[Health and survival in Icelandic nursing homes 2003 - 2014, before and after the setting of stricter criteria for nursing home admission in December 2007].

INTRODUCTION: Many factors influence the nursing needs and survival of nursing home residents, including the admission criteria. The aim of the study was to compare health, survival and predictors for one- and two-year survival of people entering Icelandic nursing homes between 2003-2007 and 2008-2014. MATERIAL AND METHODS: Retrospective, descriptive, comparative study. The data was obtained from a Directorate of Health database for all interRAI assessments of Icelandic nursing homes from January 1, 2003, to December 31, 2014 (N = 8487). RESULTS: There was a significant difference in the health and survival of new nursing home residents before and after December 31, 2007. In the latter period, the mean age was 82.7 years. In the previous period, it was 82.1 years, and the prevalence of Alzheimer's disease, ischemic heart disease, heart failure, diabetes and COPD increased between the periods. One-year survival decreased from 73.4% to 66.5%, and two-year survival decreased from 56.9% to 49.1%. The strongest mortality risk factors were heart failure and chronic obstructive pulmonary disease, as well as high scores on the CHESS scale and ADL long scale. CONCLUSION: After 2007, new residents were older, in poorer health, and their life expectancy was shorter than for those moving to nursing homes before that. The results suggest that the aim of the regulatory change was achieved, i.e., to prioritise those in worst health. Their care needs may therefore be different and greater than before.

Perceived consequences, changeability and personal control of coronary heart disease are associated with health-related quality of life.

AIMS AND OBJECTIVES: To explore changes in illness perception and health-related quality of life in patients with coronary heart disease following percutaneous coronary intervention from the time when patients were discharged from hospital and five months later and to investigate association between illness perception and physical and mental health-related quality of life at five-month follow-up. BACKGROUND: Illness perception is known to influence patients' motivation to engage in preventive behaviour. DESIGN: Prospective and comparative with two measurement points: at discharge from hospital (time 1) and five months later (time 2). METHODS: Two self-administered questionnaires were used as follows: the Illness Perception Questionnaire-Revised measured illness perception and the Short Form Health Survey (SF-36) measured physical and mental health-related quality of life. The sample consisted of patients with coronary heart disease admitted to University Hospital between November 2011-April 2012. RESULTS: A total of 69 questionnaires were returned for both measurement times. Most responders were male (71%), mean age was 68·9 (SD 10·3) years. Health-related quality of life increased over time, and illness perception changed; five months after discharge, participants were more aware that the disease was chronic and could worsen suddenly, and they perceived that the disease had less of a consequence on their lives compared to when they were staying in the hospital. Associations between increased personal control, changeability of the disease, perceptions of less of a consequence of the disease on daily life and increased health-related quality of life were demonstrated at time 2. CONCLUSION: Perceptions of personal control, changeability and consequences of the disease should be assessed and discussed with cardiac patients, as these illness perceptions are related to physical and mental health-related quality of life. RELEVANCE TO CLINICAL PRACTICE: Increased understanding of consequences of the disease, personal control and perceived changeability of the illness affects health-related quality of life; these are factors that nurses in clinical practice can influence and thereby improve patients' outcomes.

Community participation and environment of children with and without autism spectrum disorder: parent perspectives.

AIM: This study explored parent perspectives of participation patterns and environmental supports and barriers for high-functioning children with autism spectrum disorder (ASD) within their communities compared with a group of children without ASD. METHOD: The Participation and Environment Measure for Children and Youth was used to gather online data from parents of 99 children with ASD and 241 children without ASD. Mann-Whitney U test and chi-square tests were used to explore differences between groups and Cohen's d was calculated to examine effect sizes. RESULTS: Significant differences between children with and without ASD were observed for all participation and environment summary scores. Children with ASD participated less frequently, were less involved, and their parents were less satisfied with their child's participation in community-based activities. Parents of children with ASD also identified fewer supports for their child's participation and more environmental barriers than other parents. CONCLUSION: Children with ASD participated less in community-related activities than children without ASD as perceived by their parents. Barriers limiting community participation included features of the social and physical environment and limited resources. SIGNIFICANCE: Occupational therapists should focus on decreasing environmental challenges in their efforts to facilitate participation of children with ASD in the community.

