LEO is comprised of local experts who collect observations about unusual environmental events in their communities. They apply local and traditional knowledge, western science and modern technology to record and share observations and to raise awareness about the conditions in the circumpolar north. There are LEO participants in Alaska and Canada in over 100 communities.
Environmental heat is a health risk especially for the elderly and those with a pre-existing disease. Mortality effects of prolonged heat waves in Finland were studied for different age groups, genders, causes of death, and places of death. Mortality due to various causes of death increased significantly in people aged 75 or above. The increase in risk was higher in health care facilities than other places of death. In the future, more efficient mitigation of adverse health effects of heat is needed as the population ages and climate change proceeds. Special attention should be given to the conditions in health care facilities.
The purpose of this article is to describe patients' sleep in hospital. The article is based on a study of patients' sleep in a hospital's medical or surgical ward and to clarify the disturbance factors relating to their sleep. The patients of the Central Hospital of Northern Carelia's two medical and two surgical wards took part in the research. The data were collected by a structured questionnaire and a follow-up questionnaire in May-June 1996. Of the replies of 181 patients, the results of 177 were taken to the final analysis. The data were analysed by statistical methods. The data and the results are presented in frequency and percent distributions, and the background variables of those patients sleeping well and those sleeping poorly are analysed and compared. The results indicated that 65% of the researched patients slept badly in the hospital. Environmental factors were found to be related to most of the patients' sleep disturbances: 80% of them regarded those factors as the cause for their disturbed sleep. Other patients, noise, and the nurses' work were regarded as the most disturbing of the environmental factors. The internal factors had disturbed patients' sleep in the hospital less than the environmental factors. Pain was regarded as the most sleep disturbing internal factor: over half of the researched patients felt disturbed by it. During their stay in the hospital the patients experienced more positive (trust, contentment, safety) than negative feelings (fear, anxiety, depression, distrust), and those who experienced negative feelings had more difficulties in sleeping.
The nurses and the public health nurses identified mostly individuals as the focus of their service although also families and groups are increasingly receiving services. Orientation towards communities or environments is rather rare. The modes of nursing practice of nurses differentiated from each other quite a lot. On the basis of the results two main modes had been identified: organization oriented and people oriented mode. The organization oriented made is somewhat stereotyped, rather guided by rules and regulations than by the needs of people. The people oriented mode is based on the needs of clients. The needs are being assessed openly and by exploring the situation. Client-centred objectives are being established more often and the interventions are better identified than in the organization oriented mode. The interventions are focused to support the resources of the clients f.e. their own thinking processes and other abilities. On the basis of the interviews it seems to be that nursing practice is in the middle of a transition period. The accountability for one's practice is being gradually accepted. Nursing practice is developing to a more individual direction and the viewpoints of people will be better understood.