Phylogenetic analysis of Finnish A(H5N1) strains from fur animals and wild birds has identified three clusters (Finland I-III), and molecular analyses revealed emergence of mutations known to facilitate viral adaptation to mammals in the PB2 and NA proteins. Findings of avian influenza in fur animals were spatially and temporally connected with mass mortalities in wild birds. The mechanisms of virus transmission within and between farms have not been conclusively identified, but several different routes relating to limited biosecurity on the farms are implicated. The outbreak was managed in close collaboration between animal and human health authorities to mitigate and monitor the impact for both animal and human health.
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Animales Salvajes , Charadriiformes , Brotes de Enfermedades , Subtipo H5N1 del Virus de la Influenza A , Gripe Aviar , Filogenia , Animales , Gripe Aviar/virología , Gripe Aviar/epidemiología , Finlandia/epidemiología , Subtipo H5N1 del Virus de la Influenza A/genética , Subtipo H5N1 del Virus de la Influenza A/patogenicidad , Subtipo H5N1 del Virus de la Influenza A/aislamiento & purificación , Animales Salvajes/virología , Charadriiformes/virología , Brotes de Enfermedades/veterinaria , Granjas , Infecciones por Orthomyxoviridae/veterinaria , Infecciones por Orthomyxoviridae/virología , Infecciones por Orthomyxoviridae/mortalidad , Infecciones por Orthomyxoviridae/epidemiología , Zorros/virología , Aves/virología , Visón/virologíaRESUMEN
Gambling is a public health problem that can cause many kinds of harm. The aim of this study was to examine youth gambling by origin, and the risk and protective factors associated with it. The data was drawn from the School Health Promotion Study (n = 238,939) conducted in Finland, representative of the 14 to 16-year-old Finnish schoolchildren. Cross-tabulations and multivariate logistic regression were used in assessing the association between origin and weekly gambling. Interaction terms of origin and background variables related to substance use, peer and family relations and leisure time were then calculated to assess inter-group differences. The study showed that foreign-born, migrant origin and youth from mixed families were more likely to gamble weekly compared to youth with Finnish-born parents. The likelihood of gambling was particularly high among foreign-born and migrant-origin youth. Weekly gambling was significantly more common among boys than girls in all studied youth groups, and it was particularly common among foreign-born boys compared to other groups. Substance use was associated with weekly gambling and even more so among foreign-born youth. There were also differences by origin in the strength of association between other background factors and weekly gambling. Foreign-born boys appear to be especially vulnerable to multiple health and social risks including gambling, making them a particularly important group for targeted preventive programs. Preventive efforts are needed to enhance public awareness, boost parental supervision, and limit gambling-related risks. Special attention is needed to prevent migrant-origin boys from developing problems with gambling.
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AIM: To identify and examine the explanatory variables associated with clinical competence among registered nurses (RNs) and practical nurses (PNs) working in long-term care facilities (LTCF) for older adults. DESIGN AND METHODS: This was a cross-sectional study. The competence test, 'the Ms. Olsen test', was used for data collection. A convenience sample of 337 nursing staff working in LTCFs for older adults was selected between December 2020 and January 2021. A quantitative, non-experimental approach with multiple linear regression analysis examined the explanatory variables associated with clinical competence and the outcome variables. RESULTS: The main findings of the linear regression analysis show that the nursing staff's increasing age, use of Swedish as a working language and use of the Finnish nursing practice standards had statistically significant relationships with clinical competence among the participating nursing staff. CONCLUSION: This is the first knowledge test that has been developed to test nursing staff's clinical competence in elderly care. In this study in Finland, the highest clinical competence was among the nursing staff who were Swedish-speaking RNs working in institutional care homes caring for patients according to national practice standards. IMPLICATIONS: These results may be useful to nursing staff and managers working in elderly care to understand the explanatory variables associated with clinical competence in elderly care in Finland and in bilingual settings. The study highlights the importance of using national nursing standards in elderly nursing care. Knowing the explanatory variables associated with clinical competence can provide guidance for the further education of nursing staff in these settings. IMPACT: Caring according to national practice standards and caring for severely ill patients are associated with clinical competence. REPORTING METHOD: The authors adhered to the EQUATOR network guidelines Appendix S1 STROBE to report observational cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION: Registered and PNs completed a questionnaire for the data collection.
