Validation of the Nurses' Skills to Care for Alcohol-Intoxicated Patients in Emergency Department (NSCAIP-ED) instrument.

Aim To report the development and validation of the Nurses' Skills to Care for Alcohol-Intoxicated Patients in Emergency Department instrument, shortened NSCAIP-ED. Methods: A mixed-methods design was used to develop the instrument. It was used to conduct a survey where ED nurses self-evaluated their skills to care for acutely ill alcohol-intoxicated patients (N = 1220, n = 252). The data were utilised to perform instrument validation using confirmatory factor analysis (CFA) and Cronbach's alpha. Results: The construct validity was tested statistically. The CFA model fit indicators showed mostly acceptable fit (chi-square test p < 0.001; RMSEA 0.079; CFI 0.923; TLI 0.918; SRMR 0.084) and instruments' scales had well acceptable Cronbach's alpha values (all alphas were in the range of 0.866-0.912). Conclusions: The NSCAIP-ED is a feasible and reliable instrument that can be used when measuring nurses' skills to care for alcohol-intoxicated patients in the ED. This instrument could be useful for nursing managers in EDs for evaluating their nursing staff's skills in the care area in question, but also for designing continuing education based on the results.

Strabismus is more than a misalignment; a cross-sectional pilot study of HRQOL in Finnish strabismic adults referred to a university hospital.

PURPOSE: To evaluate associations between the health-related quality of life (HRQOL) and demographic, self-reported strabismus-related and orthoptic status variables in Finnish strabismic adults. METHODS: Participants (n = 137) of this study were adult patients who previously participated in the pilot study to translate and validate Adult Strabismus Questionnaire (AS-20) into Finnish. For this study, the participants' orthoptic status were collected among the previously obtained self-reported demographic and strabismus-related data. The refined AS-20 structure of 18 items and four subscales of self-perception, interaction, reading function and general function was used. Low scores on AS-20 indicate low HRQOL. The associations were evaluated with cross-tabulation and nonparametric methods of Mann-Whitney U and Kruskal-Wallis tests. Statistical significance was set at p < 0.05. RESULTS: Interaction subscale scores were the highest of all subscale scores among the participants. Age had an association with HRQOL in self-perception and the youngest participants had the lowest scores. Importantly, participants who did not experience diplopia suffered from lower self-perception and interaction but reported higher scores on reading function and general function subscales compared to the participants who experienced diplopia. Exotropia with or without vertical strabismus were most common types among the participants. The education background was not associated with HRQOL. CONCLUSION: Impacts of strabismus are similar in Finnish strabismic adults compared to international studies. Healthcare professionals and decision-makers should always consider the psychosocial impact of strabismus on patients without diplopia when making decisions on strabismus treatment and care processes.

First-Time Parents' Bonding with Their Baby: A Longitudinal Study on Finnish Parents during the First Eight Months of Parenthood.

Early positive bonding between parents and babies promotes the development of parenting skills and parents' sensitivity to their infant's needs. Positive bonding has been suggested to decrease the risk of maltreatment. There is less research into the differences between primiparae's and their spouses' bonding with their baby and changes in the parent-to-infant bonding during the first year of the baby's life. The aim of this study was to describe bonding with one's baby and related differences and changes within first-time parents. The data were collected from nine maternal health clinics in 2019-2021 in one city in Finland. The Mother-to-Infant Bonding Scale (MIBS) and the Edinburgh Postnatal Depression Scale (EPDS) were used. The data were collected during pregnancy (T1) and when the baby was aged 1-2 months (T2) and 6-8 months (T3). The questionnaire was completed separately by the primiparae (n = 81 at T1) and their spouses (n = 79 at T1). The findings demonstrated that both parents had positive feelings for their baby. The primiparae's and their spouses' MIBS scores were relatively low at T2 and T3. The change between time points or the difference in the parents' bonding was not statistically significant when examining MIBS total scores. The present study identified a positive weak-to-moderate correlation between the MIBS and EPDS. This association was highlighted in the group of primiparae. The results of this study can be used to develop maternity and child health clinic services, and to promote parents' equal growth in parenthood.

