Department of Social Services

Abstract Background The experience of social inclusion (ESI) is an important part of psychosocial wellbeing and has significant public health implications. ESI includes aspects of agency, belonging, social support, meaningfulness, and trust, which may facilitate healthier behaviors. Previous studies also showed that ESI helps individuals to cope with difficult life situations, such as protecting adolescents from anxiety during the COVID-19 pandemic. Our study aimed to identify population groups with a high prevalence of very weak ESI. Methods We used data from the 2019 FinSote survey representative of the Finnish population aged 20 + (n = 5943). ESI was measured using the Experiences of Social Inclusion Scale (ESIS), with scores below 50 indicating very weak ESI. Logistic regression was used to calculate gender and age-adjusted odds ratios (OR). Other variables included marital status, labor market position (LMP), education, self-rated health (SRH), work ability, and functional capacity. Results Particularly work-related variables were strongly associated to ESI. Among the employed, 7.7% had very weak ESI, compared to 24.5% among the unemployed. The OR for unemployed job seekers was 4.2 (95% CI 2.9-6.2), and for those on disability pension 4.3 (95% CI 2.5-7.3) compared to the employed. Respondents with reduced work ability had an OR of 3.4 (95% CI 2.7-4.4) and those with lower SRH 2.7 (95% CI 2.2-3.5). In the full model with all variables, the effects of gender, age, marital status, LMP, work ability, and SRH remained significant (Wald p < 0.05), indicating independent effects. Conclusions Work life participation, health, and work ability are crucial for ESI. Vulnerable groups, such as the unemployed, people on disability pension, and those with reduced work ability or low SRH, have a particularly high prevalence of very weak ESI. Timely and targeted interventions to strengthen ESI in these groups are advised to prevent further healthcare costs and improve overall public health. Key messages • Exclusion from work life, impaired health and reduced work ability are detrimental for ESI, which is crucial for wellbeing and a resource for future health outcomes. • From a public health perspective, targeted interventions for vulnerable groups such as the unemployed or disabled can strengthen ESI. This can be seen as an investment to reduce healthcare costs.

Bu çalışmada, kadına yönelik dijital şiddet literatürünü sistematik ve kapsamlı olarak incelemek amacıyla bibliyometrik analiz ve içerik analizi gerçekleştirilmiştir. İlk aşamada, Web of Science veri tabanından elde edilen yayınlar VOSviewer yazılımı ile analiz edilerek çalışmalardaki ülke dağılımı, yazar işbirlikleri ve anahtar kavramlar değerlendirilmiş; alanın tematik kümeleri ve kavramsal yapısı ortaya konmuştur. İkinci aşamada, 2015–2025 mayıs ayı arasında Web of Science veri tabanında yayımlanan açık erişimli, örneklemi yalnızca yetişkin kadınlardan oluşan 32 araştırma makalesi analiz edilmiştir. MAXQDA 2022 kullanılarak yürütülen kodlama sürecinde 187 kod üretilmiş; bu kodlar birlikte oluşum modelleri ve kavramsal haritalar (MAXMAPs) aracılığıyla analiz edilmiştir. Bu çift yönlü yöntem, dijital şiddetin yapısal eğilimleri ile kadınların deneyimlerinden elde edilen tematik örüntüleri bütüncül biçimde değerlendirme olanağı sunmuştur. Ardından içerik analizi ile çalışmaların kavramsal çerçevesi, bulguları ve önerileri sistematik olarak sınıflandırılmıştır. Elde edilen bulgular, dijital şiddetin kadınlar-erkekler arasındaki eşitsizlikler bağlamında çok katmanlı bir olgu olduğunu, ruh sağlığı, mesleki yaşam ve sosyal görünürlük üzerinde kalıcı etkiler yarattığını göstermektedir. Ayrıca, kadınların dijital şiddet karşısında geliştirdiği bireysel ve kolektif başa çıkma stratejileri ile dijital dayanışma pratiklerinin önemi vurgulanmıştır. Çalışma, dijital şiddet literatüründeki kavramsal çeşitliliği ve araştırma eğilimlerini görünür kılarak alanyazına katkı sağlamayı amaçlamaktadır.

