University of Akureyri

Background Ethical competence in nursing is essential. However, a theoretical definition of ethical competence in nursing and the critical components of ethical competence appear to be absent, resulting in a lack of convergence on the core content to be taught on ethical competence in nursing education. Aim and research questions This study aimed to answer the following questions: What are the essential components of ethical competence in nursing? What is their definition in terms of nursing? What is the theoretical definition of ethical competence in nursing? Method Walker and Avant’s concept synthesis. Results Ethical competence in nursing consists of 12 essential components, defined and grouped into three main themes: (1) Ethical knowledge and understanding; having knowledge and understanding of the main theories of theoretical and practical ethics and the principal codes of ethics in nursing; (2) Personal ethical qualities; having ethical awareness and ethical self-awareness, ethical sensitivity, ethical perception, and ethical judgement. (3) Ethical ability and courage to perform; capable of moral reasoning, ethical reflection, and ethical decision-making, having moral courage and demonstrating ethical action and behaviour. The theoretical definition is thus: Nurses considered ethically competent have knowledge and understanding of the main ethical principles in nursing and possess personal ethical qualities, that is, ethical self-awareness, ethical awareness, ethical sensitivity, ethical perception, and ethical judgment as well as having the ethical ability and the courage to perform ethically, that is, capable of moral reasoning, ethical reflection, ethical decision-making, having moral courage, they demonstrate ethical action, and ethically responsible conduct. Conclusions This study is essential to nursing as a discipline and profession. The findings provide a theoretical definition of ethical competence in nursing and the qualities characterising ethically competent nurses, which can be of great value in clinical practice, nursing education, leadership, and nursing research and theory development.

The human visual system can quickly process groups of objects (ensembles) and build compressed representations of their features. What does the conscious perception of ensembles consist of? Observersʼ explicit access to ensemble representations has been considered very limited – any distributional aspects beyond simple summary statistics, such as the mean or variance, cannot be explicitly accessed. In contrast, we demonstrate that the visual system can represent ensemble distributions in detail, and observers have reliable explicit access to these representations. In our new paradigm ( Feature Frequency Report ), observers viewed 36 disks of various colors for 800 ms and then reported the frequency of a randomly chosen color using a slider. The sets had Gaussian, uniform, or bimodal color distributions with a random mean color. The distributions of responses – both aggregated and separate for each observer – followed the shape of the presented distribution. Modeling revealed that performance reflected integrated information from the whole set rather than sub-sampling. After only brief exposure to a color set , the visual system can build detailed representations of feature distributions that observers have explicit access to. This result necessitates a fundamental rethinking of how ensembles are processed. We suggest that such distribution representations are the most natural way for the visual system to represent groups of objects. Explicit feature distribution representations may contribute to people ‘s impression of having a rich perceptual experience despite severe attentional and working memory limitations.

Introduction: Individuals who have had adverse childhood experiences (ACEs) tend to have more health problems as adults. They are also at higher risk of adopting health-risk behaviors, further increasing the risk of negative health outcomes and premature death. This study aimed to assess the associations between ACEs, health-related quality of life (HRQoL), health problems, and health-risk behaviors in adulthood according to the number and nature of ACEs among Iceland's general population. Material and methods: This was a retrospective cross-sectional study among 12,400 individuals aged 18-80, randomly selected from Maskína's general population panel (Þjóðgátt). Associations between variables were analyzed by chi-square test, logistic regression and ANOVA. Results: The response rate was 44.8% (female 57.2%, M = 54.8 years). A total of 91.1% of participants answered the ACE questionnaire, of which 65.9% reported at least one ACE (≥1), and 17.7% reported four or more ACEs (≥4). There was a dose-response relationship between the number of ACEs and negative health outcomes, where increased ACE scores were associated with increased risks of health problems and health-risk behaviors. Four or more ACEs were associated with an increased risk of all negative health outcomes and lower HRQoL. Associations between ACEs and negative health outcomes varied depending on the nature of the ACEs. Conclusion: Adverse childhood experiences are risk factors for various health problems in adulthood. With increased emphasis on prevention and trauma-informed care within the healthcare system and other key sectors of society, serious health and psychosocial consequences could be mitigated, reducing disease burden and improving public health in Iceland.