Health-Related Quality of Life in Adult Patients with Strabismus-Translation and Psychometric Testing of the Adult Strabismus Questionnaire (AS-20) into Finnish.

(1) Strabismus has an impact on individuals' health-related quality of life. The impact should be assessed with valid patient-reported outcome measures such as the Adult Strabismus Questionnaire (AS-20). The AS-20 was further refined using a Rasch analysis for the American population. The aims of the study were to translate and culturally adapt the AS-20 into Finnish and to evaluate the psychometric properties of the Finnish AS-20. (2) The guidelines of the Professional Society for Health Economics and Outcomes Research steered the process and four items were added from the original data as Finnish additions. The construct and convergent validity and internal consistency were evaluated via psychometric testing for three potential Finnish AS-20 structures. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was applied. (3) The participants (n = 137) reported that the translation was clear and understandable. All structures showed high reliability and internal consistency as measured using Cronbach alpha values. The convergent validity assessed using Spearman's correlation coefficients between the structures and one item of Satisfaction with Life Scale indicated very low to moderate positive correlations. The construct validity evaluated using a confirmatory factor analysis revealed the refined AS-20 structure to be satisfactory. (4) The refined AS-20 can be used in clinical practice and research, but further validation is recommended.

Association between legume consumption and the intake of other foods and nutrients in the Finnish adult population.

The role of legumes in healthy and sustainable diets is increasingly of interest. Few studies have investigated the association between legume consumption and the consumption of other food groups and the intake of nutrients. This study examined how legume consumption is associated with the consumption of other foods and the intake of nutrients among Finnish adults. Our study used cross-sectional data from the population-based FinHealth 2017 Study consisting of 2250 men and 2875 women aged ≥18 years. The associations between legume consumption (quartile classification), food groups and nutrients were analysed using multivariable linear regression. The models were initially adjusted for energy intake and additionally for age, educational level, smoking status, leisure-time physical activity and BMI. Legume consumption had a positive association with age, education level and leisure-time physical activity. The consumption of legumes was positively associated with the consumption of fruits and berries, vegetables, nuts and seeds and fish and fish products and inversely associated with the consumption of red and processed meat, cereals and butter and butter-based fat spreads. Furthermore, legume consumption was positively associated with the intake of protein, fibre, folate, thiamine and salt in both sexes and inversely associated with the intake of saturated fatty acids and sucrose (sucrose, women only). Thus, legume consumption appears to reflect overall healthier food choices. An increase in legume consumption could accelerate the transition to more sustainable diets. The confounding role of other foods and nutrients should be considered when studying associations between legume consumption and health outcomes.

Associations Between Children's Depressive Symptoms, Life Events, and Family Factors Among School-Aged Children.

BACKGROUND: About 20-30% of children worldwide report depressive symptoms. This study examined associations between children's depressive symptoms, life events, and family factors. METHODS: Nationally representative data (n = 95,725) were drawn from the 2017 School Health Promotion Study in Finland. The respondents were 4th and 5th grade pupils (aged 10-12) in primary schools and their parents/guardians (n = 33,726). Data were analyzed for child-parent dyads (n = 32,181). Associations were studied using cross tabulation and logistic regression models. RESULTS: Children's reports of poor self-rated health, problems with family interactions, and the accumulation of life events were statistically significantly associated with depressive symptoms, also when controlling for sociodemographic factors. Financial situation and parent's depressed mood, both reported by parents, were associated with children's depressive symptoms when both were included in the regression model. However, this association disappeared when other predictors were added to the model. CONCLUSION: The results make apparent the complex associations between children's depressive symptoms and family factors. Further research is needed on the discrepancies between parent and child experiences.

Changes in Bronchiolitis Incidence During the Last Two Decades in Tampere, Finland: A Retrospective Study.

