L\'{e}vy-based growth models

In the present paper, we give a condensed review, for the nonspecialist reader, of a new modelling framework for spatio-temporal processes, based on L\'{e}vy theory. We show the potential of the approach in stochastic geometry and spatial statistics by studying L\'{e}vy-based growth modelling of planar objects. The growth models considered are spatio-temporal stochastic processes on the circle. As a by product, flexible new models for space--time covariance functions on the circle are provided. An application of the L\'{e}vy-based growth models to tumour growth is discussed.Comment: Published in at http://dx.doi.org/10.3150/07-BEJ6130 the Bernoulli (http://isi.cbs.nl/bernoulli/) by the International Statistical Institute/Bernoulli Society (http://isi.cbs.nl/BS/bshome.htm

Art Teachers’ Education for Environmental Awareness. What is Hidden in Nature that we have never Seen or Heard?

It is argued here that teacher education needs to make a fundamental shift in the types of knowledge and experience that count as valuable for future teachers. The article reflects on some aspects of a weeklong project involving student teachers and 5th grade students that has taken place in the Reykjavik Botanical Garden for the past four years called What is hidden in nature that we have never seen or heard? The project has been a part of the Children’s Cultural Festival. This is a collective project where more than seventy pupils from a neighbourhood school work under the direction of a group of student teachers from the Iceland Academy of the Arts (IAA). The project focuses on the transformative power of education for sustainability (EfS), and participatory pedagogy including critical place-based learning and tacit knowledge. The settings at the Botanical Garden were developed as a part of a pedagogical course taught by the author of this article, aiming to develop the student teachers’ self-efficacy and action competence.In the Botanical Garden the student teachers plan learning settings for the pupils and carry the responsibility for that week in collaboration with the local school. The work is based on their earlier learning in the pedagogical foundation course. The way of working of the student teachers in the Botanic Garden can lead to a mutual fostering of these two concepts in ways that may be expected to promote professional development and tacit knowledge. Acquiring and being able to use the concepts augments the voice of the student teachers and I discuss why such pedagogies are valuable in teacher education

The effect of physical training in chronic heart failure

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenOBJECTIVE: Supervised cardiac rehabilitation programs have been offered to patients following myocardial infarct (MI), coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) for many years. However, limited information is available on the usefulness of rehabilitation programs in chronic heart failure (CHF). The aim of our study was to evaluate the outcome of supervised physical training on CHF patients by measuring both central and peripheral factors. MATERIAL AND METHODS: This was a prospective randomized study, including 43 patients with CHF, New York Heart Association (NYHA) class II or III, mean age 68 years. After initial measurements of V02peak, 6 minute walk distance, muscle strength, plasma levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP), echocardiogram, measurements of pulmonary function and quality of life questionnaire, patients were randomized to either a training group (n=21) or a control group (n=22). The training group had supervised aerobic and resistance training program twice a week for five months. After the training program was completed, all measurements were repeated in both groups. RESULTS: No training related adverse events were reported. Significant improvement was found between groups in the six minute walk test (+37.1 m vs. +5.3 m, p=0.01), work load on the bicycle exercise test (+6.1W vs. +2.1 W, p=0.03), time on the bicycle exercise test (+41 s vs +0 s, p=0.02) and quadriceps muscle strength test (+2.8 kg vs +0.2 kg, 0.003). Quality of life factors that reflect exercise tolerance and general health, improved significantly in the training group compared to the control group. No other significant changes were found between the two groups. CONCLUSION: Supervised physical training as used in this study appears safe for CHF patients in NYHA class II or III. The improvement in functional capacity observed in the training group seems to be related more to increased muscle performance rather than central cardiovascular conditioning.Tilgangur: Hjartaendurhæfing hefur um langt skeið verið boðin sjúklingum eftir kransæðastíflu, kransæðahjáveituaðgerð og kransæðavíkkun. Hins vegar er minna vitað um gagnsemi endurhæfingar hjá hjartabiluðum sjúklingum enda var þeim um tíma ráðið frá líkamlegri áreynslu. Tilgangur þessarar rannsóknar var að meta áhrif hjartaendurhæfingar hjá sjúklingum með hjartabilun. Efniviður og aðferðir: Fjörutíu og þrír sjúklingar með hjartabilun af flokki II eða III samkvæmt New York Heart Association (NYHA) voru rannsakaðir. Upphafsmælingar voru þrekpróf með hámarkssúrefnisupptöku, sex mínútna göngupróf, vöðvastyrksmælingar, blóðmælingar á atrial natriuretic peptide (ANP) og brain natriuretic peptide (BNP), útfallsbrot mælt með hjartaómskoðun, öndunarpróf (spirometria) og spurninga-listi um heilsutengd lífsgæði. Hópnum var síðan slembiraðað í tvo hópa, þjálfunarhóp (n=21) og viðmiðunarhóp (n=22). Þjálfunarhópurinn fékk hjartaendurhæfingu undir umsjá sjúkraþjálfara tvisvar í viku í 5 mánuði. Eftir að þjálfunartímabilinu lauk voru allar mælingar endurteknar í báðum hópunum. Niðurstöður: Engir fylgikvillar tengdir þjálfuninni komu fram. Þjálfunarhópurinn bætti sig meira í 6 mínútna gönguprófi (+37,1 m vs +5,3 m, p=0,01), hámarksálagi á þrekhjóli (+6,1 W vs +2,1 W, p=0,03), tímalengd á þrekhjóli (+41 s vs +0 s, p=0,02) og vöðvastyrk í quadriceps vöðva (+2,8 kg vs 0,2 kg, p=0,003) en viðmiðunarhópurinn. Þeir þættir heilsutengdra lífsgæða sem mældu áreynsluþol og almennt heilsufar bötnuðu marktækt meira í þjálfunarhópnum en viðmiðunarhópnum. Að öðru leyti var ekki munur á milli hópanna í mældum gildum. Ályktun: Hjartaendurhæfingin sem notuð var í þessari rannsókn virðist þolast vel hjá hjartabiluðum sjúklingum í NYHA flokki II og III. Ávinningurinn í áreynsluþoli sem mældist í þjálfunarhópnum virðist skýrast af auknum vöðvastyrk fremur en bættri starfsgetu hjarta og lungna

