YRITYKSEN SIJOITTAJAVIESTINTÄ KRIISITILANTEESSA. Ukrainan kriisi ja Venäjällä toimivien suomalaisten pörssiyhtiöiden sijoittajaviestintä

siirretty Doriast

The Well-Being of Adolescents Conceived Through Medically Assisted Reproduction : A Population-Level and Within-Family Analysis

Medically assisted reproduction (MAR) plays an increasingly important role in the realization of fertility intentions in advanced societies, yet the evidence regarding MAR-conceived children’s longer-term well-being remains inconclusive. Using register data on all Finnish children born in 1995–2000, we compared a range of social and mental health outcomes among MAR- and naturally conceived adolescents in population-averaged estimates, and within families who have conceived both through MAR and naturally. In baseline models, MAR-conceived adolescents had better school performance and the likelihood of school dropout, not being in education or employment, and early home-leaving were lower than among naturally conceived adolescents. No major differences were found in mental health and high-risk health behaviours. Adjustment for family sociodemographic characteristics attenuated MAR adolescents’ advantage in social outcomes, while increasing the risk of mental disorders. The higher probability of mental disorders persisted when comparing MAR adolescents to their naturally conceived siblings. On average, MAR adolescents had similar or better outcomes than naturally conceived adolescents, largely due to their more advantaged family backgrounds, which underscores the importance of integrating a sociodemographic perspective in studies of MAR and its consequences.Peer reviewe

Identifying nursing sensitive indicators from electronic health records in acute cardiac care―Towards intelligent automated assessment of care quality

Aim: The aim of this study is to explore the potential of using electronic health records for assessment of nursing care quality through nursing-sensitive indicators in acute cardiac care. Background: Nursing care quality is a multifaceted phenomenon, making a holistic assessment of it difficult. Quality assessment systems in acute cardiac care units could benefit from big data-based solutions that automatically extract and help interpret data from electronic health records. Methods: This is a deductive descriptive study that followed the theory of value-added analysis. A random sample from electronic health records of 230 patients was analysed for selected indicators. The data included documentation in structured and free-text format. Results: One thousand six hundred seventy-six expressions were extracted and divided into (1) established and (2) unestablished expressions, providing positive, neutral and negative descriptions related to care quality. Conclusions: Electronic health records provide a potential source of information for information systems to support assessment of care quality. More research is warranted to develop, test and evaluate the effectiveness of such tools in practice. Implications for Nursing Management Knowledge-based health care management would benefit from the development and implementation of advanced information systems, which use continuously generated already available real-time big data for improved data access and interpretation to better support nursing management in quality assessment.</p

Nurses and Midwives in the Digital Age

Technological development has enabled Artificial Intelligence (AI) to better support health care delivery and nursing. The need for nurses to be involved and steer the development and implementation of AI in health care is recognized. A 60-minute scientific debate is organized to explore if AI will replace nursing

Assisting nurses in care documentation: from automated sentence classification to coherent document structures with subject headings

Background: Up to 35% of nurses' working time is spent on care documentation. We describe the evaluation of a system aimed at assisting nurses in documenting patient care and potentially reducing the documentation workload. Our goal is to enable nurses to write or dictate nursing notes in a narrative manner without having to manually structure their text under subject headings. In the current care classification standard used in the targeted hospital, there are more than 500 subject headings to choose from, making it challenging and time consuming for nurses to use. Methods: The task of the presented system is to automatically group sentences into paragraphs and assign subject headings. For classification the system relies on a neural network-based text classification model. The nursing notes are initially classified on sentence level. Subsequently coherent paragraphs are constructed from related sentences. Results: Based on a manual evaluation conducted by a group of three domain experts, we find that in about 69% of the paragraphs formed by the system the topics of the sentences are coherent and the assigned paragraph headings correctly describe the topics. We also show that the use of a paragraph merging step reduces the number of paragraphs produced by 23% without affecting the performance of the system. Conclusions: The study shows that the presented system produces a coherent and logical structure for freely written nursing narratives and has the potential to reduce the time and effort nurses are currently spending on documenting care in hospitals. </div

Oulujoen–Iijoen vesienhoitoalueen vesienhoitosuunnitelma vuosille 2022–2027 : Osa 1: Vesienhoitoaluekohtaiset tiedot