BACKGROUND: Bronchiolitis, a lower respiratory tract infection, causes a remarkable number of hospitalizations globally. The epidemiology follows the same pattern as respiratory syncytial virus (RSV), the most common pathogen in bronchiolitis. Epidemics have typically followed a biannual pattern in Nordic countries-first, a small epidemic during spring, followed by a higher peak the next autumn. The aim of this study was to evaluate whether the incidence of bronchiolitis hospitalization has changed during the last 2 decades in Tampere, Finland. METHODS: In this retrospective register-based study, data on infants <12 months of age hospitalized with bronchiolitis in 2000-2019 were collected from electronic files of Tampere University Hospital and analyzed by monthly incidences. Additionally, data on RSV incidences were collected from the Finnish National Infectious Diseases Register for children <5 years of age and living in the study area. Poisson's regression analysis was used to evaluate changes in the incidence rates of bronchiolitis. RESULTS: Of the 1481 infants hospitalized with bronchiolitis, 82.0% had a diagnosis of RSV bronchiolitis. At first, bronchiolitis' epidemiological pattern followed its typical biannual pattern, then shifted to annual in the middle of the study period, and thereafter occurred biannually again. The highest incidence rate ratios compared to the low-incidence months were between December (22.5), January (25.8) and February (25.5) in 2000-2006, and between February (24.7), March (25.1) and April (21.0) in 2007-2019. CONCLUSIONS: The epidemiological pattern of bronchiolitis changed during the study period; incidence peaks were higher and have shifted toward spring in recent years.

Effects of intervention on lifestyle changes among coronary artery disease patients: A 6-month follow-up study.

AIM: The main aim of the study was to investigate the effects of a nurse-led lifestyle-related risk factor modification intervention on multiple lifestyle behaviours among coronary artery disease patients over six months. DESIGN: A pre-test post-test control group design was conducted in a single clinical centre in Nepal. METHODS: A total of 224 eligible patients were randomly assigned to either the usual care group or the intervention group at baseline. The lifestyle intervention consisted of a brief counselling session supplemented with informational leaflets. Standard questionnaires were used to collect self-reported data from patients on multiple lifestyle behaviours: diet, physical activity, adherence to medication, stress, body mass index, smoking and alcohol consumption. General linear model repeated measure analysis was used to estimate the effect of intervention. RESULTS: A statistically significant effect of study group-by-time interaction for diet, adherence to medication, physical activity, and perceived stress was found at 6-month follow-up. Overall, greater improvement in lifestyle habits was found in the intervention group compared with the control group at 6-month follow-up.

Early identification of depressive symptoms in school-aged children: Psychometric properties and validation of a new short version of Short Mood & Feelings Questionnaire.

BACKGROUND: Depressive mood is a common problem among children in Western countries. Professionals in school and other health services have an important role in identifying children at increased risk for depression. The Short Mood and Feelings Questionnaire (SMFQ) is a widely used screening tool, but its 13 items still make it quite time-consuming to complete. There is an urgent need for a quick and easy-to-complete self-report depressive mood scale for use in school health examinations. AIM: This paper aims to describe and validate a revised version of SMFQ: FsMFQ-6 is intended as a short screening tool for the early identification of depressive symptoms in children. METHODS: Nationally representative data (n = 95,725) were drawn from the 2017 School Health Promotion Study. The respondents were fourth- and fifth-grade pupils (aged 10-12) in Finnish primary schools. The data were analysed separately by gender. The construct validity of the scale was studied by principal component analysis and confirmatory factor analysis (CFA), convergent validity by both receiver operating characteristic (ROC) analysis and Spearman's correlation coefficient. Reliability was tested by Cronbach's alpha coefficient. RESULTS: Principal component analysis yielded a one-component model: the Finnish Short Mood and Feelings Questionnaire 6 (FsMFQ-6). CFA confirmed the validity of FsMFQ-6. Compared with mood at home (AUC = 0.80) and mood at school (AUC = 0.85), overall sensitivity and specificity were optimal at cut-off point 0. Cronbach's alpha coefficient was 0.73, indicating good internal consistency. The results for girls and boys were almost identical. CONCLUSION: The results confirmed the validity and reliability of FsMFQ-6. FsMFQ-6 recognises depressive mood in children and is suitable for screening depressive symptoms in fourth- and fifth-grade pupils in Finland. However, it is important to pay close attention to children who choose the 'Sometimes' response option more than once, for that can be a sign of depressive symptoms.

