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This paper examines the roles of different language ideologies--sets of common-sense beliefs about language and its speakers--in students' identity construction and negotiation in the context of internationalizing higher education. Along with the increasing diversity of students as English speakers, language ideologies have been critically examined for potential contribution to inequalities among students. I analyze two focus group discussions of students from international English-medium instruction master's programs at a Finnish university. I explore the students' talk using critical discursive psychology to illuminate possible intersections between language ideologies and students' situated identity construction, paying attention to ideological dilemmas alongside students' identity negotiation. The findings indicate that both emerging and established language ideologies may become relevant to students' identity construction and negotiation. Possibly, turning students' attention towards the multilinguality of every student and the specific purposes and characteristics of academic language might contribute to the discursive sustainability of inclusive interpersonal relationships among students.

This paper elaborates on the notion of object-oriented collaborative learning by building on empirical material from two case studies in higher education. Prior empirical findings show how knowledge objects are evolving entities, shaped by the interactions between participants, and how students learn from engaging in knowledge practice that involves different activities with knowledge objects. However, the pedagogy of teaching and learning with objects needs to be further explored and grounded in empirical data. Using two case studies, we examine how learning designs in higher education courses support students' learning through work on shared knowledge objects, as well as how students experience these designs and the learning process. By means of complementary datasets, the learning design, enacted teaching practices, collaboration processes, experiences, and competence learned are mapped and analysed. The findings are helpful in elucidating the learning taking place through interaction and practices mediated by shared knowledge objects, as well as informing the development of principles of a pedagogy of object-oriented collaborative learning, which provide practical recommendations and invite further research endeavours.

In this paper, we explore the part mobile phone use plays in the capitalist assemblages present in school classrooms. Capitalism is approached through the continuous movement of de- and re-territorialisation. The empirical grounding is a wide study on mobile phone use conducted at an upper secondary school in Finland. The focus of this paper is one psychology lesson on puberty and the ways in which territories such as puberty are challenged in the school life of young people through their mobile phone use in class. Analysing a student's Tumblr photo stream, we show how smartphones challenge the existing territorialities in a classroom. We locate three central deterritorialising movements: in relation to the physical space of the classroom; to the affective space of the classroom; and to the notion of body in puberty. We conclude that mobile phone use matters to students intimately and channels flows of capitalism at school.

Purpose The purpose of this paper is to describe a Finnish pilot project aiming to support high-needs clients in their everyday lives by developing an integrated care approach based on the multi-sectoral collaboration of care professionals. The Help Team for school-aged children will be described as an example of the integrative practices developed on the project.Design/methodology/approach Altogether 250 professionals from primary and secondary health care and social care and from the education sector were designated to collaborate in 37 local, multi-sectoral teams, aiming to develop integrated care practices for high-needs clients. Teamwork was supported by coaches and project seminars, the Breakthrough method and other LEAN methods. The project was evaluated internally by means of a survey and interviews with the participants.Findings As a result of the project, all 37 teams developed a specific collaboration model for their selected target group comprising different kinds of high-needs clients.Research limitations/implications The sustainability of the outcomes of the project depends on how managers and decision-makers are committed to applying the collaboration models in future.Practical implications Many of the collaboration models developed in the project will be implemented in practice in a wider area.Social implications The project highlighted the need to pay attention to the problems of people with multiple care needs and the challenges they pose for integrated care.Originality/value The project was based on the client-centered development work done by frontline professionals. Due to the high level of involvement of the professionals themselves, the project proved highly instructive for them. It is extremely important to engage frontline level professionals in development work and support them in collaborating beyond the traditional "silos". [ABSTRACT FROM AUTHOR]

Rural development refers to diverse attempts being made to address the problems of rural communities. In Finland, rural development leans heavily on entrepreneurship and small business development. Rural development processes have a strong social psychological component that entails that psychological knowledge is crucial for rural development agents. Nevertheless, psychological knowledge has also been criticised for simplifying highly complex development processes and overstating the role of internal psychological factors. In this paper, we argue that, regarding the relevance and utility of psychological knowledge, the question is not only how extensively different factors are taken into account but also how knowledge about psychological factors is read and interpreted. In this paper, we focus on Finnish rural business owners' values and demonstrate that value survey data can be read from two different social psychological perspectives: those of substantialism and relationalism. Although data and the conducted analyses are kept constant, the two readings produce differing types of knowledge of rural business owners' values; one reveals what business owners 'truly' are like and the other informs how to best communicate with business owners. Both readings are potentially useful for rural development work. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper explores the educational choice-making of students with special educational needs in the context of Finnish pre-vocational training and one of its programmes, ‘Preparatory and Rehabilitative Instruction and Guidance for Disabled Students’. The authors enquire into the kinds of educational choices available for students in the preparatory programme, and how student counselling meets their educational hopes and future plans. The analysis draws on an ethnographic study of special needs education in post-compulsory education in Finland. It shows that students need to reflect on their educational plans within institutional and diagnostic restrictions and guidance. The authors state that educational choices can be negotiable, but more attention must be given to deconstructing the self-evidences and institutional barriers linked to the transitions of young adults with special educational needs. [ABSTRACT FROM AUTHOR]

This study is situated within an existential--narrative theoretical framework to examine the impact of career-threatening injury on professional ice hockey players' well-being and career construction. Professional ice hockey culture is construed as a privileged space characterised by hegemonic masculinity, fierce competition as well as high-risk behaviours often resulting in sports injuries. In this paper, we analyse two players' life stories with a particular focus on injury as a boundary situation involving social and temporal breakdown and re-evaluation of meaning of sporting life projects. Emergent narratives surrounding existential themes of loss of meaning and loneliness in the face of injury were analysed in connection with players' search for authenticity and realignment with self-concept. Each player developed resistant narratives to the dominant ethos of professional sport in order to restore well-being and sense of self. The relational aspects of injury are highlighted in practical recommendations. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? According to estimates more than half of adult mental health service users are parents, but their experiences are largely lacking from research literature., Parental mental illness can often be viewed from a risk perspective., Parents with mental illness and their families have unmet support needs., What this paper adds to existing knowledge? Parents with mental illness want acknowledgement that they can be able and responsible., Many parents adopt an expert by experience identity., Fathers can feel their parental role is not recognized and mothers express fears of being judged if they discuss their illness., What are the implications for practice? Adult mental health services need to recognize and support parental role of service users., Joint care planning and family oriented care should be promoted., Professionals should take advantage of the knowledge of these parents and they could be more actively engaged in service development., Abstract Introduction Parental mental illness is often viewed from a risk perspective. Despite this, being a parent can be both valuable and motivating. Research literature lacks the perspective of mothers and fathers, who have experienced mental illness. Aim This study explores how parents with mental illness construct their identities as mothers and fathers and their experiences with health and social care services. Method Three focus groups with 19 participants were conducted in Finland and Scotland. Methods of discourse analysis have been used in to analyse the interview data. Results Adult service users want their parenting role recognized and supported. Parents have knowledge and skills which can be utilized and many have adopted an expert by experience identity. Discussion Being able to see oneself as a 'good' parent can be challenging but important. Parents may require support, but want to be included in the planning of their care. Services could make more use of the knowledge and skills parents and families have, and joint working could lessen parents' anxieties. Implications for practice Mental health practitioners are in a key position in providing more family centred, resource focused care. Service user expertise should be acknowledged in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to investigate the relationship between permanent tensions and organizational change.Design/methodology/approach: This study used paradox theory and a case study. The case organization is a public university hospital in Finland involving several stakeholders.Findings: The analysis suggests that the relationship between permanent tensions and organizational change is a paradox that is part of organizational reality. As an organization learns to live with its permanent tensions, the renewal paradox settles into equilibrium. When tensions are provoked, the paradox is disturbed until it finds a new balance. This flexible nature of the paradox is the force that keeps the different stakeholders simultaneously empowered to maintain their unique missions and cohesive in order to benefit from the larger synergy.Practical Implications: This research suggests that identification and evaluation of each permanent tension within an organization is important when executing organizational change. The fact that certain tensions are permanent and cannot be solved may have an influence on how planned change initiatives are executed. The results show that permanent tensions may be harnessed for the benefit of an organizational change.Originality/value: This research demonstrates originality by offering an alternative view of tensions, a view which emphasizes not only their permanent and plural nature but their importance for enabling the organization to change at its own, non-disruptive pace. The research also proposes a new concept, the "renewal paradox", to enhance understanding of the relationship between permanent tensions and organizational change. [ABSTRACT FROM AUTHOR]

