Stakeholders' views and experiences of care and interventions for addressing frailty and pre-frailty:a meta-synthesis of qualitative evidence

Frailty is a common condition in older age and is a public health concern which requires integrated care and involves different stakeholders. This meta-synthesis focuses on experiences, understanding, and attitudes towards screening, care, intervention and prevention for frailty across frail and healthy older persons, caregivers, health and social care practitioners. Studies published since 2001 were identified through search of electronic databases; 81 eligible papers were identified and read in full, and 45 papers were finally included and synthesized. The synthesis was conducted with a meta-ethnographic approach. We identified four key themes: Uncertainty about malleability of frailty; Strategies to prevent or to respond to frailty; Capacity to care and person and family-centred service provision; Power and choice. A bottom-up approach which emphasises and works in synchrony with frail older people's and their families' values, goals, resources and optimisation strategies is necessary. A greater employment of psychological skills, enhancing communication abilities and tools to overcome disempowering attitudes should inform care organisation, resulting in more efficient and satisfactory use of services. Public health communication about prevention and management of frailty should be founded on a paradigm of resilience, balanced acceptance, and coping. Addressing stakeholders' views about the preventability of frailty was seen as a salient need

Reawakening of a volcano: Activity beneath Eyjafjallajökull volcano from 1991 to 2009

The ice-capped Eyjafjallajökull volcano, south Iceland, had been dormant for 170 years when the first signs of reawakening of the volcano were captured by seismic and geodetic measurements in 1994. These were the first clear observed signs of unrest followed by 16 years of intermittent magmatic unrest culminating in 2010 when two eruptions broke out on the flank and at the summit. We analyze seismic data from 1991 through 2008 and GPS data from 1992 to May 2009 to infer magma movements beneath the volcano. The relocated earthquakes reveal an overall pipe-like pattern northeast of the summit crater, sporadically mapping the pathway of magma from the base of the crust towards an intrusion in the upper crust. During the study period, three major seismic swarms were recorded. Two of them, in 1994 and 1999–2000, occurred in the upper and intermediate crust and accompanied crustal deformation centered at the southeastern flank. No uplift was detected during the 19- to 25-km-deep 1996 swarm, near the crust–mantle boundary, but the horizontal, ~ E–W oriented T-axes indicate a period of tension/opening, suggesting magma intruding up into the base of the crust. The GPS measured deformation during 1999–2000 can be modeled as intrusion of a horizontal, circular sill with volume of 0.030 ± 0.007 km3 at 5.0 ± 1.3 km depth. The less constrained 4.5- to 5-km-deep sill model for the 1994 episode indicates a three times smaller intruded volume (0.011 km3) than during 1999–2000. In the years between/following the intrusions, contraction was observed at the southeastern flank. The contraction from 2000.5 to 2009.3 can be fitted by a circular sill model with a volume contraction of − 0.0015 ± 0.0003 km3/year at 5.5 ± 2.0 km depth. The less well constrained model for 1994.7 to 1998.6 gives a volume contraction of –(0.0009–0.0010) km3 at a fixed depth of 5 km. The accumulated volume changes (~− 0.013 km3 for the second period, ~ 0.0037 km3 for the first period) are much larger than expected due to solidification and cooling of magma alone and might partly be explained by the underestimated volume of intruded magma, mass loading effects within the crust due to the intruded magma and possibly, and to less extent, degassing (CO2)

Flóttafólk í fyrirheitna landinu : áskoranir í starfi hjúkrunarfræðinga við umönnun flóttafólks

Rannsóknaráætlun þessi er lokaverkefni til B.S prófs í hjúkrunarfræði við Háskólann á Akureyri. Fjöldi flóttafólks sem flutt hefur til Íslands hefur aukist töluvert undanfarin ár. Samhliða því hefur einstaklingum af ólíku þjóðerni sem nýta sér heilbrigðisþjónustuna fjölgað hér á landi. Menning þessara skjólstæðinga heilbrigðiskerfisins er mismunandi og hefur það aukið fjölbreytileika notenda þess. Fjölbreytileikinn getur valdið flóknum aðstæðum, þar sem venjur, siðir, gildi og menning þessara einstaklinga eru oft ólík ríkjandi menningu hér á landi. Tilgangur fyrirhugaðrar rannsóknar er að kanna aðkomu og reynslu hjúkrunarfræðinga þegar þeir hjúkra flóttafólki á Íslandi. Áskoranir og hindranir sem hjúkrunarfræðingar standa iðulega frammi fyrir verða kannaðar, þar sem þær geta haft áhrif á störf þeirra við umönnun skjólstæðinga. Hefðir, skoðanir, trúarbrögð, menning, tungumálaörðugleikar og andleg vandamál flóttamanna geta til að mynda haft afgerandi áhrif á hjúkrunina sem er veitt. Með notkun eigindlegrar rannsóknaraðferðar verður gagna aflað með hálf stöðluðum viðtölum við 15 hjúkrunarfræðinga sem starfa við hjúkrun flóttamanna á Íslandi. Hjúkrunarfræðingar þurfa að upplifa erfiðar og myndrænar áfallalýsingar vegna atburða sem flóttafólk hefur oft þurft að þola. Þessi reynsla hjúkrunarfræðinga hefur valdið því að þeir eru í aukinni áhættu að þjást t.d. af streitu, áfallastreituröskun, alvarlegu þunglyndi og kulnun í starfi. Það er því mikilvægt að hjúkrunarfræðingar sem sinna flóttafólki nýti sér streituminnkandi úrræði til að draga úr neikvæðum afleiðingum hjúkrunar flóttafólks, þar sem of mikil streita getur haft alvarlegar afleiðingar í för með sér. Lykilhugtök: Flóttafólk, hælisleitendur, kvótaflóttafólk, menning, trúarbrögð.This research proposal is a dissertation for a B. S. degree in nursing at the University of Akureyri. Over the past years, the number of refugees has greatly increased in Iceland. Alongside that, the number of individuals that need medical attention has increased, and the diversity of the patients as well. This diversity can cause some tricky situations, as customs and values of those individuals can often collide with the existing culture. The purpose of this research is to investigate the involvement of nurses and their experience dealing with refugees in Iceland. This research will also shed light on the challenges and barriers faced by nurses that influence their day-to-day work. Traditions, beliefs, religions, culture, linguistic difficulties and spiritual problems can, for example, have a huge impact on the level of care that is provided. A qualitative research approach will be applied using semi-structured interviews to gather data. Fifteen nurses who provide care for refugees will be interviewed. Nurses have to tackle difficult and picturesque details about traumatic events that refuges have often had to endure. Thus, nurses who work with refugees are more prone to experience stress, post-traumatic stress disorder, severe depression, burnout or several other negative symptoms. Therefore, it is imperative that nurses that work with refugees apply stress reducing methods in order to minimize the negative effects of too much stress. Key concepts: Refugees, asylum seekers, resettlement refugees, culture, religion