Associations between Perceived Child-Parent Relationships and School Engagement among 9-11 Aged Children.

School engagement has been shown to protect students from dropping out of education, depression and school burnout. The aim of this Finnish study was to explore the association between child-parent relationships and how much 99,686 children aged 9-11 years liked school. The data were based on the 2019 School Health Promotion Study, conducted by the Finnish Institute for Health and Welfare. This asked children whether they liked school or not and about their child-parent relationships. Univariate and multivariate analyses were used to examine the data separately for boys and girls and the results are presented as odds ratios (OR) and 95% confidence intervals (CI). According to the results, girls showed more school engagement than boys (81.9% versus 74.0%), and it was more common in children who felt that their parents communicated with them in a supportive way. This association was slightly stronger for girls than boys (OR 2.46 95% CI 2.33-2.59 versus OR 2.10 95% CI 2.02-2.20). It is important that child-parent relationships and communication are considered during school health examinations, so that children who have lower support at home can be identified.

Self-Reported School Difficulties and the Use of the School Nurse Services by Adolescent Students.

Adolescents are increasingly finding school difficult and physical, mental and social problems increase the risk of exclusion. School health services help to identify problems and prevent them from escalating and the school nurse should be consulted when children are struggling academically. This study explored associations between school difficulties and the use of school health nurse services by 73,680 comprehensive school students with median age of 15.3. The study was based on nationally representative data from the 2017 Finnish School Health Promotion study and analyzed by gender. Difficulties in schooling were common and ranged from 9.9-32.7%. Girls reported difficulties more frequently than boys. Having self-reported difficulties was associated with greater use of school health nurse services, with girls seeking help more often than boys with similar issues and more boys saying they had no need for services. In addition, more self-reported difficulties with schooling were associated with unmet need for school health nurse services. School difficulties were associated with greater use of the school health nurse service use when the data were controlled for background factors. This study highlights shortcomings in access to school health nurse services by children with self-reported school difficulties and that girls were more likely report problems and seek help.

Effects of dietary counselling on micronutrient intakes in pregnant women in Finland.

The intake of some micronutrients is still a public health challenge for pregnant women in Finland. This study examined the effects of dietary counselling on micronutrient intakes among pregnant women at increased risk of gestational diabetes mellitus in Finland. This study utilised data from was a cluster-randomised controlled trial (n = 399), which aimed to prevent gestational diabetes. In the intervention group, the dietary counselling was carried out at four routine visits to maternity care and focused on dietary fat, fibre and saccharose intake. A validated 181-item food frequency questionnaire was used for evaluating the participants' food consumption and nutrient intakes. The differences in changes in micronutrient intakes from baseline (pre-pregnancy) to 36-37 weeks' gestation were compared between the intervention and the usual care groups using multilevel mixed-effects linear regression models, adjusted for confounders. Based on the multiple-adjusted model, the counselling increased the intake of niacin equivalent (coefficient 0.50, 95% confidence interval [CI] 0.03-0.97), vitamin D (0.24, CI 0.05-0.43), vitamin E (0.46, CI 0.26-0.66) and magnesium (5.05, CI 0.39-9.70) and maintained the intake of folate (6.50, CI 1.44-11.56), from early pregnancy to 36 to 37 weeks' gestation. Except for folate and vitamin D, the mean intake of the micronutrients from food was adequate in both groups at baseline and the follow-up. In conclusion, the dietary counselling improved the intake of several vitamins and minerals from food during pregnancy. Supplementation on folate and vitamin D is still needed during pregnancy.

Effects of a lifestyle-related risk factor modification intervention on lifestyle changes among patients with coronary artery disease in Nepal.

OBJECTIVE: To investigate the effect of a lifestyle-related risk factor modification intervention on coronary artery disease (CAD) patients' lifestyle changes. METHOD: A randomized controlled study was conducted in Nepal. A total of 224 CAD patients (112 in each study group) were included at baseline, and 196 patients (98 in each group) completed the one-month follow-up. Patients in the intervention group (IG) received nurse-led intervention in addition to the usual care. Face-to face and telephone interview was conducted using standard questionnaires to collect data on lifestyle-related risk factors; smoking, alcohol consumption, diet, body mass index, stress, adherence to medical therapy, and physical activity. General linear model repeated measure analysis was used to analyse the effects of the intervention. RESULTS: Based on self-reported data we found significant improvement in lifestyle-related risk factor habits in the IG compared with the usual care group with respect to diet (p < 0.001), physical activity (p < 0.001), medication adherence (p < 0.001) and stress (p < 0.001) at one-month follow-up. CONCLUSION: Lifestyle-related risk factor modification intervention can positively influence health risk habits, even when it is less intensive but supplemented with information leaflets. PRACTICAL IMPLICATIONS: Nurse-led one-time intervention may successfully deliver counselling to improve healthy lifestyle among underserved CAD patients.

Association of Income With the Incidence Rates of First Psychiatric Hospital Admissions in Finland, 1996-2014.

Importance: The association between income and mental health has long been a question of interest. Nationwide register data provide means to examine trends and patterns of these associations. Objectives: To compare income-specific trends in the incidence rates of first psychiatric hospital admissions and to evaluate whether an income gradient exists in the incidence rates at all levels of household income. Design, Setting, and Participants: This population-based open cohort study used linked registry data from nationwide Finnish Hospital Discharge and Statistics Finland population registers to determine annual incidence rates of first psychiatric hospital admissions. All Finnish citizens (N = 6 258 033) living in the country at any time from January 1, 1996, through December 31, 2014, contributed to 96 184 614 person-years at risk of first inpatient treatment for mental disorders. The analyses were conducted from August 1, 2018, through September 30, 2019. Exposures: Equivalized disposable income, sex, age group, reduction in income decile in the previous 3 years, urbanicity, educational level, and living alone status. Main Outcomes and Measures: Annual percentage changes in the age-standardized incidence rates and incidence rate ratios (IRRs). Results: Altogether, 186 082 first psychiatric inpatient treatment episodes occurred (93 431 [50.2%] men), with overall age-standardized incidence rates per 1000 person-years varying from 1.59 (95% CI, 1.56-1.63) in 2014 to 2.11 (95% CI, 2.07-2.15) in 2008. In the highest income deciles, a continuous mean decrease per year of 3.71% (95% CI, 2.82%-4.59%) in men and 0.91% (95% CI, 0.01%-1.80%) in women occurred throughout the study period, in contrast to the lowest deciles, where the trends first increased (1.31% [95% CI, 0.62%-2.01%] increase in men from 1996 to 2007 and 5.61% [95% CI, 2.36%-8.96%] increase in women from 1996 to 2001). In the adult population, an income gradient was observed at all levels of household income: the lower the income decile, the higher the adjusted IRRs compared with the highest decile. The IRRs in the lowest decile varied from 2.94 (95% CI, 2.78-3.11) to 4.46 (95% CI, 4.17-4.76). In other age groups, the gradient did not persist at the highest income deciles. Diagnosis-specific income gradient was steepest in schizophrenia and related psychotic disorders, with estimated IRRs of the lowest income decile of 5.89 (95% CI, 5.77-6.02). Conclusions and Relevance: In this cohort study, clear negative income gradient in the incidence rates of first hospital-treated mental disorders was observed in the adult population of Finland. These findings suggest that reduction in the use of inpatient care has not taken place equally between different income groups.

Lifestyle-related risk factors among patients with coronary artery disease in Nepal.

BACKGROUND: Coronary artery disease (CAD) is the leading cause of death and morbidity globally. South Asia, including Nepal, has higher risks for CAD due to relatively higher exposures to risk factors. This study evaluated the prevalence of lifestyle-related risk factors and the associations of risk factors with socio-demographic variables among CAD patients. METHODS: A cross-sectional study was conducted among CAD patients (n = 224) admitted to a national heart centre in Nepal. Data on dietary habits, smoking, alcohol consumption, stress, physical activity, overweight or obesity and adherence to medication were collected using standard questionnaires. The numbers of risk factors were categorised into three groups (1-2 = low, 3 = medium, 4-7 = high). Data analysis was performed by cross-tabulation and multinomial logistic regression. Prevalence odds ratios (POR) and their 95% confidence intervals (CIs) were used as the measure of the associations. RESULTS: The prevalence of risk factors among patients varied from 23% to 97%, with stress being the most prevalent, and current alcohol consumption the least. The majority of study patients had multiple lifestyle-related risk factors. Male patients (POR for medium vs. low 2.83; 95% CI 1.3, 6.18) and patients with high incomes (POR for high vs. low 2.53; 95% CI 1.10, 5.83) had higher odds of being in the medium- and high-risk group, respectively. CONCLUSIONS: Lifestyle-related risk factors were highly prevalent among CAD patients. Various socio-demographic variables were associated with the risk groups. Intervention studies on lifestyle risk factor modifications among this target group are recommended.

The relationship between peer relations, self-rated health and smoking behaviour in secondary vocational schools.

AIMS: To examine the association between peer relations, self-rated health and smoking behaviour in vocational school setting. BACKGROUND: Smoking in adolescence causes health and socioeconomic inequality in adulthood. There is evidence that smokers are physically less active, have lower academic aspirations and perceive poorer health than non-smokers. METHOD: The study was conducted in spring 2013 and involved 34,776 vocational students who took part in the School Health Promotion Study in Finland. The associations between adolescent smoking habits and peer relations and smokers' self-rated health were studied adjusting for the respondents' age, parental education and family type. RESULTS: A substantial proportion of the respondents, 37% of the girls and 36% of the boys, reported smoking daily, 15% of the girls and 14% boys smoked occasionally with a further 15% of the girls and 13% of the boys stating that they were ex-smokers. Of the girls, 33% and 38% of the boys were non-smokers. Adjusted multinomial regression revealed that having a close friend or friends predicted smoking among girls and boys. Additionally, the adjusted model indicated that being a bully and/or a bully + bully-victim was associated with smoking behaviour in boys only. Boys and girls who rated their health as moderate or poor were more often daily smokers; in girls, this was also the case in occasional smokers. CONCLUSION: Smoking prevention aimed at vocational schools should take into consideration the norms and expectations related to peer relations which strongly influence adolescents' smoking habits.

Factors related to self-rated health and life satisfaction one year after radical prostatectomy for localised prostate cancer: a cross-sectional survey.

BACKGROUND: Localised prostate cancer affects patient's quality of life in many ways. The aim of this study was to explore factors related to self-rated health and life satisfaction for patients treated for prostate cancer, and to compare the results of these generic quality-of-life measures to the prostate cancer-specific quality-of-life measure (UCLA Prostate Cancer Index), which focuses on physical functioning. MATERIAL AND METHODS: This cross-sectional survey was carried out among 183 men who underwent radical prostatectomy in 2012-2015 at a university hospital in Finland and were seen 1 year postsurgery. Approval from an ethics committee and written consents from participants were received. A questionnaire was used to evaluate patients' perceived quality of life. Logistic regression model, Spearman's correlation, Kruskal-Wallis test and Mann-Whitney U-test were used to analyse factors related to quality of life. RESULTS: Of the 183 men in the study, 63% rated their health status as good, and 70% were satisfied with their lives after prostatectomy. Older age and better urinary function were the only factors that explained both better self-rated health and better satisfaction with life. The patients seemed not to interpret problems with sexual function as health-related problems. In our sample, sexual dysfunction was relatively severe, but patients considered them to be less harmful than urinary or bowel symptoms. Interestingly, 24% of the men with low sexual function did not find that dysfunction bothersome. CONCLUSIONS: Objectively measured physical functioning is not necessarily in line with patients' experienced satisfaction with life and their self-ratings of health. More longitudinal and qualitative research is needed about the meanings that patients attach to physical treatment side effects and the extent to which they can adapt to them over time. With a bigger sample and longer follow-up time, it would be possible to identify men who particularly benefited from pretreatment counselling.