Underage Use of Social Network Sites: It's About Friends.

European self-regulation to ensure children's safety on social networking sites (SNS) stipulates that children should be old enough to use their services. However, a growing number of children are not. Drawing on data from the Net Children Go Mobile (NCGM) project (2012-2014), this study focuses on children aged 9-12 years, among whom 42% have a profile on Facebook, many with the explicit permission of their parents, despite the explicit policy allowing only children aged 13 years and older. Yet, such parental influence is not the only factor contributing to an underage child having a profile. Hierarchical logistic regressions were conducted in which the odds of having a profile on Facebook among children aged 9-12 years (N=1,723) were predicted. After controlling for demographic variables, Facebook use was connected to daily use of the Internet from home (bedroom and other places), looking for new friends online, and online disinhibition (e.g., being able to talk about different things on the Internet than when speaking to people face-to-face). In terms of parental mediation, restrictions lower the probabilities of an underage child having a SNS profile, while active parental mediation increases the odds. In addition to parental mediation, peer mediation increases the chances of underage Facebook use, indicating that children play a significant role in influencing each other in adoption of new technologies and applications. Finally, digital skills related to communication have a significant effect, suggesting an integrated adoption of communicative practices online. Daily use of mobile devices had no effect in the model.

[Public attitudes towards presumed consent in organ donation in Iceland]. / Viðhorf Íslendinga til ætlaðs samþykkis við líffæragjafir.

INTRODUCTION: Organ transplant is often the only viable treatment for patients with end-stage organ failure. Until now, Icelandic legislation has required informed consent for organ donors, but a new parliamentary bill has been put forth to change the laws to presumed consent. The goal of this study was to investigate the attitude of the Icelandic population towards legislative changes to presumed consent. MATERIALS AND METHODS: Descriptive cross-sectional study using a questionnaire. The study population included all Icelanders, 18 years and older. The sample involved 1400 persons randomly selected from a Capacent Gallup mailing-list. The response rate was 63% or 880 answers. RESULTS: The majority of Icelanders are in favour of the proposed legislative change (more than 80%). Women were more likely to support presumed consent than men, 85% versus 76% respectively. Younger participants were more likely to be positive towards the new law, but no significant difference was found in attitude by family income, demographics or education. Persons who knew someone close to them that had received a transplanted organ were 50% more likely to be in complete agreement with the proposed legislation. Only 5% of participants were currently registered organ donors - 29 women and 15 men. CONCLUSION: Icelanders are very positive towards changing the law to include presumed consent in organ donation. Women and younger people tended to be more in favour and similarly those who know someone that has received donated organs. A majority of responders are willing to donate their organs, but very few are registered as donors.

Internet addictive behavior in adolescence: a cross-sectional study in seven European countries.

A cross-sectional school-based survey study (N=13,284; 53% females; mean age 15.8±0.7) of 14-17-year-old adolescents was conducted in seven European countries (Greece, Spain, Poland, Germany, Romania, the Netherlands, and Iceland). The aim of the study was to investigate the prevalence of Internet addictive behavior (IAB) and related psychosocial characteristics among adolescents in the participating countries. In the study, we distinguish two problematic groups: adolescents with IAB, characterized by a loss of control over their Internet use, and adolescents "at risk for IAB," showing fewer or weaker symptoms of IAB. The two groups combined form a group of adolescents with dysfunctional Internet behavior (DIB). About 1% of adolescents exhibited IAB and an additional 12.7% were at risk for IAB; thus, in total, 13.9% displayed DIB. The prevalence of DIB was significantly higher among boys than among girls (15.2% vs. 12.7%, p<0.001) and varied widely between countries, from 7.9% in Iceland to 22.8% in Spain. Frequent use of specific online activities (e.g., gambling, social networking, gaming) at least 6 days/week was associated with greater probability of displaying DIB. Multiple logistic regression analysis indicated that DIB was more frequent among adolescents with a lower educational level of the parents, earlier age at first use of the Internet, and greater use of social networking sites and gaming sites. Multiple linear regression analysis showed that externalizing (i.e., behavioral) and internalizing (i.e., emotional) problems were associated with the presence of DIB.