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Competencia Clínica , Cuidados a Largo Plazo , Humanos , Estudios Transversales , Cuidados a Largo Plazo/normas , Finlandia , Competencia Clínica/normas , Femenino , Adulto , Persona de Mediana Edad , Masculino , Personal de Enfermería/normas , Personal de Enfermería/estadística & datos numéricos , Factores de Edad , Encuestas y Cuestionarios , Lenguaje , Anciano , Casas de Salud/normasRESUMEN
Through collaborative autoethnography, we studied shifts in cancer patients' sense of agency and the meaning of cancer during the diagnostic and treatment phases. This article contributes to the illness management literature by adopting sense of agency perspective that provides new understanding of retrospective interpretation of cancer patients' agency. The authors' experiences of receiving cancer diagnoses and a related, collectively written story illustrate how relational and contextual elements facilitate rapid shifts in cancer patients' sense of agency and illness management. The findings illustrate shifts in the sense of agency as a collaborative and reflexive process between cognitive, emotional, and bodily constraints and adjustments. We demonstrate how shifts in patients' sense of agency and respective changes in meanings attached to cancer were shaped by near ones, healthcare actors, and other cancer patients, as well as the COVID-19 pandemic and the fear of military conflict due to Finland neighbor Russia's war on Ukraine. Furthermore, the study illustrates how shifts in sense of agency shape and are shaped by changes in the understanding of cancer as either a secondary issue, ambiguous stranger, travel companion, or enemy.
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This study was conducted to examine the construction of social identity among mental health experts by experience working in Finnish municipal mental healthcare services. The construction of social identity is approached as an ongoing lifelong process that is significantly affected by lived experiences with mental health problems and recovery from them. The research data consist of focus group discussions, and the analysis is based on a thematic design that is initially material-driven. As a result, four categories are formed to describe the effect of acting as an expert by experience on social identity and the importance of the issue. Experts by experience have to consider profound questions about their identity and future in their new life situation. The individual meanings of acting as an expert by experience are considered particularly important. The support provided by group members builds confidence in one's chances of success and thereby supports the development of social identity. Social identities of experts by experience are partially built in encounters with professionals representing the mental health care system. This creates opportunities for new roles for those who act as experts by experience.
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Salud Mental , Identificación Social , Humanos , Investigación Cualitativa , Grupos FocalesRESUMEN
The recent, rapid spreading of non-native pink salmon Oncorhynchus gorbuscha in the North Atlantic area has raised concerns about their possible negative impacts on native salmonid species. Potential interactions include competition for food resources during the short freshwater phase of juvenile O. gorbuscha, but little is known about their feeding behavior in the newly occupied North Atlantic rivers. Using stable isotope and stomach content analyses, patterns of freshwater feeding of non-native O. gorbuscha fry were studied in a large Fennoscandian river, the Teno, that discharges to the Barents Sea. Changes in stable isotope values (δ13 C, δ15 N, δ34 S) and stomach contents from the period of emergence (April to mid-May) to estuarine entry (late May/June) were examined and provided both temporally integrated and short-term indicators of freshwater feeding dependency. In addition, the occurrence of juvenile O. gorbuscha and changes in their length and weight during their emergence/migration period were investigated. Juvenile O. gorbuscha were at the spawning grounds from April through to mid-May with abundance peaking in mid-May. Fish moved to the estuary by late May and their abundance decreased toward June, and their body size increased concurrently. Stomach analyses indicated no feeding activity in April-early May in the spawning areas, but the stomach fullness indices increased markedly in fish sampled in the estuary in May and June. The most important prey items in stomachs were Chironomidae and Ephemeroptera larvae. Significant changes in all analysed stable isotopes were detected among sample periods, with a peak in mid-May and June showing significantly lower values than other sample periods. A change from the higher values reflective of parental marine feeding to the lower values reflective of freshwater feeding indicated active in-river feeding by juveniles during the study period. The documented active freshwater feeding of non-native juvenile O. gorbuscha suggests potential resource competition with native fluvial fishes, particularly salmonids.