The paper analyses children's experiences of (in)security in cases of post-separation stalking and asks how children can be safeguarded under such circumstances. Children are at particular risk when the family is stalked by the biological father or stepfather. This qualitative study draws on data collected from 13 children using three different methods: therapeutically-oriented group sessions, interviews with the children and a series of ten mother and child therapy sessions. Supplementing these data are insights gained from interviews with 18 women/mothers, the main targets of the stalking. The analysis of the narratives distinguishes three overlapping forms of security - eroded, lost and reconstructed - in which the degree of trust and extent of knowledge are the main elements. Children feel insecurity to different degrees and experiences of (in)security may vary even from child to child in the same family. The findings highlight the crucial importance of considering a child's relationship to his or her mother, siblings and trusted adults when intervening in stalking. Loved ones, day care and school staff, and social welfare workers have a significant role to play in reconstructing and strengthening children's security. The study suggests that this can be done through 'safety talk' with a mother and her children. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Messages In cases of post-separation stalking of the family, children's security can appear in three forms: eroded, lost and reconstructed., Feelings of insecurity vary and can appear to differing degrees within the same family., It is important in safeguarding children to lighten the burden that they take upon themselves of reconstructing security for themselves and their loved ones., Practitioners can play a significant role by providing space for and facilitating 'safety talk' between children and their mothers. [ABSTRACT FROM AUTHOR]

Tools assessing person-centered rehabilitation should promote client self-awareness as well as measure the target outcomes. The aim of this study was to evaluate the ability of the Assessment of Perceived Agency (ATPA19) to track changes in rehabilitation for older adults. Older adults (mean age 79) participated in a ten-month intervention (baseline n = 97, and follow-up n = 63). The ATPA19 and WHOQOL-BREF physical domain showed the strongest correlation and were the only tools that detected significant changes in older adults. The ATPA-19 is an agency-based tool that can reveal new effects complementing those of the assessment tools commonly used in rehabilitation in older adults. [ABSTRACT FROM AUTHOR]

This article presents a synthesis of two PhD studies of Support Family Intervention (SFI) in Finland. This is a service in which volunteer families provide support and respite care to children and parents who are coping with a range of psycho-social challenges by looking after the children for one weekend a month. The aim of this article is to develop a child-centred programme theory (CCPT) of SFI that combines a meta-ethnography-based theory underpinning the use of SFI with evidence of participating children's lived experiences. The CCPT that emerged is grounded on three elaborations of the programme theory currently informing SFI: a more nuanced description of the child as a stakeholder in the intervention, an investigation into the supportive properties of the environment and the activities provided by the support family to the child and clarification of the function of relationships as a central element of the intervention. Plain language summary: Support Family Intervention is a social work service provided to children and parents in Finland and other Nordic countries. The child receives a voluntary 'extra' family whom they visit on a regular basis one weekend every month. At the same time, the parents get time for recovery and rest. In this article we present the results of two doctoral theses. Our focus is on how the support family can be understood from the child's point of view. We summarise our results in a programme theory that can be used, for example, when the social worker introduces the service to the family. For the child, the home, the support family and the surroundings provide opportunities for many activities. The most important element is the relationship(s) to which the child gets access in the support family. [ABSTRACT FROM AUTHOR]

The main purpose of this paper is to present Slovenian and Finnish prospective chemistry teachers' perceptions of their future profession, especially with regard to their understanding of the role of the triple nature of chemical concepts (macro, submicro and symbolic) and their representations in chemistry learning. A total of 19 prospective teachers (10 Slovenian, 9 Finnish) at master's level in chemical education participated in the research. The prospective teachers' opinions were gathered using an electronic questionnaire comprising six open-ended questions. The study revealed many parallels between Slovenian and Finnish prospective chemistry teachers' perceptions of their future profession and their understanding of the role of the triple nature of chemical concepts, especially particle representations, in chemistry learning. The majority of the prospective teachers from both countries believe that personal characteristics are the most important attribute of a successful chemistry teacher. Thus, they highly value teachers' enthusiasm for teaching and the use of contemporary teaching approaches in chemistry. The prospective teachers displayed an adequate understanding of the role of the triple nature of chemical concepts (i.e., particle representations) in the planning and implementation of a specific chemistry lesson. [ABSTRACT FROM AUTHOR]

This paper examines the link between schooling and health. We provide new evidence on the relationship between formal schooling completed and several aspects of health by using Finnish twin data matched to individual information on schooling. Health is measured in 1990 (and 1981). Schooling is defined using comprehensive register-based information. All models account for initial health endowment in 1975. The sample sizes vary from 2542 to 4402 identical twins, depending on the specification. Using twin design, we find that unobserved family and genetic factors drive the cross-sectional correlations between schooling and many health measures, especially for females. Our within-MZ twin results for males show that high school (or vocational) or lowest level tertiary education reduces BMI and medication use. High school (or vocational) or university graduated males also exercise more than males who have completed primary education only. Given that high school or basic tertiary education have the strongest positive health effects for males, our results suggest that policies that prevent secondary school dropout alone may yield social benefits in the form of better health. [ABSTRACT FROM AUTHOR]

The question of the future of families emerges as a topic especially during times of rapid social change and uncertainty. Typically, the trends of the future are anticipated on the basis of existing expert knowledge. However, the interest of this paper will be in ordinary people, especially young adults' knowledge and ways of envisioning the future from their position in life. The approach is based on an interpretative, fictive and narrative perspective to the future, using the role-play method with students. As a result, three different story types of the futures of families are found: families can strengthen, families can weaken or a catastrophe threatens families and puts them in danger of being destroyed. In all of these future stories the young adults explain the changes in families in terms of economy, values and religions, family policy and ecological factors. The results add to knowledge of how culture and values reshape family change. [ABSTRACT FROM AUTHOR]