Living at home with eating difficulties following stroke: a phenomenological study of younger people's experiences.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.AIMS AND OBJECTIVES: To explore and describe the experience of eating and eating-related difficulties in stroke survivors living at home. BACKGROUND: The ability to consume food and to take pleasure in eating is an essential part of life. For people with stroke, eating difficulties are frequent. A phenomenological perspective of stroke survivors' experience of eating difficulties exceeding the acute stroke event and in-hospital rehabilitation is missing. DESIGN: A qualitative study founded on the Husslarian descriptive phenomenology. METHODS: Colaizzi's seven phases of data analysis provided a systematic approach to explore 17 in-depth interviews from seven participants and how eating difficulties influenced their daily lives. RESULTS: Eating difficulties revealed themselves in participants' relationship with the outer world in far-reaching disruptions of habits, capacities and actions. Four key themes illuminating the eating difficulties emerged: (1) preserving dignity by not conveying serious problems, (2) staying vigilant to bodily limitations, (3) stepping out of the security zone and (4) moving on without missing out. The findings exposed that eating difficulties might not only lead to serious consequences such as malnutrition but also, and equally importantly, lead to losses in the existential, social and cultural lifeworld. CONCLUSIONS: The experience of eating difficulties entails an ongoing readjustment process, which is strongly influenced by interactions with other people. The findings suggest that individualised long-term support is needed to facilitated the use of helpful strategies to manage eating difficulties. RELEVANCE TO CLINICAL PRACTICE: The long-term losses that people with eating difficulties experience are not reflected in conventional screening tools and interventions. To avoid haphazard identification presupposes professional knowledge of how eating difficulties are woven into daily life. This knowledge may inform innovative nursing strategies reaching beyond immediate rehabilitation. Partnership-based practice may provide an important framework to establish unique needs and to mobilise relevant actions and resources.Icelandic Nurses Association Research Assistant Fund of the University of Icelan

Hvaða áhrif hefur það að geta ekki tjáð sig um vanlíðan, hjá körlum sem hafa fengið krabbamein í blöðruhálskirtil?

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenMarkmiðið með rannsókninni var að greina þætti sem gætu tengst því hvaða karlar sem greinst hafa með krabbamein í blöðruhálskirtli eru líklegri en aðrir til að upplifa sálræna vanlíðan. Karlar (N=184) sem fengu krabbamein í blöðruhálskirtil á árunum 2001-2005 svöruðu spurningalistum um þunglyndi og kvíða, ágengar hugsanir um krabbameinið og upplifun á félagslegum hömlum á tjáningu. Niðurstöður sýndu að karlar sem höfðu ágengar hugsanir um meinið voru kvíðnari og þunglyndari, en bara ef þeir fundu fyrir miklum félagslegum hömlum eða fannst þeir ekki geta talað við aðra um sjúkdóminn. Af niðurstöðum má draga þá ályktun að karlar, sem hafa fengið blöðruhálskirtilskrabbamein og finnst þeir ekki geta rætt við maka eða vini um áhyggjur sínar varðandi sjúkdóminn, geti haft gagn af íhlutun sem hjálpar þeim að tjá áhyggjur sínar og tilfinningar