Designing motivating interactive balance and walking training for stroke survivors

In the ActivAbles and STARR projects we are developing interactive training tools for stroke survivors. Our initial user studies pointed to balance being a key ability, therefore one of the developed tools is an interactive balance pad. Equipment exists for persons with good balance (eg. Wii), but most consumer games and exercises are less suited for many stroke survivors. The development process has been done in close collaboration with stroke survivors, and we have currently a prototype system that has been tested by 10 stroke survivors for a longer period in the home during a feasibility study. The system includes an interactive balance foam pad, feedback lamps and a step counting game app which all connect to a central server. The feedback is designed to be inclusive - designs are multimodal (visual and auditory), and the setup is flexible and can easily be adapted. In this paper we report and discuss the design of the system, pilot test results and the results from a feasibility study in the home

Deformation and seismicity decline before the 2021 Fagradalsfjall eruption

Increased rates of deformation and seismicity are well-established precursors to volcanic eruptions, and their interpretation forms the basis for eruption warnings worldwide. Rates of ground displacement and the number of earthquakes escalate before many eruptions1,2,3, as magma forces its way towards the surface. However, the pre-eruptive patterns of deformation and seismicity vary widely. Here we show how an eruption beginning on 19 March 2021 at Fagradalsfjall, Iceland, was preceded by a period of tectonic stress release ending with a decline in deformation and seismicity over several days preceding the eruption onset. High rates of deformation and seismicity occurred from 24 February to mid-March in relation to gradual emplacement of an approximately 9-km-long magma-filled dyke, between the surface and 8 km depth (volume approximately 34 × 106 m3), as well as the triggering of strike-slip earthquakes up to magnitude MW 5.64. As stored tectonic stress was systematically released, there was less lateral migration of magma and a reduction in both the deformation rates and seismicity. Weaker crust near the surface may also have contributed to reduced seismicity, as the depth of active magma emplacement progressively shallowed. This demonstrates that the interaction between volcanoes and tectonic stress as well as crustal layering need to be fully considered when forecasting eruptions

Fragilidade no idoso: o que vem sendo produzido pela enfermagem Fragilidad en el anciano: lo que se produce por la enfermería Fragility in the elderly: what has being produced by nursing

Este trabalho visa identificar a produção científica desenvolvida pela enfermagem frente à fragilidade no idoso, a partir de uma revisão integrativa da literatura, realizada nas bases Scientific Electronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Scopus. Foram incluídos no estudo 16 artigos, sendo dois publicados em periódicos brasileiros e 14 em periódicos estrangeiros. Constata-se que, dos artigos analisados, 37,5% (6) enfocam a mudança de paradigma quanto ao modelo assistencial e 26,7% (4) destacam a família como cuidadora no contexto do idoso frágil. Pontua-se que o enfermeiro desempenha um papel impar no contexto da fragilidade, no desenvolvimento do cuidado individual e no suporte aos familiares e aos cuidadores dos idosos frágeis.<br>Este trabajo tiene como objetivo identificar la producción científica desarrollada por la enfermería para hacer frente a la fragilidad en los ancianos a partir de una revisión integradora de la literatura, realizado en las bases Scientific Electronic Library Online (SciELO), Literatura Latino-Americana y Caribe em Ciências da Saúde (LILACS) y Scopus. El estudio incluyó 16 artículos, dos publicados en revistas brasileiras y 14 en revistas extranjeras. Se constata que, en los artículos analizados, el 37,5% (6) se centran en cambiar el paradigma del modelo de asistencia y el 26,7% (4) destacan la familia como cuidadora en el contexto de los ancianos frágiles. El enfermero desempeña un papel sin precedentes en el contexto de fragilidad, en el desarrollo de la atención individual y apoyo a familiares y cuidadores de los ancianos frágiles.<br>This work aims to identify the scientific production generated by nursing considering the fragility in the elderly from an integrative literature review using the Scientific Electronic Library Online (SciELO), Literatura Latino-Americana and Caribe em Ciências da Saúde (LILACS) and Scopus. The study included 16 articles where two were published in Brazilian periodicals and 14 in foreign periodicals. The review in the analyzed articles shows that 37.5% (6) focus on a paradigm shift regarding the assistance model and 26.7% (4) highlight the family as the primary care unit in the context of a fragile elderly. The nurse plays a key role in the context of fragility, in the development of individual care, in the support to family members and other caregivers for the fragile elderly