Background Coronavirus disease 2019 (COVID-19) pandemic constituted the largest global health crisis in recent generations. It may also have disrupted the pattern of antimicrobial use (AMU) and subsequently affected the development of antimicrobial resistance (AMR) – a grave human health concern. This study aimed to give an overview of existing AMR surveillance systems and evaluate the impact of COVID-19 on AMU and AMR in the Nordics using data from these systems. Methods Nordic AMU data (2017–2022) were extracted from national annual reports (for both humans and animals) and the European Surveillance System (TESSy) (for humans only). For humans, AMU was expressed in defined daily dose (DDD) per 1000 inhabitants per day; for animals, it was expressed in kilogram (kg). Nordic human AMR data (2017–2022) were extracted from TESSy. Multilevel linear regression and negative binomial regression models were used to fit the TESSy data. Data between 2017 and 2019 were categorised as the pre-COVID-19 time, while data between 2020 and 2022 were the per-COVID-19 time. Results Denmark had a remarkably greater AMU in animals (about 10 times greater) than Norway, Sweden, and Finland. Iceland had the highest human AMU, while Sweden had the lowest. Drug categories, countries, and sectors were significant predictors in the model used to fit human AMU. Bacterial species and drug categories were significant predictors in the models used to fit human resistant Gram-negative and Gram-positive bacteria. The COVID-19 time was not a significant predictor in these models. Among the Nordics, Iceland had the lowest number of resistant isolates; however, high human AMU remains a great concern for Iceland. Conclusions The study provided insight into current existing AMR surveillance systems in the Nordics. It also showed that the COVID-19 pandemic had very little impact on AMU and AMR in theses countries. This implied that strict regulations on AMU as well as well-coordinated national AMR surveillance systems in the Nordics mitigated the development of AMR crisis also during COVID-19 pandemic. However, the Nordics would still benefit further from a standardized AMR surveillance at regional level, which ultimately facilitate timely information sharing and improve our preparedness for and response to future pandemics and/or large-scale outbreaks.

The relationship between ambient particulate matter (PM) and mental health conditions is well established. No study so far has investigated whether different sources of air pollution are associated with distinctive worries. We recruited n = 47 citizens living in an area with seasonal air pollution from studded tires (winter) and cruise ships (summer). We asked about seasonal well-being, symptoms of insomnia, migraine, and eco-anxiety, as well as worries about air pollution. Participants were more worried about air pollution from cruise ships as compared to studded tires (p = 0.013), which stands in contrast to PM caused by studded tires being more severe. There were significant correlations between worries about outdoor air pollution and insomnia symptoms (p = 0.003), worries about indoor air pollution and migraine symptoms (p < 0.001), worries about air pollution from studded tires and eco-anxiety (p = 0.001), and worries about air pollution from cruise ships and symptoms of migraine (p = 0.001). The low participation rate limits generalizability but is a result by itself because of the highly controversial topic of studded tires. We hypothesize that participation in studies set out to demonstrate negative effects of particulate matter needs to be strategically planned when the overall opinion of the population to be studied is positive towards the source of the hazardous pollution. Additionally, we hypothesize that the contribution of air pollution from different sources receives a varying degree of attention from the population. Further research into the relation between attitudes towards the unsustainable use of studded tires and perceived vs. real air pollution might help to design effective campaigns to influence decision-making.

This editorial delves into the conceptual and ethical challenges related to research on neural organoids and neural chimeras. Neural organoids—three-dimensional models of (parts of) the human brain derived from human stem cells—are used to study brain development, diseases, and potential therapies. These advances have led to significant ethical, epistemic and governance issues being raised, most notably regarding the potential for consciousness and the attribution of moral status to artificially created entities. The contributions to this collection examine a broad range of conceptual, ethical and legal questions. Key epistemic issues include the fundamental question of whether and how consciousness or sentience could emerge in organoids, and what criteria should be used to define and detect such states. Apart from theoretical models of consciousness, the role of similarity-based views in precautionary ethics, as well as conditions and implications of moral status ascription to neural organoids and chimeras are explored. Furthermore, the ethical dimensions of neural organoid transplantation in animals, and the potential need for particular ethical guidelines and legal regulations for neural organoid and chimera research, including concerns with regard to the patentability of organoids with consciousness-like features are discussed. This collection underscores the necessity of integrating epistemological and ethical insights and the importance of broad interdisciplinary discourse to navigate the ethical landscape of neural organoid and chimera research.