• Research on unmet care needs lacks contributions based on qualitative data. • Only practical or physical care needs are recognized whereas psychosocial needs are ignored. • With content analysis of interview data, the psychosocial nature of care needs is revealed. • Informal carers may act as buffers and meet unmet needs on behalf of care users. Unmet care needs are usually defined in terms of receiving sufficient help in instrumental activities and activities of daily living. Research on unmet needs is mostly based on quantitative data. Older persons' and informal carers' views and experiences have received less attention. In this paper, we rely on a definition of unmet needs which includes both unmet needs due to insufficient care and those situations where informal carers experience undue strain. Using theory-driven content analysis, we examine community-dwelling older adults' and their informal carers' experiences of unmet needs: what kind of unmet needs they have, why and in which ways these needs are left unmet and what would they want to do to improve the situation. The data consists of interviews gathered in Austria, Finland and Slovenia. Results of the analysis reveal that unmet needs are largely psychosocial in nature. The predominating task-oriented care systems often do not consider these as care needs. Using methods of qualitative content analysis, we conclude that care users' unmet psychosocial needs are related to lacking a personal relationship with care workers; means to maintain or develop social contacts and pursue activities and interests; and adequate home care services or respite care. Excessive responsibilities are put on informal carers as they top up and fill in the insufficient care. This study contributes to a broader understanding of unmet care needs: the relational aspects of care and the universal nature of psychosocial care needs should be addressed in care services. [ABSTRACT FROM AUTHOR]

Adapting and providing quality services for people as they age is a common challenge across Europe. The perspective of older people is fundamental in a person-centred care approach. Expanding research at the European level that explicitly includes their views can offer a relevant contribution to the development of evidence-based guidelines that can be shared in education and training across health and social care professions. This study aimed to identify common meaningful dimensions of professional competence in health and social care emphasised by older people from six countries in different regions of Europe according to their experiences. A qualitative approach was chosen with a total of 95 semi-structured interviews conducted in Austria, Finland, Lithuania, Portugal, Turkey and UK, following a common topic guide. Participants in this study were aged 60 and above, and recruitment considered age, gender, level of education and living arrangements. Results identified a set of universal skills and practices that according to older people, health and social care professionals should meet. Competences at the interpersonal level were central in older people's discourses, and its core dimensions are anchored in relational, communication and socio-emotional skills of professionals. These findings reinforce the aspiration of establishing best practices in care that relies on the harmonisation of a competence framework that can be shared in the training and education of health and social care professionals across Europe and that voices older people's preferences, expectations and needs. [ABSTRACT FROM AUTHOR]

Background: Family violence (FV) is a prevalent health issue around the world and health care services have an important role in both recognizing and treating the consequences of violence. However, FV experiences among health care professionals themselves have not been investigated much. We also lack specific knowledge on the associations between FV and mental health. Aim: The purpose of the study was to investigate the prevalence and effects of FV in a sample of Finnish health care professionals. In addition to analysing direct connections between different types of FV and mental health, the mediating effect of sleep quality was also taken into account. Methods: The study followed a cross‐sectional design. The sample comprised 1952 health care professionals from Central Finland, who participated in a survey measuring their health and well‐being. The dependent variables were perceived sleep quality and mental health as measured by depressive symptoms and the mental health continuum short form (MHC‐SF) questionnaire. Data were analysed using cross‐tabulations, anova and structural equation modelling. Results: Thirty‐eight per cent of the participants reported experiencing FV. The most common forms of abuse were 'psychological FV only' and 'psychological & physical abuse'. Participants with FV experiences scored significantly worse on depressive symptoms (p < 0.001), MHC‐SF classification (p = 0.008), sleep quality (p = 0.001) and emotional (p < 0.001), social (p < 0.001), and psychological (p = 0.008) well‐being. The mediation analyses indicated that the harmfulness of FV was at least partially explained by impaired sleep quality. Conclusion: The results indicate that FV experiences are common among Finnish health care professionals and that they can significantly affect their mental health. FV should thus be taken to account in seeking to promote the occupational well‐being of health care professionals. The results also suggest that the harmfulness of FV might be mediated by sleep quality. This finding prompts the need for further investigation and FV‐related interventions. [ABSTRACT FROM AUTHOR]

BACKGROUND: In this study, we examined the development of children's moderate to vigorous physical activity (MVPA) and physical education (PE) enjoyment through the Physical Activity as Civil Skill Program 2012‐2014. METHODS: Participants were 661 (265 intervention, 396 control) elementary school children in central and northeast Finland. The program was implemented across 2 years with 3 measurement phases using self‐reported MVPA and PE enjoyment, and accelerometer‐determined MVPA of a random subsample (N = 76). RESULTS: The proportion of children meeting the current MVPA guidelines declined from 38% to 22% (intervention) and 14% to 9% (control), whereas PE enjoyment was stable in both groups. Boys were more physically active than girls only within control group children. Teachers' feedback indicated that violence and bullying among intervention students reduced during the program, which can be considered as an additional benefit. CONCLUSIONS: It may be that both MVPA and PE enjoyment may require more tailored actions to be increased across a long‐term program. It is important to ensure that school‐based physical activity programs, especially including transition from elementary to middle school level, provide all children positive experiences, and thus, may improve their motivation, and MVPA participation during school days and leisure time. [ABSTRACT FROM AUTHOR]

Unaccompanied refugee minors (UMs) are at significant risk to experience severe mental health symptoms (Derluyn, Broekaert & Schuyten). Trauma‐focused treatments have been found to be effective for traumatized refugees (Slobodin & de Jong). However, trauma‐focused mental health services are seldom available, and treatment fails when UMs lack trust in service providers (Majumder, O'Reilly, Karim & Vostanis). In order to address this gap, a 10‐session group based mental health intervention for UMs was developed and then pilot tested in 3 accommodation units for UMs in Finland. The implementation and effectiveness of the intervention was studied by qualitative and quantitative methods. The process was completed by 18 UMs. Symptom measures showed no statistically significant changes on the mental health variables studied. However, staff members and UMs reported increased trust and communication, and participating staff members felt empowered to facilitate groups independently. The group model promoted social interaction and built trust in the accommodation units. Further studies are required to UMs. [ABSTRACT FROM AUTHOR]

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

Purpose The purpose of this study is to take an existential-phenomenological perspective to understand and describe the experienced leader identity development of healthcare leaders working in dual roles. Leader identity development under the influence of strong professional identities of nurses and doctors has remained an under-researched phenomenon to which the study contributes.Design/methodology/approach Existential-phenomenology serves as a perspective underpinning the whole research, and an existential-phenomenological method is applied in the interview data analysis.Findings The study showed leader identity development in healthcare to be most strongly influenced and affected by clinical work and its meanings and followers' needs and leader–follower relationships. In addition, four other key categories were presented as meaningful in leader identity development; leader identity development is an ongoing process occurring in relations of the key categories.Originality/value The existential-phenomenological approach and analysis method offer a novel way to understand leader identity development and work identities as experienced. [ABSTRACT FROM AUTHOR]

Background: A growing body of research indicates that cross-cultural competence in nurses can improve migrant patients’ health-related outcomes, but little is known about the potential benefits of cross-cultural competence on the nurses’ own well-being. Objective: To examine whether cross-cultural competence (empathy, skills, positive attitudes, and motivation) is associated with perceived time pressure at work, psychological distress, and sleep problems among registered nurses in Finland, and whether there are differences in these potential associations between native and foreign-born nurses. Methods: The present cross-sectional study was based on a sample of 212 foreign-born nurses licensed to practice in Finland and a random sample of 744 native Finnish nurses. Data were collected with a questionnaire and analyzed using multiple linear regression and structural equation modeling (SEM). Results: Of all four dimensions of cross-cultural competence, only empathy was associated with perceived time pressure (β = –0.13, p = .018), distress (β = –0.23, p < .001), and sleep problems (β = –0.14, p = .004) after the adjustment for gender, age, employment sector, and frequency of interacting with patients and colleagues from different cultures. There were no differences between native and foreign-born nurses in these observed associations (all ps > .05). Conclusions: Cross-cultural empathy may protect against perceived time pressure, distress, and sleep problems in both native and foreign-born nurses. Thus, the promotion of this component of cross-cultural competence among nursing personnel should be encouraged. [ABSTRACT FROM AUTHOR]

