Patient satisfaction with care and interaction with staff in the Acute Cardiac Unit at Landspitali - The National University Hospital of Iceland.

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinnInngangur: Heilbrigðisþjónusta á Íslandi hefur þótt standa ágætlega í alþjóðlegum samanburði en reynsla sjúklinga af samskiptum við heilbrigðiskerfið hefur ekki mikið verið rannsökuð. Markmið þessarar rannsóknar var að kanna upplifun sjúklinga af þjónustu og samskiptum við heilbrigðisstarfsfólk á Hjartagátt Landspítala. Aðferðir: Spurningalisti byggður á Patient Satisfaction Questionnaire III var sendur til einstaklinga sem komu á Hjartagátt Landspítala frá 1. janúar til 29. febrúar 2012. Spurningalistinn var í formi fullyrðinga og gáfu þátttakendur til kynna hversu sammála eða ósammála þeir voru þeim á skala frá 1-5. Við greiningu gagna var notast við lýsandi tölfræði, Cronbach's alpha við greiningu á innra samræmi kvarðanna og þáttagreiningu. Hópar voru bornir saman með Wilcoxon-Mann-Whitney og Kruskal-Wallis prófum og fylgni metin með fylgnistuðlum Pearson og Spearman. Niðurstöður: Spurningalistinn var sendur til 485 einstaklinga og 275 (57%) svöruðu. Miðgildi (spönn) aldurs þeirra sem svöruðu var 62 (19-95) ár og 132 (48%) voru konur. Innra samræmi var hátt í öllum kvörðum spurningalistans nema einum. Meðaleinkunn úr öllum spurningalistanum var 6,8±1,0 (af 10). Alls voru 91% þeirra sem svöruðu ánægðir með framkomu lækna, 86% með framkomu hjúkrunarfræðinga og annars starfsfólks og 88% ánægðir með þá þjónustu sem þeir fengu. Hins vegar fannst 25% einstaklinga útskýringar á einkennum sínum ekki fullnægjandi og eftirfylgni ábótavant. Ályktanir: Almennt virðast skjólstæðingar Hjartagáttar ánægðir með þjónustuna sem þeir fá. Niðurstöður benda þó til að bæta megi þjónustu á sumum sviðum, einkum hvað varðar upplýsingagjöf við útskrift og eftirfylgni.Introduction: The Icelandic health care system ranks favourably in international comparison but patients' experience of interaction with the health service has not been well studied. The goal of this study was to examine the satisfaction of patients admitted to the Acute Cardiac Unit (ACU) at Landspitali - The National University Hospital of Iceland. Methods: A questionnaire based on the Patient Satisfaction Questionnaire III was mailed to patients admitted to the ACU between 1 January and 29 February 2012. Questions were presented as statements and participants asked to respond how strongly on a scale from 1 to 5 they agreed or disagreed with each statement. Data analysis was performed using descriptive statistics, Cronbach´s alpha for internal consistency of scales and principal components analysis, Wilcoxon-Mann-Whitney and Kruskal-Wallis tests for comparison of groups and Pearson and Spearman correlation coefficients for correlation between variables. Results: The questionnaire was mailed to 485 individuals of whom 275 (57%) responded. The median age of the participants was 62 (range, 19-95) years and 132 (48%) were women. Internal consistency of the scales was mostly high (Cronbach's alpha 0.62-0.91) and principal components analysis revealed one main factor. The mean score of the questionnaire was 6.8 ±1.0 and 91%, and 86% of the participants were pleased with their interaction with physicians and nurses, respectively. Similarly, 88% were pleased with the care they recieved but 25% felt they received insufficient explanations of their symptoms or that follow-up care was lacking. Conclusion: Patients of the ACU generally appear to be satisfied with their care. However, our results suggest that improvement is needed in several areas, including information provided at discharge and follow-up care. Key words: Health service, acute cardiac unit, heart disease, quality of care, PSQ-III questionnaire, survey

A complex speciation-richness relationship in a simple neutral model

Speciation is the "elephant in the room" of community ecology. As the ultimate source of biodiversity, its integration in ecology's theoretical corpus is necessary to understand community assembly. Yet, speciation is often completely ignored or stripped of its spatial dimension. Recent approaches based on network theory have allowed ecologists to effectively model complex landscapes. In this study, we use this framework to model allopatric and parapatric speciation in networks of communities and focus on the relationship between speciation, richness, and the spatial structure of communities. We find a strong opposition between speciation and local richness, with speciation being more common in isolated communities and local richness being higher in more connected communities. Unlike previous models, we also find a transition to a positive relationship between speciation and local richness when dispersal is low and the number of communities is small. Also, we use several measures of centrality to characterize the effect of network structure on diversity. The degree, the simplest measure of centrality, is found to be the best predictor of local richness and speciation, although it loses some of its predictive power as connectivity grows. Our framework shows how a simple neutral model can be combined with network theory to reveal complex relationships between speciation, richness, and the spatial organization of populations.Comment: 9 pages, 5 figures, 1 table, 50 reference

Modelling the 20th and 21st century evolution of Hoffellsjökull glacier, SE-Vatnajökull, Iceland