Epidemiology and association with outcomes of polypharmacy in patients undergoing surgery: retrospective, population-based cohort study

BACKGROUND: The aim of this study was to determine the prevalence of preoperative polypharmacy and the incidence of postoperative polypharmacy/hyper-polypharmacy in surgical patients and their association with adverse outcomes. METHODS: This was a retrospective, population-based cohort study among patients older than or equal to 18 years undergoing surgery at a university hospital between 2005 and 2018. Patients were categorized based on the number of medications: non-polypharmacy (fewer than 5); polypharmacy (5-9); and hyper-polypharmacy (greater than or equal to 10). The 30-day mortality, prolonged hospitalization (greater than or equal to 10 days), and incidence of readmission were compared between medication-use categories. RESULTS: Among 55 997 patients, the prevalence of preoperative polypharmacy was 32.3 per cent (95 per cent c.i. 33.5 to 34.3) and the prevalence of hyper-polypharmacy was 25.5 per cent (95 per cent c.i. 25.2 to 25.9). Thirty-day mortality was higher for patients exposed to preoperative hyper-polypharmacy (2.3 per cent) and preoperative polypharmacy (0.8 per cent) compared with those exposed to non-polypharmacy (0.6 per cent) (P < 0.001). The hazards ratio (HR) of long-term mortality was higher for patients exposed to hyper-polypharmacy (HR 1.32 (95 per cent c.i. 1.25 to 1.40)) and polypharmacy (HR 1.07 (95 per cent c.i. 1.01 to 1.14)) after adjustment for patient and procedural variables. The incidence of longer hospitalization (greater than or equal to 10 days) was higher for hyper-polypharmacy (11.3 per cent) and polypharmacy (6.3 per cent) compared with non-polypharmacy (4.1 per cent) (P < 0.001). The 30-day incidence of readmission was higher for patients exposed to hyper-polypharmacy (10.2 per cent) compared with polypharmacy (6.1 per cent) and non-polypharmacy (4.8 per cent) (P < 0.001). Among patients not exposed to polypharmacy, the incidence of new postoperative polypharmacy/hyper-polypharmacy was 33.4 per cent (95 per cent c.i. 32.8 to 34.1), and, for patients exposed to preoperative polypharmacy, the incidence of postoperative hyper-polypharmacy was 16.3 per cent (95 per cent c.i. 16.0 to 16.7). CONCLUSION: Preoperative polypharmacy and new postoperative polypharmacy/hyper-polypharmacy are common and associated with adverse outcomes. This highlights the need for increased emphasis on optimizing medication usage throughout the perioperative interval

Implementation and feasibility of the stroke nursing guideline in the care of patients with stroke: a mixed methods study

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked FilesBACKGROUND: Nurses often have difficulties with using interdisciplinary stroke guidelines for patients with stroke as they do not focus sufficiently on nursing. Therefore, the Stroke Nursing Guideline (SNG) was developed and implemented. The aim of this study was to determine the implementation and feasibility of the SNG in terms of changes in documentation and use of the guideline in the care of stroke patients on Neurological and Rehabilitation wards, barriers and facilitators, and nurses' and auxiliary nurses' view of the implementation. METHODS: A sequential explorative mixed method design was used including pre-test post-test measures and post intervention focus groups interviews. For the quantitative part retrospective electronic record data of nursing care was collected from 78 patients and prospective measures with Barriers and Facilitators Assessment Instrument (BFAI) and Quality Indicator Tool (QIT) from 33 nursing staff including nurses and auxiliary nurses. In the qualitative part focus groups interviews were conducted with nursing staff on usefulness of the SNG and experiences with implementation. RESULTS: Improved nursing documentation was found for 23 items (N = 37), which was significant for nine items focusing mobility (p = 0.002, p = 0.024, p = 0.012), pain (p = 0.012), patient teaching (p = 0.001, p = 0.000) and discharge planning (p = 0.000, p = 0.002, p = 0.004). Improved guideline use was found for 20 QIT-items (N = 30), with significant improvement on six items focusing on mobility (p = 0.023), depression (p = 0.033, p = 0.025, p = 0.046, p = 0.046), discharge planning (p = 0.012). Facilitating characteristics for change were significantly less for two of four BFAI-subscales, namely Innovation (p = 0.019) and Context (p = 0.001), whereas no change was found for Professional and Patient subscales. The findings of the focus group interviews showed the SNG to be useful, improving and providing consistency in care. The implementation process was found to be successful as essential components of nursing rehabilitation were defined and integrated into daily care. CONCLUSION: Nursing staff found the SNG feasible and implementation successful. The SNG improved nursing care, with increased consistency and more rigorous functional exercises than before. The SNG provides nurses and auxiliary nurses with an important means for evidence based care for patients with stroke. Several challenges of implementing this complex nursing intervention surfaced which mandates ongoing attention.Icelandic Nursing Association Scientific Fund of Landspitali University Hospital, Reykjavik, Icelan