Background The Second European Union Minorities and Discrimination Survey recently demonstrated widespread discrimination across EU countries, with high discrimination rates observed in countries like Finland. Discrimination is known to negatively impact health, but fewer studies have examined how different types of perceived discrimination are related to health. Methods This study examines (i) the prevalence of different types of perceived discrimination among Russian, Somali and Kurdish origin populations in Finland, and (ii) the association between different types of perceived discrimination (no experiences; subtle discrimination only; overt or subtle and overt discrimination) and health (self-rated health; limiting long-term illness (LLTI) or disability; mental health symptoms). Data are from the Finnish Migrant Health and Wellbeing Study (n = 1795). Subtle discrimination implies reporting being treated with less courtesy and/or treated with less respect than others, and overt discrimination being called names or insulted and/or threatened or harassed. The prevalence of discrimination and the associations between discrimination and health were calculated with predicted margins and logistic regression. Results Experiences of subtle discrimination were more common than overt discrimination in all the studied groups. Subtle discrimination was reported by 29% of Somali origin persons and 35% Russian and Kurdish origin persons. The prevalence of overt discrimination ranged between 22% and 24%. Experiences of discrimination increased the odds for poor self-reported health, LLTI and mental health symptoms, particularly among those reporting subtle discrimination only. Conclusions To promote the health of diverse populations, actions against racism and discrimination are highly needed, including initiatives that promote shared belonging. [ABSTRACT FROM AUTHOR]

ObjectiveTo study the associations between home food availability and dietary patterns among pre-school children.DesignCross-sectional study in which parents of the participating children filled in an FFQ and reported how often they had certain foods in their homes. We derived dietary pattern scores using principal component analysis, and composite scores describing the availability of fruits and vegetables as well as sugar-enriched foods in the home were created for each participant. We used multilevel models to investigate the associations between availability and dietary pattern scores.SettingThe DAGIS study, Finland.SubjectsThe participants were 864 Finnish 3–6-year-old children recruited from sixty-six pre-schools. The analyses included 711 children with sufficient data.ResultsWe identified three dietary patterns explaining 16·7 % of the variance. The patterns were named ‘sweets-and-treats’ (high loadings of e.g. sweet biscuits, chocolate, ice cream), ‘health-conscious’ (high loadings of e.g. nuts, natural yoghurt, berries) and ‘vegetables-and-processed meats’ (high loadings of e.g. vegetables, cold cuts, fruit). In multivariate models, the availability of fruits and vegetables was inversely associated with the sweets-and-treats pattern (β=−0·05, P<0·01) and positively associated with the health-conscious (β=0·07, P<0·01) and vegetables-and-processed meats patterns (β=0·06, P<0·01). The availability of sugar-enriched foods was positively associated with the sweets-and-treats pattern (β=0·10, P<0·01) and inversely associated with the health-conscious pattern (β=−0·03, P<0·01).ConclusionsConsidering dietary patterns, the availability of sugar-enriched foods in the home seems to have a stronger role than that of fruits and vegetables. Parents should restrict the availability of unhealthy foods in the home. [ABSTRACT FROM PUBLISHER]

Background: Although income level may play a significant part in mortality among migrants, previous research has not focused on the relationship between income, migration and mortality risk. The aim of this register study was to compare all-cause mortality by income level between different migrant groups and the majority settled population of Finland. Methods: A random sample was drawn of 1,058,391 working age people (age range 18–64 years; 50.4% men) living in Finland in 2000 and linked to mortality data from 2001 to 2014. The data were obtained from Statistics Finland. Cox proportional hazards models were used to investigate the association between region of origin and all-cause mortality in low- and high-income groups. Results: The risk for all-cause mortality was significantly lower among migrants than among the settled majority population (hazards ratio (HR) 0.57; 95% confidence interval (CI) 0.53–0.62). After adjustment for age, sex, marital status, employment status and personal income, the risk of mortality was significantly reduced for low-income migrants compared with the settled majority population with a low income level (HR 0.46; 95% CI 0.42–0.50) and for high-income migrants compared with the high-income settled majority (HR 0.81; 95% CI 0.69–0.95). Results comparing individual high-income migrant groups and the settled population were not significant. Low-income migrants from Africa, the Middle East and Asia had the lowest mortality risk of any migrant group studied (HR 0.32; 95% CI 0.27–0.39). Conclusions: Particularly low-income migrants seem to display a survival advantage compared with the corresponding income group in the settled majority population. Downward social mobility, differences in health-related lifestyles and the healthy migrant effect may explain this phenomenon. [ABSTRACT FROM AUTHOR]

Background: Many women with vulvodynia are women of fertile age, and this syndrome may cause many physical and psychosexual functional disorders. Women with vulvodynia often find that healthcare professionals seem to demonstrate a lack of awareness about the syndrome and its care. These issues have not been previously studied among student healthcare staff. Aim: To investigate awareness and knowledge about vulvodynia and its care among staff in the student healthcare sector in Finland. Method: The study design was cross sectional. A survey instrument called ‘Awareness and knowledge of vulvodynia and its care’ was developed for this study and was used for data collection. The data were collected from a web‐based survey conducted with student healthcare professionals (N = 191, n = 79) in all 13 student healthcare units in Finland. Descriptive statistical methods were used to describe the connections between the factors associated with awareness of vulvodynia and its care. Ethical standards were followed throughout the study. Results: The primary results of the study indicated that the respondents had somewhat good awareness of how to identify vulvodynia and somewhat poor awareness of the treatments for vulvodynia. Participants' awareness of the meaning of encountering patients, as well as the information and support they provided, was good. Based on the knowledge test, knowledge of vulvodynia and its care was estimated to be poor. The respondents' experience‐based skills in treating vulvodynia and education about vulvodynia were mostly associated with better awareness and knowledge about vulvodynia and its care. Conclusion: The student healthcare staff who meet and care for women of fertile age have irregular awareness and knowledge of vulvodynia and its care. The creation of educational programs to develop such awareness and knowledge is recommended to obtain a standard quality of care for all women with vulvodynia. [ABSTRACT FROM AUTHOR]

In psychiatric clinical practice, professionals pursue risk management alongside various uncertainties concerning diagnoses and treatment decisions. In this article, I draw on an ethnographic study of understandings of bipolar disorder in Finland to argue that risk management in psychiatry is better characterised as practical uncertainty work. I show how both the clinicians and the patients coordinate the uncertainties of bipolar disorder symptoms, risks and treatment decisions, into something that can be managed. I examine the ways in which temporality structures this uncertainty work and I explore two different modes of framing time. Clinical time stems from the current psychiatric thinking committed to the standardised diagnosis and the ideals of evidence-based medicine. Through this, professionals frame a task-oriented and linear treatment path from diagnosis and treatment to a managed life with bipolar disorder. Experienced time, in contrast, relates to the logics of care and self-care amid the embodied experiences of different actors. This framing of time involves a cyclical process where the patient, the clinician and the treatment interventions each need to adjust to changing situations. [ABSTRACT FROM AUTHOR]

