Effects on biodiversity, physical conditions and sediment in streams receiving stormwater discharge treated and delayed in wet ponds

The impact of human activities on watercourses has led to increased contamination, eutrophication, erosion and reduced biodiversity in streams and rivers. Increased urbanization is one of the factors that may influence the water quality. Wet stormwater ponds are a commonly used buffer structure to delay and treat the water before it reaches the recipient – often streams as studied in this paper. However, knowledge on how stormwater outlets from wet ponds may affect downstream recipients is still limited. We studied the impact of six outlets from wet stormwater ponds to streams in 2016 and 2017, by measurements in the streams upstream and downstream of the outlet. The aim was to study possible effects on physical conditions, sediment grain size and invertebrate community composition. The Fauna Index showed no significant differences between upstream and downstream stations. However, we found a significant decrease in biodiversity (Shannon-Wiener) and a significantly lower evenness downstream of the stormwater outlets, even though the water was delayed and treated in a pond first. The physical conditions were both positively and negatively affected depending on the specific outlet. Finally, the smallest particle fraction (&lt;63 μm) in the stream sediments was reduced at downstream sites compared to upstream sites at four outlets indicating possible erosion effects. Our study shows that the stormwater outlets have an effect on the recipients, but whether it is measurable depends on the methods utilized.</p

A life-changing process when living with chronic kidney disease: A qualitative study

Background: Patients with chronic kidney disease and their family members experience a number of lifestyle changes caused by the illness. The value of advance care planning includes understanding health status and options for future care, communication between close family members, and identification of wishes and preferences for care and treatment in relation to family and everyday life. Objective: Explore how patients with chronic kidney disease and their families experience everyday life and how they experience having to make choices about treatment. Design: An explorative study using a qualitative method with a phenomenological-hermeneutic approach. Participants: Twelve patients with chronic kidney disease without kidney replacement therapy who were considering their treatment options and eight family members. Approach: Individual semistructured interviews with a narrative approach were conducted between August 2021 and March 2022. The data were analysed using Ricoeur's interpretation theory on three levels: naïve reading, structural analysis and critical interpretation and discussion. Findings: One main theme was generated: Family dynamics in a life-changing process. From this, three subthemes were derived: Living in an ordinary life placed in a waiting position, The dilemma of readiness to share and Feelings of being left alone. Conclusion: There are changes in family roles and in identity and a desire to maintain the known and ordinary life. Living with chronic kidney disease as a part of daily life is managed differently in the family, which can lead to feelings such as sadness, frustration and loss of shared life and resilience.</p

Phosphate adsorption to iron sludge from waterworks, ochre precipitation basins and commercial ferrihydrite at ambient freshwater phosphate concentrations

Measures such as storm water ponds, constructed wetlands and buffer strips along streams are used to reduce diffuse phosphorus (P) loading to surface waters. These systems often retain particulate P well, whereas the retention of dissolved P is less efficient and might require addition of P adsorbents. In this study, we screened waterwork ochre sludge (WWS) originating from groundwater treatment and ochre sludge from ochre precipitation basins along streams for their applicability as P adsorbents at ambient P concentrations. We compared with a commercial ferric hydroxide (CFH 12™) for which adsorption properties is well described. The adsorption capacity of 9 products was measured over 24 h at different P concentrations (5–2000 µg L −1), a range that covers Danish drainage water and stormwater. WWS desorbed phosphate at concentrations below 50–200 µg P L −1 and should only be considered for use in systems with a constantly high load of dissolved P. High affinity combined with little or no desorption characterized the commercial product and the ochre sludge from the precipitation basins, rendering these useful for treating drainage water and storm water. The study underlines that waste products may act as potentially effective P adsorbers at environmentally relevant P levels.</p

Do new lakes behave like natural lakes regarding sediment composition and phosphorus fluxes?

Numerous new lakes have been established during the last few decades. Lakes established on former agricultural soils often have high legacy phosphorus (P)-content, which constitutes a risk for potential internal P-loading after the lake is formed. In this study, we compared the P release and sediment P-pools from 31 new lakes and 31 natural lakes, to assess their similarities and differences. A suite of other sediment characteristics was identified and compared for both natural and new lakes; catchment characteristics of the new lakes also were analyzed. P release from the sediment of new lakes was significantly lower than from natural lakes (13.2 mg P m−2 d−1) compared to new lakes (6.9 mg P m−2 d−1). The P release was found to be low when molar Fe:P ratios were above 10. A significant correlation was found between the content of mobile-P (loosely adsorbed P, iron-bound P, and leachable organic P) and TP in the sediment, irrespective of lake type. The composition of the mobile P-pool also differed, with the new non-excavated lakes showing a higher proportion of RP-BD; both new lake types had significantly (p = 0.021) lower proportions of nrP, compared to natural lakes in the uppermost 10 cm sediment. In addition, variance in P release and mobile-P content of new lakes could be explained in terms of the land use of the catchments. Most sediment characteristics of new lakes established without topsoil excavation reached the average levels of natural Danish lakes with respect to density, organic content and P content within 20–30 years, while excavated lakes showed no such tendencies.</p

