Cross-sectional study of the associations between the implementation of the WHO FCTC tobacco advertising, promotion and sponsorship bans and current e-cigarette use among youth from countries with different income levels.

BACKGROUND: The WHO Framework Convention on Tobacco Control (WHO FCTC) Article 13 requires countries to ban tobacco advertising, promotion and sponsorship (TAPS), and bans are recommended to cover electronic cigarettes (e-cigarettes). We examined youth e-cigarette prevalence by TAPS regulations in countries with different income levels. METHODS: We analysed data on 165 299 respondents from 48 countries with 2016/2018 WHO FCTC implementation reports and 2016-2019 Global Youth Tobacco Survey. We used multilevel logistic regressions to examine associations between TAPS regulations and current e-cigarette use, stratified by country income. RESULTS: About 1 in 10 respondents was currently using e-cigarettes. Respondents in countries with TAPS bans on the internet were less likely to use e-cigarettes (adjOR=0.58; 95% CI 0.39 to 0.86) than youth in countries without such bans. In lower middle-income and low-income countries, bans on displaying tobacco products at the point of sale (adjOR=0.55; 95% CI 0.34 to 0.90), bans on product placement (adjOR=0.44; 95% CI 0.28 to 0.69) and strength of additional TAPS measures were associated with lower prevalence of e-cigarette use among students. Being taught about the dangers of the use of tobacco in school was associated with lower odds of e-cigarette use. No differences in the use of e-cigarettes were observed by types of TAPS among respondents in high-income countries. CONCLUSIONS: Strengthening implementation of TAPS policies and assuring they cover new and emerging products, online channels and points of sales are essential, especially in lower income countries. Maintaining tobacco health education is also important to protect youth from e-cigarette use.

Implementation of the Article 13 WHO FCTC measures and changes in cigarette smoking among youth in 42 countries.

INTRODUCTION: Despite a decline in global smoking prevalence among adolescents, around 21 million youth report current cigarette smoking. Exposure to tobacco advertising, promotion and sponsorship (TAPS) is a risk factor for smoking initiation, and therefore the Article 13 of the WHO Framework Convention on Tobacco Control (WHO FCTC) requires comprehensive TAPS bans. We examined the associations between changes in youth cigarette smoking and implementation of Article 13. METHODS: We used two rounds of cross-sectional data from the Global Youth Tobacco Survey (GYTS) for 42 countries: first between 2006 and 2015, and second between 2017 and 2020. The GYTS data were linked with the WHO FCTC implementation reports from 2016 and 2018. The outcome was current smoking. Multilevel binary logistic regression models, stratified by country income level, were used to test the prevalence differences between the latest and previous GYTS rounds and their associations with TAPS bans with postestimations using marginal analyses. RESULTS: The percentage of students currently smoking decreased from 10.0% (95% CI 8.0 to 12.1) to 7.7% (95% CI 6.1 to 9.3) from first to second GYTS rounds (p<0.001), adjusting for country clustering. In low-income and lower-middle-income countries, the degree of decrease significantly differed between countries with versus without bans on display, partial internet TAPS ban, ban on depiction of tobacco products and by number of TAPS measures, adjusting for age and sex of the respondents. In high-income and upper-middle-income countries, the degree of decrease significantly differed by presence (or absence) of partial or full internet TAPS ban, ban on product placement and by number of TAPS measures. CONCLUSION: Implementation of TAPS bans is associated with decreased smoking among adolescents both in high-income and low-income countries. Enhanced and continuous efforts are necessary to protect youth from the promotion of tobacco and nicotine products.

Trends of fall-related and other fatal injuries in older adults in Finland between 1998 and 2020.

BACKGROUND: The number of falls and fall-related injuries will likely increase as the number of older adults expands. Increases in total deaths due to falls have been observed over Europe. Less is known about other injuries leading to death.To examine the incidence trends of fall-related and other fatal injuries among adults aged 65 or older in Finland. METHODS: We analyzed open data from Statistics Finland's register on the causes of death of those aged ≥65 collected between 1998 and 2020 yielding a total of 32 150 deaths due to injury using Poisson regression and distributional comparisons chi-squared tests. RESULTS: The most common injuries leading to death among people aged ≥65 in Finland were fall related. There has been an increase in the absolute number of fall-related and other injuries, but when adjusting for person-years in population, a significant decrease can be observed. The crude rates of deaths from fall-related injuries among males annually increased 1.1-4.4% from 1998 to 2020, while the changes in rates among females ranged between -2% and 1.6%. The crude rates of other injuries ranged between -0.5% to +3.8%. Recently (2018-20), nearly 40% of the cases in males and 25% of cases in females were not fall related but comprised other types of injury mechanisms such as traffic, poisoning and drowning. CONCLUSION: Strengthening the implementation of preventive strategies is essential to prevent injuries. To reduce injury-related mortality and disability, improvement of acute and post-acute care for injured older patients is warranted.

Nursing interventions in preventing pressure injuries in acute inpatient care: a cross-sectional national study.

BACKGROUND: Several nursing interventions for pressure injury prevention have been identified, including risk and skin status assessment. The aim of this study was to explore prevention of pressure injuries in Finnish acute inpatient care. The data were collected on pressure injury risk and skin status assessments, repositioning, the use of support surfaces, preventive skin care, malnutrition risk assessment, and nutritional care. METHODS: This multicentre, cross-sectional study was conducted in 16 acute care hospitals, excluding psychiatric care. Adult patients from inpatient care were recruited on the annual international Stop Pressure Ulcers Day in 2018 and 2019. Enrolment covered 6,160 participants in 503 units. Descriptive statistics were used to describe pressure injuries, risk assessments, and preventive nursing interventions. Cross tabulation, Pearson's chi-square and Fisher's exact tests were also used. Reporting follows the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. RESULTS: In all, 30% of the participants had their pressure injury risk assessed during the care, and for 19% within 8 h after admission. The same time limit in risk assessment was fulfilled for 16% of the participants with a pressure injury, and 22% of the participants using a wheelchair or being bedridden. A skin status assessment within 8 h after admission was conducted for 30% of all participants, and for 29% of the participants with a pre-existing pressure injury, and for 38% of the participants using a wheelchair or being bedridden. The risk of malnutrition was screened in 20% of the participants. Preventive interventions were targeted to participants with a pressure injury instead of patients with a high-pressure injury risk. CONCLUSION: This study adds evidence about pressure injury risk assessments and the implementation of preventive nursing interventions in Finnish acute care. Skin status and pressure injury risk assessments were irregularly conducted, and the outcome was not used by nurses to guide the implementation of preventive interventions. The results reveal the gaps in evidence-based nursing practice, which require further efforts to prevent pressure injuries. Improving the national focus on pressure injury prevention practice is critical for improving healthcare for our patients.

Pressure injury prevalence and incidence in acute inpatient care and related risk factors: A cross-sectional national study.

The aim of this national cross-sectional study was to explore the prevalence of pressure injuries and incidence of hospital-acquired pressure injuries, and the relating factors in somatic-specialised inpatient care in Finland. The study was conducted in 16 (out of 21) Finnish health care organisations offering specialised health care services. Data were collected in 2018 and 2019 from adult patients (N = 5902) in inpatient, emergency follow-up, and rehabilitation units. Pressure injury prevalence (all stages/categories) was 12.7%, and the incidence of hospital-acquired pressure injuries was 10%. Of the participants, 2.6% had at least one pressure injury at admission. The risk of hospital-acquired pressure injuries was increased for medical patients with a higher age, the inability to move independently, mode of arrival, being underweight, and the absence of a skin assessment or pressure injury risk assessment at admission. For surgical patients, the risk was associated with the inability to move independently, mode of arrival, and lack of skin assessment at admission, while being overweight protected the patients. Overall, medical patients were in greater risk of hospital-acquired pressure injuries than the surgical patients. An assessment of the pressure injury risk and skin status should be carried out more systematically in Finnish acute care hospitals.

Good nurse-nurse collaboration implies high job satisfaction: A structural equation modelling approach.

AIMS: To explore the relationship between nurse-nurse collaboration and job satisfaction among hospital nurses and to test and refine a model explaining this relationship. DESIGN: A secondary analysis of a cross-sectional survey. METHODS: Registered nurses (N = 406, female 88%) in one university hospital in Finland and one in Norway completed a self-administered questionnaire in 2015. Structural equation modelling analysis was used to analyse the relationships between collaboration and job satisfaction subscales. RESULTS: The constructed SEM model fit the data well (RMSEA = 0.05, CFI = 0.985, χ2 p-value > 0.1). The model strongly supported the hypothesized covariance between nurse-nurse collaboration and job satisfaction, while significant and positive relationships were observed between most of the subscales. The results suggest that there is a strong association between nurse-nurse collaboration and job satisfaction such that nurses are more satisfied when there is good collaboration and vice versa.

Perceptions on nurse-nurse collaboration among registered nurses in Finland and Norway.

BACKGROUND: Intraprofessional collaboration necessitates understanding and knowledge on how nurses perceive each other and what factors promote good collaboration. The relationship between nurse-nurse collaboration has been explored relatively little, though intraprofessional collaboration is an essential factor for a healthy work environment. AIM: This study explores the Finnish and the Norwegian nurses' perceptions of nurse-nurse collaboration in nursing care and factors associated with those perceptions. DESIGN: A cross-sectional quantitative study design. METHODS: In 2015, data were collected from 406 Finnish and Norwegian RNs in two acute-care hospitals, by employing the Dougherty and Larson's Nurse-Nurse Collaboration Scale (NNCS). Descriptive statistics, cross-tabulations, Pearson's chi-Square tests and multivariate anova were used for analysis. Ethical approval for this study was obtained from ethics committees in both countries. RESULTS: Findings indicated that the perception of nurse-nurse collaboration was good in both countries. However, significant inter-country differences were found in the collaboration subscales. Compared with their Finnish counterparts, Norwegian nurses awarded higher scores to conflict management, communication, shared process, coordination and professionalism. The results suggest that nurse characteristics, such as main working time and total work experience, were related to the perception of collaboration. CONCLUSION: The subscales with the highest scores in both countries were professionalism, shared process and communication. Factors such as conflict management and coordination are areas which should be emphasised to achieve good collaboration between nurses. Here, nurse leaders play an important part in assessing and improving RN-RN collaboration.

Job satisfaction among registered nurses in two Scandinavian acute care hospitals.

AIM: To explore job satisfaction among registered nurses working in acute care hospitals, and to examine which background factors influence registered nurses' total job satisfaction. BACKGROUND: Job satisfaction among registered nurses is important when considering the well-being and retention of registered nurses. Research has shown that registered nurses in different countries experience various levels of job satisfaction. METHOD: In 2015, a total of 406 Finnish and Norwegian registered nurses answered a survey based on the Kuopio University Hospital Job Satisfaction Scale. The collected data were analysed with nonparametric tests and multiple linear analyses. RESULTS: The registered nurses rated motivating factors of work and work welfare highest, while the lowest degrees of job satisfaction were related to requiring factors of work and participation in decision-making. CONCLUSIONS: Registered nurses appreciate their work in both countries, however attention should be paid to work demands and the extent to which registered nurses are involved in decision-making to enhance their job satisfaction. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse leaders should be aware of registered nurses' diverse backgrounds and use this knowledge to recognize registered nurses in need of support. The paths through which registered nurses participate in decision-making should be streamlined and workloads should be regularly assessed so that work is distributed evenly.