The Little Ice Age maximum extent of glaciers in Iceland was reached about 1890 AD and most glaciers in the country have retreated during the 20th century. A model for the surface mass balance and the flow of glaciers is used to reconstruct the 20th century retreat history of Hoffellsjökull, a south-flowing outlet glacier of the ice cap Vatnajökull, which is located close to the southeastern coast of Iceland. The bedrock topography was surveyed with radio-echo soundings in 2001. A wealth of data are available to force and constrain the model, e.g. surface elevation maps from ~1890, 1936, 1946, 1989, 2001, 2008 and 2010, mass balance observations conducted in 1936–1938 and after 2001, energy balance measurements after 2001, and glacier surface velocity derived by kinematic and differential GPS surveys and correlation of SPOT5 images. The approximately 20% volume loss of this glacier in the period 1895–2010 is realistically simulated with the model. After calibration of the model with past observations, it is used to simulate the future response of the glacier during the 21st century. The mass balance model was forced with an ensemble of temperature and precipitation scenarios derived from 10 global and 3 regional climate model simulations using the A1B emission scenario. If the average climate of 2000–2009 is maintained into the future, the volume of the glacier is projected to be reduced by 30% with respect to the present at the end of this century. If the climate warms, as suggested by most of the climate change scenarios, the model projects this glacier to almost disappear by the end of the 21st century. Runoff from the glacier is predicted to increase for the next 30–40 yr and decrease after that as a consequence of the diminishing ice-covered area

Cellular Dynamical Mean Field Approach to Strongly Correlated Systems

We propose a cellular version of dynamical-mean field theory which gives a natural generalization of its original single-site construction and is formulated in different sets of variables. We show how non-orthogonality of the tight-binding basis sets enters the problem and prove that the resulting equations lead to manifestly causal self energies.Comment: RevTex, 4 pages, 1 embedded figur

Klínískar leiðbeiningar um áhættumat og forvarnir hjarta- og æðasjúkdóma

Hægt er að lesa greinina í heild sinni með því að smella á hlekkinn View/OpenHjarta- og æðasjúkdómar eru algengasta orsök ótímabærs heilsubrests og dauðsfalla á Vesturlöndum. Það er því mikilvægt að meðferð og forvarnir gegn þessum sjúkdómum séu markvissar. Markmið þessara leiðbeininga er að auðvelda heilbrigðisstarfsfólki forvarnarstarf vegna hjartaog æðasjúkdóma með það að leiðarljósi að: hindra myndun æðakölkunar minnka líkur á að æðakölkun valdi skemmdum í líffærum fækka áföllum (sjúkdómstilfellum eða ótímabærum dauða) af völdum hjarta- og æðasjúkdóm

Winter mass balance of Drangajökull ice cap (NW Iceland) derived from satellite sub-meter stereo images

Sub-meter resolution, stereoscopic satellite images allow for the generation of accurate and high-resolution digital elevation models (DEMs) over glaciers and ice caps. Here, repeated stereo images of Drangajökull ice cap (NW Iceland) from Pléiades and WorldView2 (WV2) are combined with in situ estimates of snow density and densification of firn and fresh snow to provide the first estimates of the glacier-wide geodetic winter mass balance obtained from satellite imagery. Statistics in snow- and ice-free areas reveal similar vertical relative accuracy (<  0.5 m) with and without ground control points (GCPs), demonstrating the capability for measuring seasonal snow accumulation. The calculated winter (14 October 2014 to 22 May 2015) mass balance of Drangajökull was 3.33 ± 0.23 m w.e. (meter water equivalent), with ∼ 60 % of the accumulation occurring by February, which is in good agreement with nearby ground observations. On average, the repeated DEMs yield 22 % less elevation change than the length of eight winter snow cores due to (1) the time difference between in situ and satellite observations, (2) firn densification and (3) elevation changes due to ice dynamics. The contributions of these three factors were of similar magnitude. This study demonstrates that seasonal geodetic mass balance can, in many areas, be estimated from sub-meter resolution satellite stereo images.This study was funded by the University of Iceland (UI) Research Fund. Pleiades images were acquired at research price thanks to the CNES ISIS program (http://www.isis-cnes.fr). The WV2 DEM was obtained through the ArcticDEM project. This work is a contribution to the Rannis grant of excellence project, ANATILS. Collaboration and travels between IES and LEGOS were funded by the Jules Verne research fund and the TOSCA program from the French Space Agency, CNES. This study used the recent lidar mapping of the glaciers in Iceland that was funded by the Icelandic Research Fund, the Landsvirkjun research fund, the Icelandic Road Administration, the Reykjavik Energy Environmental and Energy Research Fund, the Klima-og Luftgruppen (KoL) research fund of the Nordic Council of Ministers, the Vatnajokull National Park, the organization Friends of Vatnajokull, the National Land Survey of Iceland, the Icelandic Meteorological Office and the UI research fund. The ground-based mass balance measurements on Drangajokull have been jointly funded by Orkubu Vestfjarda (Westfjord Power Company), the National Energy Authority (2004-2009) and the Icelandic Meteorological Office (2009-2015).Peer Reviewe