BackgroundClinical diagnostic assessments and the outcome monitoring of patients with depression rely predominantly on interviews by professionals and the use of self-report questionnaires. The ubiquity of smartphones and other personal consumer devices has prompted research into the potential of data collected via these devices to serve as digital behavioral markers for indicating the presence and monitoring of the outcome of depression.ObjectiveThis paper explores the potential of using behavioral data collected with smartphones to detect and monitor depression symptoms in patients diagnosed with depression. Specifically, it investigates whether this data can accurately classify the presence of depression, as well as monitor the changes in depressive states over time.MethodsIn a prospective cohort study, we collected smartphone behavioral data for up to 1 year. The study consists of observations from 164 participants, including healthy controls (n=31) and patients diagnosed with various depressive disorders: major depressive disorder (MDD; n=85), MDD with comorbid borderline personality disorder (n=27), and major depressive episodes with bipolar disorder (n=21). Data were labeled based on depression severity using 9-item Patient Health Questionnaire (PHQ-9) scores. We performed statistical analysis and used supervised machine learning on the data to classify the severity of depression and observe changes in the depression state over time.ResultsOur correlation analysis revealed 32 behavioral markers associated with the changes in depressive state. Our analysis classified patients who are depressed with an accuracy of 82% (95% CI 80%-84%) and change in the presence of depression with an accuracy of 75% (95% CI 72%-76%). Notably, the most important smartphone features for classifying depression states were screen-off events, battery charge levels, communication patterns, app usage, and location data. Similarly, for predicting changes in depression state, the most important features were related to location, battery level, screen, and accelerometer data patterns.ConclusionsThe use of smartphone digital behavioral markers to supplement clinical evaluations may aid in detecting the presence and changes in severity of symptoms of depression, particularly if combined with intermittent use of self-report of symptoms.

Introduction: Loneliness, social inactivity, and social isolation are intertwined concepts. When assessed separately, they indicate poor well-being, adverse health effects, and increased mortality. Studies exploring overlapping and comparing the prognosis of these concepts are scarce. We investigated (1) overlapping of concepts of loneliness, social inactivity, and social isolation, (2) characteristics of groups: group 0 (not lonely, socially inactive, or socially isolated), group 1 (lonely), group 2 (not lonely but socially inactive and/or socially isolated), and (3) the health-related quality of life (HRQoL), psychological well-being (PWB), and 3.6-year mortality of these groups. Methods: The home-dwelling older adults (n = 989; 75 y+) of the Helsinki Aging Study in 2019–2022 completing all required questionnaires were assessed. Group 0 included 494, group 1 included 280, and group 2 included 215 participants. Variables studied were demographics, diagnoses, mobility, physical functioning (Barthel index), and cognition (Mini-Mental State Examination). Outcomes were HRQoL (15D) and PWB. Mortality was retrieved from central registers. Results: Half of the sample was lonely, socially inactive, or socially isolated, but only 2% were simultaneously lonely, socially inactive, and socially isolated. Of lonely participants, 38% were also socially inactive and/or socially isolated. The lonely participants were significantly more often widowed or lived alone and had the lowest HRQoL and poorest PWB compared with the other groups. After adjustments (age, sex, Charlson Comorbidity Index), mortality did not statistically differ between the groups. Conclusion: Loneliness is an independent determinant of poor HRQoL and PWB, and it should be considered separately from social inactivity and social isolation.

See the Reply by Umoh et al.

AimsTo explore stakeholders' perceptions of a facilitator's role in supporting carers when embedding iSupport for Dementia psychoeducation program, in care services.MethodsA qualitative descriptive study design was applied. Data were collected from workshops and interviews with carers of people living with dementia (PLWD)and with health and social care professionals from two tertiary hospitals and two community aged care organisations across three Australian states between October 2021 and March 2022. A thematic analysis was used to analyse data. The COREQ guideline was followed to report our findings.ResultsA total of 30 family carers and 45 health and social care professionals participated in the study. Three main themes and seven subthemes were identified from the data. We described the main themes as (1) the facilitator's role at the time of dementia diagnosis, (2) the facilitator's role throughout the everyday dementia care journey and (3) the facilitator's role during transition moments.ConclusionsCaring for family members with dementia is demanding and stressful for carers. Embedding a facilitator‐enabled iSupport for Dementia program in hospital and community aged care settings has the potential to mitigate sources of stress associated with care recipient factors, carer factors and care service factors, and improve the health and well‐being of carers and those for whom they care.Relevance to Clinical PracticeOur findings will inform the establishment of iSupport facilitators appointed by dementia care providers in hospital and community care settings and help determine their roles and responsibilities in delivering the iSupport program. Our findings relate to nurse‐led and coordinated dementia care in hospital and community aged care settings.Patient or Public ContributionThis study was co‐designed with stakeholders from two aged care organisations and two tertiary hospitals. The study participants were staff employed by these organisations and carers of PLWD who were service users.