Online social networking in adolescence: patterns of use in six European countries and links with psychosocial functioning.

PURPOSE: Online communication tools, such as social networking sites (SNS), have been comprehensively embraced by adolescents and have become a dominant daily social practice. Recognizing SNS as a key context of adolescent development, this study aimed to investigate associations between heavier SNS use, and adolescent competencies and internalizing problems. METHODS: Data was collected in six European countries: Greece, Spain, Poland, the Netherlands, Romania, and Iceland. Participants were 10,930 adolescents aged 14-17 years (F/M: 5,719/5,211; mean age 15.8 ± .7 years); 62.3% were aged 14-15.9 years and 37.7% were aged 16-17.9 years. Participants reported on their use of online communication tools, and their general competencies and internalizing problems (Youth Self Report). RESULTS: SNS are both ubiquitous--used by 70% of adolescents--and engaging, given that 40% of users spend 2 or more hours daily on SNS (labeled heavier SNS use). Heavier SNS use was associated with more internalizing problems, and the relation was consistently more pronounced among younger adolescents. Moreover, heavier SNS use was associated with lower academic performance and lower activities scores, especially for younger adolescents. In contrast, among older adolescents heavier SNS use was positively associated with offline social competence. CONCLUSIONS: Although heavier SNS use is associated with higher social competence for older adolescents, it is also associated with increased internalizing problems and diminished competencies in academics and activities, especially for younger adolescents. Age, capturing developmental differences in social and regulatory skills, appears to moderate the effects of heavier SNS use on adolescent functioning.

[The weight of school children and its relationship to performance in studies and well-being.].

OBJECTIVE: There has been significant weight gain among Western populations during the past few decades, including children and adolescents. The aim of this research was to investigate the possibility of discovering a correlation between the weight of primary school children and their well-being and performance in studies. There was also an interest in determining the weight development of children and adolescents during a period of thirty years and attempting to answer the question whether they were still putting on weight. METHODS AND MATERIALS: The target population of the research project comprised pupils in the 4th, 7th and 10th grades of primary schools within the service area of Akureyri Health Centre during the winter of 2000-2001. The above classes were chosen on the basis of the fact that they all sat the national coordinated examination. Data were collected to discover Body Mass Index (BMI, weight/height_, kg/m_), measure performance in studies (the results in nationally coordinated examinations in Icelandic and arithmetic) and assess well-being by means of a questionnaire (Youth Self Report, YSR), which was only presented to the 7th and 10th grade. Furthermore, BMI was determined for corresponding groups from the school years 1970-71, 1980-81 and 1990-91, using information obtained from school health reports for the pupils in question. RESULTS: This group consisted of 819 pupils and information was available on 568 of those, or about 70%. The weight gain which turned out to have occurred between the years 1970 and 1990 did not occur in the final decade of the 20th century and this applies to all three year groups. No difference was between those living in urban and rural areas. This was found to be the case, both when comparing the average BMI of the year groups and the proportion of children who are above a certain threshold of criteria. Furthermore, it was found that excessive weight/obesity is related to slack study results and a poor state of well-being among pupils in the 10th grade of the primary school. Such a relationship, however, did not exist among students in the 7th grade. Heavier pupils in the 4th grade perform better in their studies than their lighter peers, although this difference is not statistically significant. CONCLUSIONS: The unfavourable trend towards weight gain that we have seen in the past may now be changing. Other research pointing in the same direction has not been found, however, and more results are needed before this can be stated as a fact. Weight has a stronger influence on the well-being of adolescents in their upper teens, or towards the end of primary school, than is the case with younger pupils. This research does not explain why, although it may be assumed that the social environment of older children and adolescents is a significant factor in this respect. As the children grow older, a correlation begins to appear between being overweight and having less performance in studies and none of the heavier pupils show excellent school performance.