Surface elevation change and mass balance of Icelandic ice caps derived from swath mode CryoSat-2 altimetry

We apply swath processing to CryoSat-2 interferometric mode data acquired over the Icelandic ice caps to generate maps of rates of surface elevation change at 0.5 km postings. This high-resolution mapping reveals complex surface elevation changes in the region, related to climate, ice dynamics, and subglacial geothermal and magmatic processes. We estimate rates of volume and mass change independently for the six major Icelandic ice caps, 90% of Iceland's permanent ice cover, for five glaciological years between October 2010 and September 2015. Annual mass balance is highly variable; during the 2014/2015 glaciological year, the Vatnajökull ice cap (~70% of the glaciated area) experienced positive mass balance for the first time since 1992/1993. Our results indicate that between glaciological years 2010/2011and 2014/2015 Icelandic ice caps have lost 5.8 ± 0.7 Gt a−1 on average, ~40% less than the preceding 15 years, contributing 0.016 ± 0.002 mm a−1 to sea level rise

Development of a subglacial lake monitored with radio-echo sounding: case study from the eastern Skaftá cauldron in the Vatnajökull ice cap, Iceland

We present repeated radio-echo sounding (RES, 5 MHz) on a profile grid over the eastern Skaftá cauldron (ESC) in Vatnajökull ice cap, Iceland. The ESC is a ∼ 3 km wide and 50–150 m deep ice cauldron created and maintained by subglacial geothermal activity of ∼ 1 GW. Beneath the cauldron and 200–400 m thick ice, water accumulates in a subglacial lake and is released semi-regularly in jökulhlaups. The RES record consists of annual surveys conducted at the beginning of every summer during the period 2014–2020. Comparison of the RES surveys reveals variable lake area (0.5–4.1 km2) and enables traced reflections from the lake roof to be distinguished from bedrock reflections. This allows construction of a digital elevation model (DEM) of the bedrock in the area, further constrained by two borehole measurements at the cauldron centre. It also allows creation of lake thickness maps and an estimate of lake volume at the time of each survey, which we compare with lowering patterns and released water volumes obtained from pre- and post-jökulhlaup surface DEMs. The estimated lake volume was 250 GL (gigalitres = 106 m3) in June 2015, but 320 ± 20 GL drained from the ESC in October 2015. In June 2018, RES profiles revealed a lake volume of 185 GL, while 220 ± 30 GL were released in a jökulhlaup in August 2018. Considering the water accumulation over the periods between RES surveys and jökulhlaups, this indicates 10 %–20 % uncertainty in the RES-derived volumes at times when significant jökulhlaups may be expected

Pollution from the 2014–15 Bárðarbunga eruption monitored by snow cores from the Vatnajökull glacier, Iceland

The chemical composition of Icelandic rain and snow is dominated by marine aerosols, however human and volcanic activity can also affect these compositions. The six month long 2014-15 Bárdarbunga volcanic eruption was the largest in Iceland for more than 200years and it released into the atmosphere an average of 60kt/day SO 2 , 30kt/day CO 2 , 500t/day HCl and 280t/day HF. To study the effect of this eruption on the winter precipitation, snow cores were collected from the Vatnajökull glacier and the highlands northeast of the glacier. In addition to 29 bulk snow cores from that precipitated from September 2014 until March 2015, two cores were sampled in 21 and 44 increments to quantify the spatial and time evolution of the chemical composition of the snow.The pH and chemical compositions of melted snow samples indicate that snow has been affected by the volcanic gases emitted during the Bárdarbunga eruption. The pH of the melted bulk snow cores ranged from 4.41 to 5.64 with an average value of 5.01. This is four times greater H + activity than pure water saturated with the atmospheric CO 2 . The highest concentrations of volatiles in the snow cores were found close to the eruption site as predicted from CALPUFF SO 2 gas dispersion quality model. The anion concentrations (SO 4 , Cl, and F) were higher and the pH was lower compared to equivalent snow samples collected during 1997-2006 from the unpolluted Icelandic Langjökull glacier. Higher SO 4 and Cl concentrations in the snow compared with the unpolluted rainwater of marine origin confirm the addition of a non-seawater SO 4 and Cl. The δ 34 S isotopic composition confirms that the sulphur addition is of volcanic aerosol origin.The chemical evolution of the snow with depth reflects changes in the lava effusion and gas emission rates. Those rates were the highest at the early stage of the eruption. Snow that fell during that time, represented by samples from the deepest part of the snow cores, had the lowest pH and highest concentrations of SO 4 , F, Cl and metals, compared with snow that fell later in the winter. Also the Al concentration, did exceed World Health Organisation drinking water standard of 3.7μmol/kg in the lower part of the snow core closest to the eruption site.Collected snow represents the precipitation that fell during the eruption period. Nevertheless, only minor environmental impacts are evident in the snow due to its interaction with the volcanic aerosol gases. In addition, the microbial communities identified in the snow that fell during the eruption were similar to those found in snow from other parts of the Arctic, confirming an insignificant impact of this eruption on the snow microecology