Background: An improved understanding of the role of neuropsychiatric symptoms (NPS) in the course of Alzheimer's disease (AD) has recently emerged. NPS lead to hospitalization and caregiver stress, but are more variable during the course of the disease than other symptoms. Knowledge about the role of specific NPS in disease progression and prognosis is especially limited.Objectives: To examine the relationship between specific NPS and AD severity during a 5-year follow-up period, and to determine which baseline NPS predict AD progression.Methods: 236 persons with very mild (CDR 0.5) or mild (CDR 1) AD at baseline and their caregivers were followed up for five years as part of the ALSOVA study. The Neuropsychiatric Inventory was used to assess NPS, and AD severity progression was measured with the Clinical Dementia Rating Sum of Boxes. Data was analyzed with Generalized Estimated Equations and Linear Mixed Models.Results: The baseline NPS that best predicted AD progression were delusions, agitation, and aberrant motor behavior, while AD severity during follow-up was associated with hallucinations, delusions, agitation, apathy, aberrant motor behavior, and sleep and appetite disturbances.Conclusions: Persons with mild AD presenting delusions, agitation, and aberrant motor behavior at the time of diagnosis could have a more rapidly progressing disease, and some NPS are associated with AD severity. These results highlight the importance of evaluating NPS at the time of AD diagnosis, and the need to offer additional support to persons presenting delusions, agitation and aberrant motor behavior, and their caregivers. [ABSTRACT FROM AUTHOR]

Background: The incidence of type 1 diabetes is increasing worldwide. Since so little is known about work life of individuals with type 1 diabetes, we examined incidence and prevalence trends of type 1 diabetes among working-aged Finns. We also investigated the employment rate and how workers with type 1 diabetes perceive their health and work ability, and their intended retirement age.Methods: We analyzed changes in the incidence, prevalence, and employment rate using nationwide multi-register-based FinDM data, and estimated a Self-Rated Health, Work Ability Score, and inquired about retirement intentions of 767 working individuals with type 1 diabetes in a cross-sectional survey. All estimates were compared to the corresponding data of the Finnish general population.Results: The average annual age-standardized incidence rate of type 1 diabetes among men aged 18-39 was 29 per 100,000/year; the incidence rate has increased by 33% from 1992 to 2007. Among women, the incidence remained at 16 per 100,000/year. Among working-aged (18-64) people, the age-standardized prevalence of type 1 diabetes increased by 39% among women and 33% among men. Two out of every three working aged individuals with type 1 diabetes were in the labor force; this is about 10% lower than in the Finnish population. The average age-standardized employment rate among those individuals with type 1 diabetes belonging to the labor force was 82%, compared to 84% in the general population. Working individuals with type 1 diabetes rated their health and work ability as being slightly lower than the general working population, but nonetheless, there were no significant differences in retirement intentions.Conclusions: Between 1992 and 2007, the number of working-aged people and workers with type 1 diabetes increased by 35%. Most workers with type 1 diabetes manage as well at work as the general population. Special attention should be paid to workers with type 1 diabetes when they are diagnosed and/or report moderate or poor work ability. [ABSTRACT FROM AUTHOR]

Aims To describe the health-related quality of life (HRQOL) of patients with prostate cancer and their spouses in comparison with the Finnish general population, using the RAND 36-Item Health Survey. An additional purpose was to describe the associations between the background variables of the participants and their HRQOL. Background The HRQOL of patients with prostate cancer and especially their spouses at the time of diagnosis is not well known. Design A cross-sectional study. Methods Responses were received from 232 patients and 229 spouses at 5 central hospitals in Finland between October 2013 and January 2016. Results Compared to the Finnish general population mean, the HRQOL of the patients and their spouses was, on average, better for all dimensions. Patients' age, the presence of disease, and the treatment method were associated with the dimensions of HRQOL. The dimensions of HRQOL were also associated with spouses' age, basic and vocational education, and the presence of disease. Conclusion The patients and their spouses experienced their HRQOL as very similar; however, on average, it is better than the general population mean. However, the evidence suggests that support from the nurses should focus on emotional well-being, the dimension that received the lowest scores in both groups. [ABSTRACT FROM AUTHOR]

Background: Clinical trials (CTs) are the "gold standard" to ensure the development of new effective treatments in medicine. A study was conducted to assess knowledge of, and attitudes toward, clinical trials among patients with Parkinson's disease (PD), along with factors that motivate them to participate.Methods: A 50-item questionnaire on the views of patients with PD about CTs was developed. It included statements that the respondents assessed on a Likert scale from 1 ("strongly disagree") to 5 ("strongly agree"). The questionnaire was mailed to a random sample (n = 2000) of members of the patient organization the Finnish Parkinson Association. In all, 708 response forms were returned, of which 681 were accepted after exclusion (a 34% response rate).Results: In general, attitudes of patients with PD toward CTs were positive. Older subjects and patients with lower education levels had inadequate knowledge of general issues related to CTs. Older age, low level of education, and lower number of PD medications were significant predictors for failure to understand the nature and purpose of clinical research. Additionally, significant positive correlation was found between education level and willingness to participate in CTs.Conclusions: Patients with PD have important gaps in their knowledge of methodological issues associated with CTs. The oldest subjects and those with a low level of education have the greatest information needs. Investigators should pay more attention to ensuring the comprehensibility of the information provided to potential CT participants. [ABSTRACT FROM AUTHOR]

Background: Individuals with schizophrenia spectrum disorders use the Internet for general and health-related purposes. Their ability to find, understand, and apply the health information they acquire online in order to make appropriate health decisions - known as eHealth literacy - has never been investigated. The European agenda strives to limit health inequalities and enhance mental health literacy. Nevertheless, each European member state varies in levels of Internet use and online health information-seeking. This study aimed to examine computer/Internet use for general and health-related purposes, eHealth literacy, and attitudes toward computer/Internet among adults with schizophrenia spectrum disorders from two distant European regions.Methods: Data were collected from mental health services of psychiatric clinics in Finland (FI) and Greece (GR). A total of 229 patients (FI = 128, GR = 101) participated in the questionnaire survey. The data analysis included evaluation of frequencies and group comparisons with multiple linear and logistic regression models.Results: The majority of Finnish participants were current Internet users (FI = 111, 87%, vs. GR = 33, 33%, P < .0001), while the majority of Greek participants had never used computers/Internet, mostly due to their perception that they do not need it. In both countries, more than half of Internet users used the Internet for health-related purposes (FI = 61, 55%, vs. GR = 20, 61%). The eHealth literacy of Internet users (previous and current Internet users) was found significantly higher in the Finnish group (FI: Mean = 27.05, SD 5.36; GR: Mean = 23.15, SD = 7.23, P < .0001) upon comparison with their Greek counterparts. For current Internet users, Internet use patterns were significantly different between country groups. When adjusting for gender, age, education and disease duration, country was a significant predictor of frequency of Internet use, eHealth literacy and Interest. The Finnish group of Internet users scored higher in eHealth literacy, while the Greek group of never Internet users had a higher Interest in computer/Internet.Conclusions: eHealth literacy is either moderate (Finnish group) or low (Greek group). Thus, exposure to ICT and eHealth skills training are needed for this population. Recommendations to improve the eHealth literacy and access to health information among these individuals are provided. [ABSTRACT FROM AUTHOR]