Vesienhoitosuunnitelmaan on koottu tiedot vesien tilasta sekä vesien tilan parantamiseksi ja ylläpitämiseksi tarvittavista toimenpiteistä Oulujoen–Iijoen vesienhoitoalueella. Luokiteltujen virtavesien yhteen lasketusta pituudesta 64 % ja järvien pinta-alasta 94 % vastaa erinomaisen tai hyvän ekologisen tilan kriteerejä. Rannikkovesien tilaluokat ovat laajalti heikentyneet edelliseen luokitteluun verrattuna. Pinta-alasta alle viidennes on hyvässä ekologisessa tilassa. Pintavesien ekologista tilaa heikentää yleisesti rehevöityminen ja liettyminen. Kuormitusta syntyy maan kuivauksesta ja muokkaamisesta, mutta myös pistemäisellä kuormituksella on vaikutusta. Muita paineita ovat hydrologiset ja morfologiset muutokset, rannikon tuntumassa happamoittavien aineiden kuormitus ja varsinkin Kuusamon alueella vesirutto. Yksikään pintavesimuodostumista ei ole kemialliselta tilaltaan hyvä. Tämä johtuu kaikkialla esiintyvien bromattujen difenyylieettereiden ympäristölaatunormin ylityksestä, Oulujoen vesistössä ja sen eteläpuoleisissa vesistöissä myös maaperään vuosikymmenten aikana kertyneestä elohopeasta. Kaikkien pohjavesimuodostumien kemiallinen ja määrällinen tila on hyvä. Vesienhoitoalueella on tunnistettu 35 riski-pohjavesialuetta ja 44 selvityskohteesta tarvitaan lisää tietoa. Rehevyyteen liittyviä parantamistarpeita on koko vesienhoitoalueella painottuen kuitenkin sen eteläisiin ja läntisiin osiin. Vesienhoitosuunnitelmassa esitettävillä toimenpiteillä vähennetään rehevöitymisen lisäksi vesiympäristölle vaarallisten ja haitallisten aineiden esiintymistä, happamuuskuormitusta sekä vesistöjen rakenteessa ja hydrologiassa tapahtuneiden muutosten vaikutuksia. Tarkemmat, vesistökohtaiset tiedot toimenpiteistä ja niiden kohdentumisesta löytyvät vesienhoitoalueen toimenpideohjelmasta. Esitettyjen toimenpiteiden kokonaiskustannukset ovat noin 160 miljoonaa euroa. Tästä noin 40 miljoonaa euroa on muun lainsäädännön perusteella toteutettavien ja 120 miljoonaa euroa vesienhoidon täydentävien toimenpiteiden osuus. Arviolta 25 järveä, 29 jokea ja yksi rannikkovesimuodostuma eivät toimenpiteistä huolimatta tule saavuttamaan hyvää ekologista tilaa vielä vuonna 2027. Vesien tila on kuitenkin laajalti kohentumassa vesienhoitotoimenpiteiden toteutuksen myötä

Assessing the carbon footprint of digital health interventions: a scoping review

Objective: Integration of environmentally sustainable digital health interventions requires robust evaluation of their carbon emission life-cycle before implementation in healthcare. This scoping review surveys the evidence on available environmental assessment frameworks, methods, and tools to evaluate the carbon footprint of digital health interventions for environmentally sustainable healthcare.Materials and methods: Medline (Ovid), Embase (Ovid). PsycINFO (Ovid), CINAHL, Web of Science, Scopus (which indexes IEEE Xplore, Springer Lecture Notes in Computer Science and ACM databases), Compendex, and Inspec databases were searched with no time or language constraints. The Systematic Reviews and Meta-analyses Extension for Scoping Reviews (PRISMA_SCR), Joanna Briggs Scoping Review Framework, and template for intervention description and replication (TiDiER) checklist were used to structure and report the findings.Results: From 3299 studies screened, data was extracted from 13 full-text studies. No standardised methods or validated tools were identified to systematically determine the environmental sustainability of a digital health intervention over its full life-cycle from conception to realisation. Most studies (n = 8) adapted publicly available carbon calculators to estimate telehealth travel-related emissions. Others adapted these tools to examine the environmental impact of electronic health records (n = 2), e-prescriptions and e-referrals (n = 1), and robotic surgery (n = 1). One study explored optimising the information system electricity consumption of telemedicine. No validated systems-based approach to evaluation and validation of digital health interventions could be identified.Conclusion: There is a need to develop standardised, validated methods and tools for healthcare environments to assist stakeholders to make informed decisions about reduction of carbon emissions from digital health interventions.</p

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks