•Finland had a different drug profile compared to the other countries.•Opioids were the main cause of death among fatal poisoned drug addicts in all countries.•Cocaine and MDMA deaths increased in ...all countries.•Sweden saw a high number of deaths from fentanyl analogues.•New psychoactive substances have emerged in all countries except Iceland.
This study is the seventh report on fatal poisonings among drug addicts in the Nordic countries. In this report, we analyse data from the five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden. Data on gender, number of deaths, places of deaths, age, main intoxicants and substances detected in blood were recorded to obtain national and comparable Nordic data, and to allow comparison with earlier studies conducted in 1984, 1991, 1997, 2002, 2007 and 2012.
The death rate (number of deaths per 100,000 inhabitants) was highest in Iceland (6.58) followed closely by Sweden (6.46) and then lowest in Denmark (4.29). The death rate increased in Finland (5.84), Iceland and Sweden and decreased in Denmark compared to earlier studies. The death rate in Norway, which has decreased since 2002, has stabilised around 5.7 as of 2017. Women accounted for 7–23% of the fatal poisonings. The percentage was lowest in Iceland and highest in Finland and Norway. The age range was 14–70 years. The median age (41 years) was highest in Denmark and Norway. The other countries had a median age between 33 and 35 years.
Opioids were the main cause of death. Methadone remained the main intoxicant in Denmark, while heroin/morphine was still the main intoxicant in Norway, as was buprenorphine in Finland. However, the picture has changed in Sweden compared to 2012, where heroin/morphine caused most deaths in 2017. Sweden also experienced the highest number of deaths from fentanyl analogues (67 deaths) and buprenorphine (61 deaths). Deaths from fentanyl analogues also occurred in Denmark, Finland and Norway, but to a smaller extent. Over the years, the proportion of opioid deaths has decreased in all countries except Sweden, which has experienced an increase. This decline has been replaced by deaths from CNS stimulants like cocaine, amphetamine and methylenedioxymethamphetamine (MDMA). Cocaine deaths have occurred in all countries but most frequently in Denmark. MDMA deaths have increased in all countries but mostly in Finland.
Poly-drug use was widespread, as seen in the earlier studies. The median number of detected drugs per case varied from 4–6. Heroin/morphine, methadone, buprenorphine, cocaine, amphetamine, methamphetamine, MDMA, tetrahydrocannabinol (THC) and benzodiazepines were frequently detected. Pregabalin and gabapentin were detected in all countries, especially pregabalin, which was detected in 42% of the Finnish cases. New psychoactive substances (NPS) occurred in all countries except Iceland.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Aim
Organisation of care, perinatal and neonatal management of very preterm infants in the Nordic regions were hypothesised to vary significantly. The aim of this observational study was to test this ...hypothesis.
Methods
Information on preterm infants in the 21 greater healthcare regions of Denmark, Finland, Iceland, Norway and Sweden was gathered from national registers in 2021. Preterm birth rates, case‐mix, perinatal interventions, neonatal morbidity and survival to hospital discharge in very (<32 weeks) and extremely preterm infants (<28 weeks of gestational age) were compared.
Results
Out of 287 642 infants born alive, 16 567 (5.8%) were preterm, 2389 (0.83%) very preterm and 800 (0.28%) were extremely preterm. In very preterm infants, exposure to antenatal corticosteroids varied from 85% to 98%, live births occurring at regional centres from 48% to 100%, surfactant treatment from 28% to 69% and use of mechanical ventilation varied from 13% to 77% (p < 0.05 for all comparisons). Significant regional variations within and between countries were also seen in capacity in neonatal care, case‐mix and number of admissions, whereas there were no statistically significant differences in survival or major neonatal morbidities.
Conclusion
Management of very preterm infants exhibited significant regional variations in the Nordic countries.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
•Energy poverty measurement developed for the Nordic context.•Objective and subjective energy poverty occurs in different housing settings.•Heat pumps and solid wood heating alleviate energy poverty ...risk in Finland.•Women, families with children and households using oil heating are more vulnerable.
Vulnerability to energy poverty occurs when a household has difficulties to meet adequate energy service levels. Recent energy crises manifested the consequences of energy vulnerability also in the Nordic countries. This study brings evidence on energy poverty in Finland, using a large household energy survey dataset (N = 4,295). The ten-per-cent limit threshold is used to measure objective energy vulnerability and the subjective measure is based on the regularity of households’ self-assessed psychological burden regarding their energy expenditures. In our dataset, 18 % of households in detached and semi-detached houses were objectively energy poor and 27 % felt a regular energy-cost burden. Heating type, building age, education level and gender were significant determinants. Ownership of a ground-source heat pump and usage of solid wood reduces winter energy poverty in Finland. Women, particularly in older age groups were significantly more vulnerable than men. For some groups, objective and subjective measurement produced distinctively different results. Households using oil heating in a hybrid heating arrangement were more vulnerable in the objective measurement but they did not feel a similar subjective energy cost burden. Families with children felt subjectively more burdened by their energy expenses than other groups, but they were not more energy-poor along the objective measurement. This is one of the first energy vulnerability studies based on large amount of citizen survey data in Finland and we recommend that further research focuses particularly on how different social groups can access and use different heating installations as this is a key determinant of energy vulnerability in countries with substantial domestic heating energy needs.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Purpose
To evaluate the clinical features, diagnostic challenges, management, and prognosis of sebaceous carcinoma (SC) of the eyelids and periocular region in a Nordic country.
Methods
Patients were ...identified from the Finnish Cancer Registry and the Helsinki University Hospital databases during the 21‐year period 1998–2018. Age, sex, location, clinical and histopathologic diagnosis, treatment and outcome were registered.
Results
Sebaceous carcinoma (SC) was diagnosed in 32 patients. The incidence was 0.6 per million. Median age at the time of histopathologic diagnosis was 74 years, and 72% of patients were women. Diagnostic delay was often long, median 12 months. The most common cause for delay was misdiagnosis (72%): a chalazion in 34% and a benign tumour in 22%. The most common location was the upper eyelid (53%) and tumour type a solitary nodule (94%). The SC was not correctly diagnosed in 12 (40%) of 30 preoperative biopsies. The treatment for 31 (97%) patients was complete surgical removal with reconstruction. Conjunctival intraepithelial growth was found in 50%. The leading postoperative problem was ocular irritation (30%). During a median follow‐up of 58 months, two patients (6%) experienced a local recurrence and one patient died from metastatic SC.
Conclusions
The estimated incidence of SC in Finland was somewhat higher than in other Western countries. The diagnosis was often markedly delayed. Especially differentiation from chalazion continues to be essential. To improve outcomes, it is essential to inform the pathologist about the possibility of SC in eyelid biopsies and specimens and ideally submit them to an ophthalmic pathology service.
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DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UILJ, UKNU, UL, UM, UPUK
Frost-retted hemp fibers were investigated to assess their suitability for composite applications. Chemical analysis of frost-retted hemp fibers highlighted a high amount of solubles (pectins) at the ...fibers surface and a low lignin content in the fibers that was attributed to an unfavorable synthesis of lignin in the cell wall due to the particularly cold temperature during hemp growth in the Nordic countries. The fibers tensile properties were considered at two different scales and the performances of hemp/PLA composites were assessed. Recommendations were provided for the use of frost-retted hemp fibers in the reinforcement of thermoplastic composites.
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BFBNIB, GIS, IJS, KISLJ, NUK, PNG, UL, UM, UPUK
Responsible management education (RME) has become a common initiative in the educational discourse of business schools worldwide. However, little is known about how (non‐)engagement with RME in the ...past influenced the way RME is organised today. We examine this in one of the pioneering countries of RME, Finland, using extensive qualitative research materials. Our results suggest that RME has been embedded with authenticity‐driven change (local context and research) since the 1990s. In the late 2000s after the legal educational reforms implemented in Finland, the prestige‐driven change (accreditations) began to shape the embedding of RME. In the 2020s, both the authenticity‐ and prestige‐driven changes with vertical and horizontal RME, respectively, often appear as hybrids. This article discusses both the weaknesses and strengths of these approaches in embedding RME.
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FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Falls remain the second leading cause of injury-related deaths worldwide; therefore, longstanding practical fall-prevention efforts are needed. Falls can also lead to a reduction in independence and ...quality of life among older adults. Fall-prevention research has found that early prevention promotes a prolonged independence. However, it remains unknown which intervention is most beneficial for early prevention and how these interventions should be implemented for long-term effects. In addition, the present and future burden on social and healthcare services contributes to a gap in needs and requires an evidence-based fall prevention. Research suggests that strength, balance, and functional training are effective in reducing falls and fall-related injuries. Such training could greatly impacting independence. Fear of falling and strategies for managing falls are the suggested components to be included when evaluating fall-prevention programs. Thus, the preservation of physical functions is highly relevant for both independence and quality of life. It also contributes to psychological and social well-being, which are important factors for enabling individuals to stay at home for as long as possible. To meet future challenges associated with the expected increase in the older population, older adults should be viewed as a golden resource. With assistance from professionals and researchers, they can learn and gain the ability to institute fall-prevention programs in their own environments. These environments are primarily beyond the responsibilities of the healthcare sector. Therefore, programs comprising current knowledge about fall prevention should be developed, evaluated, and implemented with older adults by using a "train-The-trainer" approach, where a natural collaboration is established between civil society and/or volunteers, healthcare professionals, and researchers. For sustainable and effective fall-prevention programs, a co-design and early collaborative approach should be used in the natural environment, before social and healthcare services are required.
Suffering from a contested illness poses a serious threat to one’s identity. We analyzed the rhetorical identity management strategies respondents used when depicting their health problems and lives ...in the context of observed or suspected indoor air (IA) problems in the workplace. The data consisted of essays collected by the Finnish Literature Society. We used discourse-oriented methods to interpret a variety of language uses in the construction of identity strategies. Six strategies were identified: respondents described themselves as normal and good citizens with strong characters, and as IA sufferers who received acknowledge from others, offered positive meanings to their in-group, and demanded recognition. These identity strategies located on two continua: (a) individual- and collective-level strategies and (b) dissolved and emphasized (sub)category boundaries. The practical conclusion is that professionals should be aware of these complex coping strategies when aiming to interact effectively with people suffering from contested illnesses.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK, VSZLJ
The purpose of this study was to examine femicide cases in Iceland, which is a small Nordic welfare society. Cases of femicide were explored during a 30-year time period from 1986-2015. Femicide was ...defined as the murder of a woman by a partner, former partner or related to passion. Verdicts and news of the incidents were analysed. Verdicts were found using the search machine Fons Juries, run by a private legal company, which collected all verdicts from the Supreme Court from 1920, and all verdicts from the district courts existing in electric form. News that included murders of women was collected from websites of the main newspapers in Iceland. Eleven women were killed during this time period according to the definition used in this study. Most of the incidents happened in the home of the perpetrator, victim or both. Nearly all of them took place during the night or in the evening during weekends, with more incidents occurring during cold and dark months than brighter and warmer months. All of them took place in the capital city or in that area. Strangulation was the most common murder method, followed by stabbing the woman with a knife. Only one woman was shot, and that perpetrator was the only one who killed himself afterward. The mean age of the perpetrators was 29. Most of them had a low level of education or their education was unknown, and had a low paying job. Two-thirds of them were under the influence of alcohol and/or drugs when the incident happened and the majority had a psychiatric problem, mainly personality disorders or symptoms of such disorders, such as antisocial personality disorder. Even though it is rare, femicide incidents do exist in a small Nordic welfare society such as Iceland, despite an extensive welfare policy and gender equality.
The purpose of this study was to examine femicide cases in Iceland, which is a small Nordic welfare society. Cases of femicide were explored during a 30-year time period from 1986-2015. Femicide was ...defined as the murder of a woman by a partner, former partner or related to passion. Verdicts and news of the incidents were analysed. Verdicts were found using the search machine Fons Juries, run by a private legal company, which collected all verdicts from the Supreme Court from 1920, and all verdicts from the district courts existing in electric form. News that included murders of women was collected from websites of the main newspapers in Iceland. Eleven women were killed during this time period according to the definition used in this study. Most of the incidents happened in the home of the perpetrator, victim or both. Nearly all of them took place during the night or in the evening during weekends, with more incidents occurring during cold and dark months than brighter and warmer months. All of them took place in the capital city or in that area. Strangulation was the most common murder method, followed by stabbing the woman with a knife. Only one woman was shot, and that perpetrator was the only one who killed himself afterward. The mean age of the perpetrators was 29. Most of them had a low level of education or their education was unknown, and had a low paying job. Two-thirds of them were under the influence of alcohol and/or drugs when the incident happened and the majority had a psychiatric problem, mainly personality disorders or symptoms of such disorders, such as antisocial personality disorder. Even though it is rare, femicide incidents do exist in a small Nordic welfare society such as Iceland, despite an extensive welfare policy and gender equality.
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