Intergenerational continuity in parenting quality has been demonstrated but the mechanisms underlying this continuity are less understood. This study investigated whether the offspring personality and years of education mediate the continuity in qualities of the parent-child relationship and whether offspring personality moderates this association. The sample comprised 1308 Finnish offspring (G2; 62% female) and their mothers (G1). G1 ( Mean age = 37.7) reported self-perceived qualities of the parent-child relationship in terms of emotional warmth and acceptance towards G2 aged 3-18 years in 1980. Thirty-two years later, once having become parents themselves, G2 ( Mean age = 42.9) self-rated their own qualities of the parent-child relationship towards their children using the same scales. Between these follow-ups, G2 self-rated their personality (consisting of temperament and character traits) using the Temperament and Character Inventory and reported years of education. Results indicated that G2 character traits-Self-directedness and Cooperativeness-partially mediated the intergenerational continuity in self-perceived emotional warmth and explained 16% of this association. No mediating role of G2 temperament traits was found (all ps > .240). Character traits accounted for the indirect association better than education in a multiple mediator model. Moreover, no moderating role of either temperament or character traits was found (all ps ≥ .064). Study findings show that warm and accepting qualities of the parent-child relationship in childhood are related to offspring character traits that reflect personality maturity in adulthood, which in turn would predict their own positive parent-child relationship later in life. [ABSTRACT FROM AUTHOR]

This study examines the slimming practice produced by Internet-based weight-loss services and their use. Drawing on theories of practice, the study analyses the script of use that is constructed by the services, and the meanings, materialities and competences that are enacted in their use. Based on 20 semi-structured interviews with women who were users of two Finnish online weight-loss services, the study concludes that the services transform food into quantitative depictions of calories and nutrition. They configure slimmers as calculative agents and slimming as a practice based on incessant recording and monitoring. For online slimmers, the services acted in the double role of a control device with a focus on calorie restriction, and a learning device used to develop a skill of healthy eating. In the latter role, online slimming was hoped to result in an internalisation of a lifestyle change that would make calculation and constant monitoring unnecessary and the services redundant for their users. The results suggest that for its practitioners, online slimming is temporary rather than long-standing, but it may and is expected to act as a mediary in establishing other practices related to healthy lifestyles. [ABSTRACT FROM AUTHOR]

Background: Due to vitamin D intake below recommendation (10 mg/day) and low (<50nmol/l) serum 25- hydroxycholecalciferol (25(OH)D) concentration in Finnish population, the fortification of liquid dairy products with 0.5 mg vitamin D/100g and fat spreads with 10 mg/100g started in Finland in December 2002. In 2010, the fortification recommendation was doubled. The aim of this study was to investigate whether the vitamin D intake and status have improved among Finnish adults as a consequence of these nutrition policy actions. A further aim was to study the impact of vitamin supplement use to the total vitamin D intake. Methods: A cross-sectional survey was conducted every 5 years. The National FINDIET Survey was conducted in Finland as part of the National FINRISK health monitoring study. Dietary data were collected by using a computer-assisted 48-h dietary recall. In 2002, dietary data comprised 2007, in 2007, 1575 and 2012, 1295 working aged (25-64 years) Finns. Results: The mean D-vitamin intake increased from 5 mg/day to 17 mg/day in men and from 3 mg/day to 18 mg/day in women from 2002 to 2012. The most important food sources of vitamin D were milk products, fat spreads and fish dishes. The share of milk products was 39% among younger men and 38% among younger women, and 29% among older men and 28% among older women. Fat spreads covered on average 28% of vitamin D intake, except for younger men for which it covered 23%. Fish dishes provided 28% of vitamin D intake for older men and women, and approximately 18% for younger ones. In January-April 2012, the average serum 25-hydroxycholecalciferol (25(OH)D) concentration for men was 63 nmol/l for men and for women 67 nmol/l for women. Conclusions: The fortification of commonly used foods with vitamin D and vitamin D supplementation seems to be an efficient way to increase the vitamin D intake and the vitamin D status in the adult population. [ABSTRACT FROM AUTHOR]

Research and clinical practitioners have mixed views whether reading and spelling difficulties should be combined or seen as separate. This study examined the following: (a) if double dissociation between reading and spelling can be identified in a transparent orthography (Finnish) and (b) the cognitive and noncognitive precursors of this phenomenon. Finnish-speaking children (n = 1963) were assessed on reading fluency and spelling in grades 1, 2, 3, and 4. Dissociation groups in reading and spelling were formed based on stable difficulties in grades 1-4. The groups were compared in kindergarten phonological awareness, rapid automatized naming, letter knowledge, home literacy environment, and task-avoidant behavior. The results indicated that the double dissociation groups could be identified even in the context of a highly transparent orthography: 41 children were unexpected poor spellers (SD), 36 were unexpected poor readers (RD), and 59 were poor in both reading and spelling (RSD). The RSD group performed poorest on all cognitive skills and showed the most task-avoidant behavior, the RD group performed poorly particularly on rapid automatized naming and letter knowledge, and the SD group had difficulties on phonological awareness and letter knowledge. Fathers' shared book reading was less frequent in the RD and RSD groups than in the other groups. The findings suggest that there are discernible double dissociation groups with distinct cognitive profiles. This further suggests that the identification of difficulties in Finnish and the planning of teaching and remediation practices should include both reading and spelling assessments. [ABSTRACT FROM AUTHOR]

Conclusion: Transcutaneous vagal nerve stimulation (tVNS) might offer a targeted, patient-friendly, and low-cost therapeutic tool for tinnitus patients with sympathovagal imbalance. Objectives: Conventionally, VNS has been performed to treat severe epilepsy and depression with an electrode implanted to the cervical trunk of vagus nerve. This study investigated the acute effects of tVNS on autonomic nervous system (ANS) imbalance, which often occurs in patients with tinnitus-triggered stress. Methods: This study retrospectively analysed records of 97 patients who had undergone ANS function testing by heart rate variability (HRV) measurement immediately before and after a 15–60 min tVNS stimulation. Results: The pre-treatment HRV recording showed sympathetic preponderance/reduced parasympathetic activity in about three quarters (73%) of patients. Active tVNS significantly increased variability of R-R intervals in 75% of patients and HRV age was decreased in 70% of patients. Either the variability of R-R intervals was increased or the HRV age decreased in 90% of the patients. These results indicate that tVNS can induce a shift in ANS function from sympathetic preponderance towards parasympathetic predominance. tVNS caused no major morbidity, and heart rate monitoring during the tVNS treatment showed no cardiac or circulatory effects (e.g. bradycardia) in any of the patients. [ABSTRACT FROM AUTHOR]

Aim: To develop a national consensus on outcome measures that define functional ability in children with cerebral palsy (CP) according to the International Classification of Functioning, Disability and Health (ICF) framework.Method: The project started in 2008 in neuropaediatric units of two university hospitals and one outpatient clinic. Each professional group selected representatives to be knowledge brokers for their own specialty. Based on the evidence, expert opinion, and the ICF framework, multiprofessional teams selected the most valid measures used in clinical practice (2009-2010). Data from 269 children with CP were analysed, classified by the Gross Motor Function Classification System, Manual Ability Classification System, and Communication Function Classification System, and evaluated.Results: The process aimed at improving and unifying clinical practice in Finland through a national consensus on the core set of measures. The selected measures were presented by professional groups, and consensus was reached on the recommended core set of measures to be used in all hospitals treating children with CP in Finland.Interpretation: A national consensus on relevant and feasible measures is essential for identifying differences in the effectiveness of local practices, and for conducting multisite intervention studies. This project showed that multiprofessional rehabilitation practices can be improved through respect for and inclusion of everyone involved. [ABSTRACT FROM AUTHOR]