Self-rated health, symptoms and health behaviour of upper secondary vocational students by field of study.

This article examines the self-rated health, symptoms and health behaviour of upper secondary vocational students in Finland. The data consist of the responses of first- and second-year vocational students (n = 34 554) to the 2013 School Health Promotion Survey. The data were analysed statistically and processed separately for girls and boys. Associations between self-rated health, symptoms and health behaviour and fields of study were examined by cross-tabulation. Statistical significance was measured using the chi-squared test. Self-rated health, symptoms and health behaviour were found to have a statistically significant association with field of study (p < 0.001). Vocational students in different fields had different experiences of health, different symptoms and different health behaviours. The results complement existing evidence about disparities in well-being among young people in the context of education.

Occurrence and Recovery of Different Neglect-Related Symptoms in Right Hemisphere Infarct Patients during a 1-Year Follow-Up.

OBJECTIVES: To examine the occurrence of and recovery from visual neglect-related symptoms with the focus on neglect laterality, ipsilateral orienting bias, and slowed processing speed in right hemisphere (RH) infarct patients during a 1-year follow-up. Furthermore, to propose guidelines for assessing processing speed alongside the Behavioural Inattention Test (BIT). METHODS: We studied three RH patient groups: neglect (N+), mild left inattention (MLI+), and non-neglect (N-) patients, and healthy controls. The BIT with some additional analyses was conducted at the acute phase and at 6 and 12 months. RESULTS: The N+ group's BIT score increased and originally lateralized omissions became more evenly distributed during the follow-up. The N+ and MLI+ groups' starting points were more rightward located than the healthy group's at the acute phase and at 6, and partly at 12 months. Patient groups were slower than the controls in performing cancellation tests at the acute phase. The N+ and MLI+ groups remained slower than the controls throughout the follow-up. CONCLUSIONS: During the first year after RH infarct, originally left-sided manifestation of neglect shifted toward milder non-lateralized attentional deficit. Ipsilateral orienting bias and slowed processing speed appeared to be rather persistent neglect-related symptoms both in neglect patients and patients with initially milder inattention. We propose some effortless, tentative ways of examining processing speed and ipsilateral orienting bias alongside the BIT to better recognize these neglect-related symptoms, and highlight the need to assess and treat patients with initially milder inattention, who have been under-recognized and under-treated in clinical work. (JINS, 2018, 24, 617-628).

Loneliness in Professional Caring Relationships, Health, and Recovery.

This study investigated patients' experiences of loneliness in professional caring relationships and their associations with perceived recovery, health, psychological distress, and general loneliness in life. The sample consisted of 406 patients who had undergone breast cancer or heart surgery 6 months earlier. The data were collected in May 2014-March 2015 using a postal survey including the Caring Loneliness Scale (CARLOS), questions concerning perceived health and recovery, 12-item General Health Questionnaire (GHQ-12), and a question concerning perceived general loneliness in life. Data analysis was done using Mann-Whitney U test and Kruskal-Wallis test. The variables showing a statistically significant association with professional caring loneliness were perceived health, recovery, psychological distress, and general loneliness in life. It is necessary for health care professionals to identify the phenomenon of this dimension of loneliness because it is bound to affect patients' experiences. Further studies with different patient groups are required.