The red algae species Kappaphycus alvarezii holds significant potential to evolve into a multimillion-dollar industry in the Solomon Islands. However, production levels have remained stagnant over the past decade. This study hypothesizes that technical inefficiencies at the farm level are a major factor limiting the industry's growth. Specifically, we examined the relationships between farm characteristics, resource use, and production efficiency in Wagina, an island with high cultivation potential. We selected 78 farmers for the survey via a structured questionnaire. Technical efficiency (TE) was assessed using Stochastic Frontier Analysis (SFA) conducted in R software. Results revealed mean TE values of 0.362 for small-scale and 0.535 for medium-scale production systems, suggesting substantial inefficiencies in resource utilization. Notably, the number of plots, the number of lines, and seed density per line were positively associated with TE, while education level and farmers’ age were negatively correlated. The results suggest that improving farm structures and optimizing resource allocation could enhance production efficiency. Addressing the factors that negatively influence TE may help unlock the industry’s full potential.

Background: Evidence-based design aims to create healthy environments grounded in scientific data, yet the influence of spatial qualities on cognitive processes remains underexplored. Advances in neuroscience offer promising tools to address this gap while meeting both scientific and practical demands. Consumer-grade mobile EEG devices are increasingly used; however, their lack of transparency complicates output interpretation. Well-established EEG indicators from cognitive neuroscience may offer a more accessible and interpretable alternative. Methods: This feasibility study explored the sensitivity of five established EEG power band ratios to cognitive shifts in response to subtle environmental design experiences. Twenty participants completed two crossover sessions in an office-like setting with nature-inspired versus urban-inspired design elements. Each session included controlled phases of focused on-screen cognitive task and off-screen breaks. Results: Factorial analyses revealed no significant interaction effects of cognitive state and environmental exposure on EEG outcomes. Nonetheless, frontal (θ/β) and frontocentral (β/[α + θ]) ratios showed distinct patterns across cognitive states, with more pronounced contrasts in the nature-inspired compared to the urban-inspired design conditions. Conversely, occipital ([θ + α]/β), (θ/α), and (β/α) ratios remained consistent across exposures. Data triangulation with autonomic nervous system responses and performance metrics supported these observations. Conclusions: The findings suggest that EEG power band ratios can capture brain–environment interactions. However, limitations of consumer-grade EEG devices challenge both scientific rigour and practical application. Refining methodological reliability could improve interpretability, supporting more transparent and robust data-driven design decisions.

This paper presents a detailed semantic and accompanying syntactic analysis of predicates denoting events that we describe as ‘excessive’ in Icelandic. Icelandic uses two types of strategies for marking of excess, the preposition yfir complemented by an anaphor (e.g. Sara bakaði yfir sig ‘Sara baked too much’), and the verbal prefix of- (e.g. Sara of-bakaði kökuna ‘Sara over-baked the cake’). We argue that the former strategy regularly expresses excess relative to the external argument, while the latter strategy expresses excess relative to the internal argument. We illustrate how the semantics of such predicates can be analysed using standard semantic approaches to degree predicates with some extensions, and how a decompositional approach to morphosyntax such as Distributed Morphology can capture these distinctions in a conceptually appealing way, with a plausible account of the syntax-semantics interface.

This article offers a new account of the ‘primitive society’ concept in the history of sociology. While accounts and critiques of the primitive concept pervade adjacent disciplines, few have investigated the role of the primitive in sociological thought. This article contends that while ‘primitive society’ was often peripheral to the ‘classical’ generation of European sociologists, it became central to modernization theory’s efforts to build a generalized theory of global modernity. While the decline of modernization theory saw a coincident decline in the usage of the primitive concept, this article notes recent efforts by social theorists to revive the concept. The article concludes by arguing that the ‘primitive’ concept may be more useful in post-digital modernity than it was in 19th-century social science.