Background Earlier research and clinical practice show that specific language impairment (SLI) is often associated with nonverbal cognitive deficits and weakened skills in executive functions (EFs). Executive deficits may have a remarkable influence on a child's everyday activities in the home and school environments. However, research information is still limited on EFs in school-aged children with SLI, mostly conducted among English- and Dutch-speaking children. Aims To study whether there are differences in EFs between Finnish-speaking children with SLI and typically developing (TD) peers at school age. EFs are compared between the groups with and without controlling for nonverbal intelligence. Methods & Procedures : Parents and teachers of children with SLI ( n = 22) and age- and gender-matched TD peers ( n = 22) completed The Behavior Rating Inventory of Executive Functions (BRIEF). The mean age of the children was 8,2 years. BRIEF ratings of parents and teachers were compared between the children with SLI and with TD peers by paired analysis using conditional logistic regression models with and without controlling for nonverbal IQ. Intellectual functioning was assessed with the Wechsler Intelligence Scale for Children. Outcomes & Results Children with SLI had weaker scores in all parent and teacher BRIEF scales compared with TD peers. Statistically significant differences between the groups were found in BRIEF scales Shift, Emotional Control, Initiate, Working Memory, Plan/Organize and Monitor. Differences between the groups were statistically significant also in intellectual functioning. On BRIEF scales some group differences remained statistically significant after controlling for nonverbal IQ. Conclusions & Implications This study provides additional evidence that also Finnish-speaking school-aged children with SLI are at risk of having deficits in EFs in daily life. EFs have been proposed to have an impact on developmental outcomes later in life. In clinical practice it is important to pay attention to EFs in school-aged children with SLI when making diagnostic evaluations and planning interventions for them. [ABSTRACT FROM AUTHOR]

Primary Objective: The use of mobile apps in clinical settings is becoming a widely accepted tool for many healthcare professionals. Physical therapists (PTs) have been underresearched in this area, leaving little information regarding the challenges in using mobile apps in the PT environment. The FITT framework provides a theoretical underpinning for this investigation.Research Design and Methods: A survey was developed based on the FITT framework and research questions. Licensed PTs in attendance at the FPTA conference were asked to complete the survey. A descriptive analysis was conducted for the study and demographic variables. A factor analysis was performed to determine the appropriateness of the FITT framework.Main Outcome and Results: The individual-technology dimension showed the best fit to the framework, with the weakest fit being the individual-task dimension. The majority of PTs surveyed do not currently use apps in their professional practice nor do they feel that their organizational leadership endorses app usage.Conclusions: The integration of mobile apps into physical therapy practice can improve the standard of care. Additional apps and marketing of these apps could elevate use of this technology. However, leadership support with the necessary resources for app usage will be key to improved overall FITT. [ABSTRACT FROM AUTHOR]

This article explores the ways in which lethal intimate partner violence perpetrated by both men and women is made sense of in news reports in Finnish tabloids. An analytical approach drawing upon critical discursive psychology, complemented with tools from membership categorization analysis, was adopted for distinguishing recurring patterns in accounting for violence and use of gendered categorizations in the news. Two recurring interpretative repertoires of violence were identified. The first constructs violence as originating from interactional or relationship problems, while the second relies upon characterizations of the perpetrators as pathological or deviant to explain violence. The analysis accords particular attention to the ways in which the ideal of gender-neutrality that is prevalent in Finnish society is drawn upon in these repertoires, and how this ideal entwines with the circulation of gender-specific assumptions. The analysis also illustrates how categorizations often work in the reports to preserve the normality of men as perpetrators of lethal intimate partner violence while attaching deviance and moral questionability to women both as victims and as perpetrators, thus maintaining the taken-for-grantedness of gendered differences in relation to violence. [ABSTRACT FROM AUTHOR]

Background/objectives: Fish intake and the long-chain omega-3 polyunsaturated fatty acids (PUFAs) in fish have been suggested to lower the risk of cognitive decline. We assessed whether serum long-chain omega-3 PUFAs eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA) are associated with performance on neuropsychological tests in an older population and whether exposure to methylmercury, mainly from fish, or apolipoprotein-E4 (Apo-E4) phenotype can modify the associations.Subjects/methods: A total of 768 participants from the population-based Kuopio Ischaemic Heart Disease Risk Factor Study were included. Cognitive function was measured using five neuropsychological tests: the Trail Making Test, the Verbal Fluency Test, the Selective Reminding Test, the Visual Reproduction Test and the Mini Mental State Exam. Multivariate-adjusted analysis of covariance and linear regression were used to analyze the cross-sectional associations.Results: We found statistically significant associations between serum EPA+DPA+DHA and better performance in the Trail Making Test and the Verbal Fluency Test. The individual associations with EPA and DHA were similar with the findings with EPA+DPA+DHA, although the associations with DHA were stronger. No associations were observed with serum DPA. Pubic hair mercury content was associated only with a worse performance in the Trail Making Test, and mercury had only little impact on the associations between the serum PUFAs and cognitive performance. Apo-E4 phenotype did not modify the associations with PUFAs or mercury.Conclusions: Higher serum long-chain omega-3 PUFA concentrations were associated with better performance on neuropsychological tests of frontal lobe functioning in older men and women. Mercury exposure or Apo-E4 phenotype had little impact on cognitive performance. [ABSTRACT FROM AUTHOR]

Recent studies have suggested that the professional training received by general educators does not adequately prepare them to properly implement inclusion-based practices. The idea of inclusion in practice has not significantly changed the situation of teaching pupils with special educational needs (SENs) in mainstream classes. This study's primary intent is to examine the factors that identify the school staff's ability to meet the needs of SEN pupils in their daily teaching situations. A total of 187 elementary school teachers, principals and teaching assistants in a Finnish city completed a structured questionnaire that used a self-evaluation method. Two components were generalised according to answers concerning the respondents’ confidence in and knowledge of teaching SEN pupils. The results indicate that teachers’ qualifications constitute the main reason affecting their ability in this area. Pedagogical and practical knowledge, as well as collaborative skills in teaching SEN pupils, is focused on special educators. These findings reveal the need for additional and in-service training and more effective cooperation between special and general education to share the knowledge of teaching SEN pupils in practice. [ABSTRACT FROM PUBLISHER]

Background: Previous studies of loneliness have largely focused on establishing risk factors in specific age groups such as in later life or in young people. Researchers have paid less attention to the link between social capital and loneliness across different age groups. The aim of this study was to examine the association between social capital and experienced loneliness in different age groups in a Finnish setting.Methods: The data originates from a population-based cross-sectional survey conducted among 4618 people aged 15-80 in Western Finland in 2011. The response rate was 46.2 %. The association between social capital, measured by frequency of social contacts, participation in organisational activities, trust and sense of belonging to the neighbourhood and loneliness was tested by logistic regression analyses stratified by four age groups.Results: Frequent loneliness (defined as experienced often or sometimes) was higher among younger people (39.5 %) compared to older people (27.3 %). Low levels of trust were linked to loneliness in all four age groups. The association between other aspects of social capital and loneliness varied across age groups.Conclusions: Frequent loneliness is common among the general adult population and could be seen as a public health issue. Our findings imply that low social capital, especially in terms of low trust, may be a risk factor for loneliness. However, further research is needed to assess the influence of poor health and reverse causality as explanations for the findings. [ABSTRACT FROM AUTHOR]