PurposeTo investigate the clinical efficacy and safety of a bone cement-injectable cannulated pedicle screw (CICPS) in the treatment of spondylolysis-type lumbar spondylolisthesis with osteoporosis.MethodsA retrospective study was conducted on 37 patients (Dual-energy X-ray bone density detection showed different degrees of osteoporosis) with spondylolysis-type lumbar spondylolisthesis who underwent lumbar spondylolisthesis reduction and fusion using a new type of injectable bone cement screw from May 2011 to March 2015. Postoperative clinical efficacy was evaluated by the Visual Analogue Scale (VAS) scores and the Oswestry Disability Index (ODI). Imaging indexes were used to evaluate the stability of internal fixation of the devices 1, 3, 6, and 12 months after surgery and annually thereafter. The safety of the CICPS was assessed by the prevalence of intraoperative and postoperative complications.ResultsA total of 124 CICPS were implanted intraoperatively. Bone cement leakage occurred in 3 screws (2.42%), and no clinical discomfort was found in any patients. All 37 patients were followed up with an average follow-up time of 26.6 ± 13.4 months (12–58 months). In the evaluation of the clinical effects of the operation, the average postoperative VAS score of the patients decreased from 4.30 ± 1.58 before surgery to 0.30 ± 0.70 after surgery (P < 0.001), and the ODI decreased from 47.27% ± 16.97% before surgery to 3.36% ± 5.70% after surgery (P < 0.001). No screw was loose, broken or pulled out.ConclusionCICPS is safe and effective in the treatment of spondylolysis-type lumbar spondylolisthesis complicated by osteoporosis.

AimsThe purpose was to examine the prevalence and determinants of self‐reported eating problems in old home care clients, screened separately by a clinical nutritionist and a dental hygienist.Methods and ResultsThe data came from the Nutrition, Oral Health and Medication (NutOrMed) study, the participants of which were ≥75‐year‐old home care clients living in Finland. The structured interviews were conducted at the participants' (n = 250) homes. Of the participants, 29% reported poor appetite, 20% had problems with chewing, and 14% had problems with swallowing when asked by a clinical nutritionist. Additionally, 18% reported oral health‐related eating problems when asked by a dental hygienist. Participants with continuous xerostomia (odds ratio [OR]: 3.0, 95% confidence interval [CI]: 1.0–9.0) or poor self‐reported oral health (OR: 4.3, 95% CI: 1.4–13.0) had a higher risk for problems with chewing when asked by a clinical nutritionist. Edentulous participants (OR: 3.5, 95% CI: 1.2–10.9) and participants with toothache or problems with dentures (OR: 10.3, 95% CI: 4.0–26.0) had a higher risk for oral health‐related eating problems when asked by a dental hygienist.ConclusionEating problems are common in older adults, and interprofessional collaboration is required for their identification and alleviation.

To gather and synthesize current empirical evidence on remote leadership and to provide knowledge that can be used to develop successful remote leadership in health care. A integrative literature review with an integrated mixed methods design. The literature search was carried out between February and March 2019 in the CINAHL, Medline (Ovid), PsycInfo, Scopus, SocIndex, Web of Science and Business Source Elite (EBSCO) databases. An integrative review was conducted to identify relevant studies published from 2010 to 2019. Of the 88 eligible studies, 21 studies met the inclusion criteria and were selected for the final review. The included studies were analysed using mixed methods synthesis, more specifically, data-based convergent synthesis. The performed analysis identified three main themes: characteristics of successful remote leadership; enhancing the leader-member relationship; and challenges in remote leadership. The first theme included the following sub-themes: remote leader characteristics; trust; communication; and leading the team culture. The second theme covered the importance of organizing regular face-to-face meetings, clear communication policies and the connection between positive team spirit and good remote leader-member relationship, while the third theme emphasized leader- and member-related challenges for remote work. As none of the identified studies had been conducted in a health care setting, future remote leadership research must also specifically consider the health care context. This will be pivotal to exploring how remote work can foster a safe workplace culture, empower health care workers, increase job satisfaction and improve patient outcomes. Remote leadership has rarely been studied in the health care context. Trust, communication, team spirit and a leader's characteristics are central to remote leadership, a finding which is useful for re-evaluating and improving the current culture at health care organizations.

The novel coronavirus disease of 2019 (COVID-19) pandemic has created challenging circumstances for the physical and mental health of individuals across the United States. This commentary addresses the role of grief in mental health outcomes relating to the pandemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).