The cryosphere faces increasing threats from anthropogenic pollutants, including per- and polyfluoroalkyl substances (PFAS), a class of synthetic chemicals produced in significant quantities and released into the environment for over seven decades. PFAS are widely utilized for their water- and grease-resistant properties in numerous industrial, household, personal care, and medical products. Despite their widespread applications, all PFAS or their degradation and transformation products are environmentally persistent and pose health risks to humans. PFAS are detected ubiquitously, even in remote regions like the Arctic and Antarctica, and they bioaccumulate within polar trophic food chains. The primary transport and transmission mechanisms for PFAS involve atmospheric transport through volatile precursors, atmospheric oxidation, ocean currents, and the formation of sea spray aerosols. Additionally, contamination of surface snow, post-deposition processes in snow, and sediment interactions significantly contribute to PFAS transport. The physical and chemical properties, including density, melting points (Tm), boiling points (Tb), solubility, vapor pressure, electronegativity, low polarizability, chemical stability, and thermal stability, play key roles in determining their environmental fate and transformation. The toxicity of certain PFAS has raised concerns, prompting bans and efforts to develop safer alternatives. Despite increasing public awareness and regulations to limit the production of legacy PFAS, their long-term environmental impacts remain unclear. As global warming accelerates cryosphere shrinkage, which releases PFAS with meltwater, cold-adapted ecosystems and associated biota face unprecedented challenges and uncertainties, particularly regarding the accumulation of non-degradable materials. This situation underscores the urgent need to comprehensively understand the fate of PFAS and adopt effective management strategies for polar systems. This review summarizes current literature on the transport, distribution, and legacy of PFAS, along with their known ecological impacts, bioremediation potential, and other management options in the cryosphere.

Hemispherectomy is the most promising treatment for patients with severe hemispheric intractable epilepsy. Several techniques for this surgical intervention have been established, but the choice of technique is currently mostly dependent on the surgeon’s experience with a specific approach. We aim to demonstrate whether the choice of the surgical technique moderates surgical outcome in patients with severe hemispheric intractable epilepsy, as measured by seizure freedom and the incidence of death after surgery. We extracted 2382 articles from PubMed and Cochrane. Two independent experts selected 555 articles. We performed a meta-analysis for all studies and a pooled data analysis for studies where information on individual patients was available. None of the retrieved studies was randomized. Disconnective surgery yielded significantly higher rates of seizure freedom (0.83) than resective (0.70, p<0.001) or combined surgery (0.64, p<0.001) for patients with at least 1 year follow–up (N cases=1165). For death (N cases=1197), resective surgery had the highest rate of death within a year (0.07), significantly higher than disconnective surgery (0.012, p=0.001) and combined surgical techniques (0.006, p<0.001). The assessed techniques did not systematically differ in rate of acute complications, but in their type, for example, acute neurological complications were most common after disconnective surgery (p<0.001), unspecific symptoms after resective surgery (p<0.004). Chronic neurological complications were most common after resective surgery (p<0.001). Seizure freedom is more likely following disconnective surgery as compared to resective or combined techniques. Disconnective and combined surgical techniques lead to fewer chronic complications and death than resective approaches.

Minimal research has examined culturally nuanced healing experiences across national landscapes, highlighting the need for a comprehensive understanding of culturally relevant healing experiences for survivors of gender-based violence (GBV). This paper explores these experience among 136 survivors of GBV across seven global contexts. Using the Clinical Ethnographic Narrative Interview-Trauma, after reflecting on their healing journey, survivors shared advice for others healing from GBV. Using the Comparative Ethnographic Narrative Analysis Method, we found shared, culturally distinct, and nuanced themes in this advice, including actions to promote healing, building a positive self-concept, and finding strength. Findings underscore the importance of contextually sensitive and survivor-informed approaches in social and health services, urging more tailored healing strategies after GBV. Findings also demonstrate the importance of analyzing cultural nuance in qualitative research themes to allow more culturally relevant survivorship care.