ObjectivesIn Finland, a dental subsidization reform, implemented in 2001–2002, abolished age restrictions on subsidized dental care. The aim of this study was to investigate income-related inequality in the perceived oral health and its determinants among adult Finns before and after the reform.Materials and methodsThree identical cross-sectional nationally representative postal surveys, concerning perceived oral health and the use of dental services among people born before 1971, were conducted in 2001 (n = 2157), in 2004 (n = 1814) and in 2007 (n = 1671). Three measures of perceived oral health were used: toothache or oral discomfort during the past 12 months, current need for dental care and self-reported oral health status. Concentration index was used to analyse the income-related inequalities. Its decomposition was used to study factors related to the inequalities.ResultsThe proportion of respondents reporting need for dental care decreased from 2001 to 2007, while no changes were seen in reports of toothache or self-reported oral health status. Income-related inequalities in reports of toothache and perceived need for care widened, while the inequality in self-reported oral health remained stable. Most of the inequalities were related to income itself, perceived general health and the time since the last visit to dental care.ConclusionsIt seems that the income-related inequalities in perceived oral health remained or even widened after the reform. [ABSTRACT FROM PUBLISHER]

ObjectiveThe aim was to compare the changes in parents’ oral health-related behaviour, knowledge and attitudes in 2001–2003 and 2003–2005, during a 3.4-year-intervention in Pori and in the reference area Rauma, Finland.Materials and methodsThe study population consisted of parents of children who participated in the oral health promotion programme in Pori (all 5th and 6th graders who started the 2001–2002 school year in the town of Pori,n = 1691) and the parents of same-aged children in a reference town (n = 807). In 2001–2003, the promotion was targeted only to the children in Pori. In 2003–2005, the promotion was targeted also to parents, for example via local mass media. The statistical significances of the differences in parents’ self-reported behaviour, knowledge and attitudes, and changes in these, were evaluated using Mann-Whitney U-tests and confidence intervals.ResultsIn 2001–2003, the trend in changing behaviours was in favour of parents in Pori. Mothers in Pori also improved their knowledge and the attitude ‘importance of brushing for health and appearance’. In 2003–2005, the trend in changing behaviours was rather similar in both towns, which may be due to diffusion of the oral health intervention to Rauma via the media.ConclusionsThe results suggest that health promotion targeted to children, which in previous studies has been shown to be successful in improving children’s behaviours, also helped their parents in mending their habits. [ABSTRACT FROM PUBLISHER]

Purpose: The objective of this study is to determine whether persons with neuropsychiatric disorders experience a common set of psychosocial difficulties using qualitative data from focus groups and individual interviews.Method: The study was performed in five European countries (Finland, Italy, Germany, Poland and Spain) using the focus groups and individual interviews with persons with nine neuropsychiatric disorders (dementia, depression, epilepsy, migraine, multiple sclerosis, Parkinson’s disease, schizophrenia, stroke and substance dependence). Digitally recorded sessions were analysed using a step-by-step qualitative and quantitative methodology resulting in the compilation of a common set of psychosocial difficulties using the International Classification of Functioning, Disability and Health (ICF) as a framework.Results: Sixty-seven persons participated in the study. Most persons with neuropsychiatric disorders experience difficulties in emotional functions, sleeping, carrying out daily routine, working and interpersonal relationships in common. Sixteen out of 33 psychosocial difficulties made up the common set. This set includes mental functions, pain and issues addressing activities and participation and provides first evidence for the hypothesis of horizontal epidemiology of psychosocial difficulties in neuropsychiatric disorders.Conclusions: This study provides information about psychosocial difficulties that should be covered in the treatment and rehabilitation of persons with neuropsychiatric disorders regardless of clinical diagnoses.Implications for RehabilitationEmotional problems, work and sleep problems should be addressed in all the treatments of neuropsychiatric disorders regardless of their specific diagnosis, etiology and severity.Personality issues should be targeted in the treatment for neurological disorders, whereas communication skill training may also be useful for mental disorders.The effects of medication and social environment on patient’s daily life should be considered in all the neuropsychiatric conditions. [ABSTRACT FROM AUTHOR]

Importance: Previous research has focused on examining the familial clustering of schizophrenia, bipolar disorder, and autism spectrum disorders (ASD). Little is known about the clustering of other psychiatric and neurodevelopmental disorders among siblings of persons with ASD.Objective: To examine the risk for psychiatric and neurodevelopmental disorders among full siblings of probands with ASD.Design, Setting, and Participants: The Finnish Prenatal Study of Autism and Autism Spectrum Disorders used a population-based cohort that included children born from January 1, 1987, to December 31, 2005, who received a diagnosis of ASD by December 31, 2007. Each case was individually matched to 4 control participants by sex and date and place of birth. The siblings of the cases and controls were born from January 1, 1977, to December 31, 2005, and received a diagnosis from January 1, 1987, to December 31, 2009. This nested case-control study included 3578 cases with ASD with 6022 full siblings and 11 775 controls with 22 127 siblings from Finnish national registers. Data were analyzed from March 6, 2014, to February 12, 2016.Main Outcomes and Measures: The adjusted risk ratio (RR) for psychiatric and neurodevelopmental disorders among siblings of probands with ASD vs siblings of matched controls. Additional analyses were conducted separately for ASD subgroups, including childhood autism, Asperger syndrome, and pervasive developmental disorders not otherwise specified. Analyses were further stratified by sex and intellectual disability among the probands.Results: Among the 3578 cases with ASD (2841 boys [79.4%]) and 11 775 controls (9345 boys [79.4%]), 1319 cases (36.9%) and 2052 controls (17.4%) had at least 1 sibling diagnosed with any psychiatric or neurodevelopmental disorder (adjusted RR, 2.5; 95% CI, 2.3-2.6). The largest associations were observed for childhood-onset disorders (1061 cases [29.7%] vs 1362 controls [11.6%]; adjusted RR, 3.0; 95% CI, 2.8-3.3), including ASD (374 cases [10.5%] vs 125 controls [1.1%]; adjusted RR, 11.8; 95% CI, 9.4-14.7), tic disorders (28 cases [0.8%] vs 24 controls [0.2%]; adjusted RR, 4.3; 95% CI, 2.3-8.2), attention-deficit/hyperactivity disorder (189 cases [5.3%] vs 180 controls [1.5%]; adjusted RR, 3.7; 95% CI, 2.9-4.7), learning and coordination disorders (563 cases [15.7%] vs 697 controls [5.9%]; adjusted RR, 3.2; 95% CI, 2.8-3.6), intellectual disability (104 cases [2.9%] vs 137 controls [1.2%]; adjusted RR, 3.1; 95% CI, 2.3-4.2), conduct and oppositional disorders (180 cases [5.0%] vs 221 controls [1.9%]; adjusted RR, 2.8; 95% CI, 2.2-3.5), and emotional disorders with onset specific to childhood (126 cases [3.5%] vs 157 controls [1.3%]; adjusted RR, 2.6; 95% CI, 1.9-3.4). Autism spectrum disorders were also associated with schizophrenia spectrum disorders, affective disorders, anxiety disorders, and other neurotic and personality disorders among siblings.Conclusions and Relevance: Psychiatric and neurodevelopmental disorders cluster among siblings of probands with ASD. For etiologic research, these findings provide further evidence that several psychiatric and neurodevelopmental disorders have common risk factors. [ABSTRACT FROM AUTHOR]