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Ríos , Salmón , Animales , Agua Dulce , Dieta/veterinaria , IsótoposRESUMEN
Peatlands play a key role in the circulation of the main greenhouse gases (GHG) - methane (CH4), carbon dioxide (CO2), and nitrous oxide (N2O). Therefore, detecting the spatial pattern of GHG sinks and sources in peatlands is pivotal for guiding effective climate change mitigation in the land use sector. While geospatial environmental data, which provide detailed spatial information on ecosystems and land use, offer valuable insights into GHG sinks and sources, the potential of directly using remote sensing data from satellites remains largely unexplored. We predicted the spatial distribution of three major GHGs (CH4, CO2, and N2O) sinks and sources across Finland. Utilizing 143 field measurements, we compared the predictive capacity of three different data sets with MaxEnt machine-learning modeling: (1) geospatial environmental data including climate, topography and habitat variables, (2) remote sensing data (Sentinel-1 and Sentinel-2), and (3) a combination of both. The combined dataset yielded the highest accuracy with an average test area under the receiver operating characteristic curve (AUC) of 0.845 and AUC stability of 0.928. A slightly lower accuracy was achieved using only geospatial environmental data (test AUC 0.810, stability AUC 0.924). In contrast, using only remote sensing data resulted in reduced predictive accuracy (test AUC 0.763, stability AUC 0.927). Our results suggest that (1) reliable estimates of GHG sinks and sources cannot be produced with remote sensing data only and (2) integrating multiple data sources is recommended to achieve accurate and realistic predictions of GHG spatial patterns.
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Dióxido de Carbono , Monitoreo del Ambiente , Gases de Efecto Invernadero , Óxido Nitroso , Tecnología de Sensores Remotos , Gases de Efecto Invernadero/análisis , Óxido Nitroso/análisis , Dióxido de Carbono/análisis , Monitoreo del Ambiente/métodos , Finlandia , Metano/análisis , Suelo/química , Cambio Climático , EcosistemaRESUMEN
BACKGROUND: Psychological research about meaningfulness is concerned with a subjective sense of meaning of one's own life, that is, meaning in life. Empirical research in this field is attracting interest, as meaning in life has wide-ranging positive implications for mental health and well-being. AIM: The aim of this article is to test the validity of the Finnish translation of the Sources of Meaning and Meaning in Life (SoMe) questionnaire. In the article, meaningfulness and crisis of meaning are correlated with sources of meaning, and results are compared with other validation studies in Norway, Denmark, and Brazil as well as with the original German questionnaire. METHODS: To meet our aim, 551 participants were recruited to answer the Finnish questionnaire. The internal and construct validity of the Finnish questionnaire were tested with reliability analysis, confirmatory factor analysis, exploratory factor analysis, and analysis of intercorrelations of items in the questionnaire. RESULTS: The analysis demonstrated similar reliability to other validation studies of the questionnaire and results highly comparable to the Norwegian study regarding the internal structure of the questionnaire. Results of intercorrelations of items within the questionnaire were also comparable to the other validation studies.
Asunto(s)
Psicometría , Humanos , Finlandia , Masculino , Femenino , Adulto , Encuestas y Cuestionarios/normas , Persona de Mediana Edad , Reproducibilidad de los Resultados , Psicometría/normas , Psicometría/instrumentación , Adulto Joven , Anciano , Satisfacción Personal , Adolescente , Análisis FactorialRESUMEN
Many studies have found that conservatives show an advantage in mental health and happiness and various causes of this have been debated (e.g., religiousness, ideology, or genetics). However, not much attention has been given to examining whether this advantage is psychometrically real, or whether it is due to test bias. We analyzed data from two large Finnish surveys of adults (Ns = 848 and 4,978) from Lahtinen (2024), that measured general anxiety and depression symptoms, as well as a new wokeness scale. Using differential item functioning tests, we found no evidence for measurement bias in these scales. The correlation between index scores of wokeness and mental health (internalizing) was -0.36, which increased to -0.41 when measurement error was removed. The association between wokeness and anxiety (r = -0.33, adjusted r = 0.37) was stronger than wokeness and depression (r = 0.20, adjusted r = 0.22).