This article studies how one educational package, Lubbi Finds the Language Bone, (Lubbi) became hegemonic in the market, with 86% of Icelandic preschools now using the program. The article examines how Lubbi, originally designed in 2009 by speech pathologists to support children needing additional language help, has evolved into a cornerstone of pedagogy in preschools for children aged 1 to 6. The study employs discourse and thematic analysis to explore (a) how Lubbi was introduced and normalized within preschool pedagogy, and (b) the implications of its widespread adoption for professional autonomy and pedagogical diversity. Findings reveal that Lubbi’s popularity stems from strategic cultural alignment, effective marketing, and systemic pressures linked to neoliberal educational reforms. However, the dominance of pre-packaged programs like Lubbi raises concerns about the erosion of teacher autonomy and the prioritization of formalized literacy instruction over play-based learning. This study contributes to the discourse on neoliberalism in early childhood education, highlighting the tensions between market-driven solutions and pedagogical integrity.

The specific association of the potentially plant‐pathogenic Pseudomonas syringae with Peltigera lichens raises questions about the factors driving this host specificity. To explore this, the metabolic profile of seven lichen species belonging to three genera ( Cladonia , Peltigera and Stereocaulon ) was analysed using LC‐MSMS. In addition, we assessed the growth of P. syringae strains in media supplemented with extracts from each lichen species. This revealed that Peltigera exhibits lower metabolite richness compared to other genera, but shows a higher chemical investment in specific compounds. Growth kinetics showed comparable P. syringae growth across lichen‐supplemented media, except for Cladonia arbuscula and Cladonia sp., where the former exhibited lower growth rates. Inhibition assays with lichen extracts showed no inhibition of P. syringae . The lichen metabolome is predominantly composed of lipids and organic acids. Furthermore, specific compounds, such as aminoglycosides, may facilitate P. syringae presence in Peltigera by inhibiting Bacillus subtilis and other antagonists. In addition, compounds absent in Peltigera , like anthracene, might serve as a carbon source inhibitor like Bacillus velezensis .

Objectives The ICEPAIN study is a longitudinal research project focused on building an extensive database on health-related quality of life (HRQoL), lifestyle, and pain among the general population in Iceland. The project started with a cross-sectional data collection and will be followed by similar data collection after 5 and 10 years from participants who have agreed to be contacted again. In this article, descriptive data on the prevalence and nature of chronic pain in the Icelandic general population will be presented in relation to sociodemographic factors, lifestyle, adverse life experiences, and HRQoL. Methods Data were collected through a web-based platform using a national panel representing a randomised population sample of 12,400 individuals aged 18–80 years from the National Population Register of Iceland. The instruments consisted of questionnaires on pain, lifestyle factors, adverse life experiences, and HRQoL. The sample was stratified according to age, gender, and residence. Results The response rate was 45% (N = 5,557), and most participants (81%) agreed to be contacted again for later data collection. The mean age of the respondents was 54.8 years (SD = 13.7). Half of the participants (50.3%) had experienced some pain the previous week, and 40% had chronic pain (≥3 months). The prevalence of chronic pain was inversely related to educational level and satisfaction with household income and positively associated with body mass index. A significant correlation was found between chronic pain prevalence and several lifestyle variables, such as physical exercises, smoking habits, sleep, and adverse life experiences. Chronic pain had a significant negative impact on both physical and mental components of HRQoL. Conclusion These results indicate a complex relationship between chronic pain, lifestyle, and adverse life experiences. The longitudinal design will provide further information on the long-term development among these variables.

Prior research has found that high levels of work–family conflict negatively impact women's well-being. However, variations in the effects of work–family conflict on women based on class have been understudied. Moreover, most estimates of work–family conflict did not distinguish between work-to-family and family-to-work conflict. This study uses data from a cross-sectional phone survey of Icelandic women to assess the association between work–family conflict (in both directions) and symptoms of depression and anxiety among women of differing class positions. Key findings showed that (a) work-to-family and family-to-work conflict were positively related to symptoms of anxiety and depression among all women, but these relationships were contingent on class; (b) working-class women are more likely to experience symptoms of depression and anxiety due to work-to-family conflict than women of higher social strata; and (c) working-class women are more likely to experience symptoms of depression due to family-to-work conflict than women of higher social strata. The results demonstrate the need for further research on how women's ability to reconcile work and family varies by class and how public policy can account for such differences.