State and Transition Models in Space and Time – Using STMs to Understand Broad Patterns of Ecosystem Change in Iceland

Managing ecological systems sustainably requires a deep understanding of ecosystem structure and the processes driving their dynamics. Conceptual models can lead to improved management, by providing a framework for organizing knowledge about a system and identifying the causal agents of change. We developed state-and-transition models (STMs) to describe landscape changes in Iceland over three historical periods with different human influence, from pre-settlement to present days. Our models identified the set of possible states, transitions and thresholds in these ecosystems and their changes over time. To illustrate the use of these models for predicting and improving management interventions, we applied our present-day STM to a case study in the central highlands of Iceland and monitored ecosystem changes within an ongoing field experiment with two management interventions (grazing exclusion and fertilization) in areas experiencing contrasting stages of degradation. The results of the experiment broadly align with the predictions of the model and underscore the importance of conceptual frameworks for adaptive management, where the best available knowledge is used to continuously refine and update the models

Quantification of grazing efficacy, growth and health score of different lumpfish (Cyclopterus lumpus L.) families: possible size and gender effects

Postponed access: the file will be available after 2022-09-12To investigate the possible family influence on sea lice grazing of lumpfish on Atlantic salmon, ten families of lumpfish (N = 480) with a mean (± SD) weight of 54.8 ± 9.2 g were distributed among ten sea cages (5 × 5 × 5 m) each stocked with 400 Atlantic salmon with a mean (± SD) weight of 621.4 ± 9.2 g. All the ten cages were stocked with 48 lumpfish (12% stocking density). The stocking of cages was such that each cage consisted of two random families where full- and paternal half-sib families were randomly allocated to the different cages. There were clear differences in sea lice grazing efficacy, growth and cataract prevalence between the ten families assessed in this study. Lumpfish from families 2, 6 and 10 had the lowest mean weights but showed comparable growth rates compared to the other families throughout the study and this may be as a direct result of genetic influence. In addition, fish from these families had a significantly higher incidence of lice grazing of both L. salmonis and C. elongatus compared to the other families. Using mixed linear model to analyse the data revealed significant family and paternal effect on sea lice grazing. There was a trend for a reduction in sea lice grazing with increased size within each family. The results indicated that it was the smallest size classes of lumpfish (40–140 g) which exhibited higher sea lice grazing potential compared to the larger size classes within families. There were no clear differences in the lice grazing potential between male and female lumpfish within and between families. Overall, present findings showed that sea lice grazing of both L. salmonis and C. elongatus can be enhanced using targeted family production and if this behaviour has a genetic basis it may further enhanced through selection and targeted breeding programs.acceptedVersio

A population-based study of stimulant drug treatment of ADHD and academic progress in children.

To access publisher's full text version of this article. Please click on the hyperlink in Additional Links field.We evaluated the hypothesis that later start of stimulant treatment of attention-deficit/hyperactivity disorder adversely affects academic progress in mathematics and language arts among 9- to 12-year-old children. We linked nationwide data from the Icelandic Medicines Registry and the Database of National Scholastic Examinations. The study population comprised 11,872 children born in 1994-1996 who took standardized tests in both fourth and seventh grade. We estimated the probability of academic decline (drop of ≥ 5.0 percentile points) according to drug exposure and timing of treatment start between examinations. To limit confounding by indication, we concentrated on children who started treatment either early or later, but at some point between fourth-grade and seventh-grade standardized tests. In contrast with nonmedicated children, children starting stimulant treatment between their fourth- and seventh-grade tests were more likely to decline in test performance. The crude probability of academic decline was 72.9% in mathematics and 42.9% in language arts for children with a treatment start 25 to 36 months after the fourth-grade test. Compared with those starting treatment earlier (≤ 12 months after tests), the multivariable adjusted risk ratio (RR) for decline was 1.7 (95% confidence interval [CI]: 1.2-2.4) in mathematics and 1.1 (95% CI: 0.7-1.8) in language arts. The adjusted RR of mathematics decline with later treatment was higher among girls (RR, 2.7; 95% CI: 1.2-6.0) than boys (RR, 1.4; 95% CI: 0.9-2.0). Later start of stimulant drug treatment of attention-deficit/hyperactivity disorder is associated with academic decline in mathematicsPfizer Novartis University of Iceland Icelandic Centre for Research (RANNIS