Advance care planning in chronic kidney disease: A national Danish survey of knowledge and attitudes among clinicians

Introduction: Patients with chronic kidney disease and their families strongly request advance care planning. They want it to start early—before treatment decisions are made—and to be an ongoing process during their illness trajectory. Previous international studies show that health care professionals find there to be significant barriers that impact the extent of involvement in advance care planning. Aim: To identify Danish nephrology health care professionals' knowledge and attitudes to advance care planning and the status of current advance care planning practice in Denmark. Method: An anonymous, cross-sectional survey was administrated online. The questionnaire was developed in Australia and translated and culturally adapted into Danish. Health care professionals were recruited via email lists. In descriptive statistics and multiple ordinal regression, the influence of the respondents' attributes on the extent of involvement in advance care planning was explored, along with the involvement of family, and skills, comfort, barriers and facilitators in relation to advance care planning. Results: The 207 respondents comprised nephrologists (23%), other physicians (8%), nurses (62%) and other HCPs (7%), of whom 27% had participated in advance care planning training. In total, 66% indicated that they lacked access to material about advance care planning for patients with chronic kidney disease and 46% indicated that the conversations were performed ad hoc. A total of 47% reported that advance care planning was performed well at their workplace. Reported barriers were time, lack of experience and procedure. Training in advance care planning could facilitate the involvement. Nurses were less likely to feel skilled and comfortable in engaging advance care planning, while those with more than 10 years of experience were more likely to feel skilled and comfortable. Conclusion: Training in advance care planning with patients with chronic kidney disease and their families on both a theoretical and clinical level is important to ensure comfort among health care professionals and to facilitate the extent of involvement. A systematic chronic kidney disease-specific approach is significant, in order to guide the conversations and ensure that advance care planning is conducted to a set standard.</p

Advance care planning to patients with chronic kidney disease and their families: An intervention development study

Aim: To develop an advance care planning intervention based on the needs of patients with chronic kidney disease, families and healthcare professionals. Background: Patients with chronic kidney disease and their families request early advance care planning that continues throughout their illness trajectory. Healthcare professionals experience barriers to initiating advance care planning. Involvement of stakeholders in development of health interventions is important, to identify priorities, understand the problem and find solutions. Method: The development was inspired by the Medical Research Council's framework, and codesign was applied. One future workshop and one design workshop were conducted with the consumers. The process was iterative, and data were analysed using the action research spiral. The Guidance for reporting intervention development studies in healthcare (GUIDED) was used. Results: Five areas were considered significant to an advance care planning intervention; a biopsychosocial approach, early palliative care, a family-focused approach, early and continuous advance care planning and a consumer-centred approach. Based on these, a conversation process with healthcare professionals was designed to give patients and families the opportunity to share values, preferences and wishes for treatment and their family and everyday life. Conclusion: Codesign facilitated a collaborative process that allowed the consumers to have a significant impact on the design of an advance care planning intervention. A conversation process concerning everyday life, illness and treatment was designed for patients and families. The intervention included an advance care planning tool to guide the healthcare professionals. Practice Implications: The intervention has the intention to improve the communication between healthcare professionals, patients and families. The study provides important knowledge about the significance of giving the patients and their families support in sharing their values, preferences and wishes for treatment and everyday life, thus, to improve care and treatment in their illness trajectory. Impact: What problem did the study address Patients with chronic kidney disease and their families strongly request early initiation of advance care planning that continues throughout the illness trajectory. Healthcare professionals experience barriers to the initiation of the advance care planning and request a more systematic approach. What were the main findings Development of a conversation process about everyday life, illness and treatment for patients diagnosed with chronic kidney disease and families, including an advance care planning tool to guide the healthcare professionals. Where and on whom will the research have an impact The study contributes an advance care planning intervention to patients in the early stages of chronic kidney disease and their families. We believe that the intervention could be included during consultations with healthcare professionals in other stages of chronic kidney disease as well as other chronic disease. Reporting Method: To strengthen the reporting of the development of the advance care planning intervention, we used the Guidance for reporting intervention development studies in healthcare (GUIDED). Patient or Public Contribution: The development of the intervention in this study was a collaborative process between patients, families, healthcare professionals and representatives from the Danish Kidney Association, the department's user council and the research team.</p

Physical stream quality measured by drones and image analysis versus the traditional manual method

Information on the physical and ecological state of streams along with an overview of the need for maintenance is traditionally a time-consuming manual field task with subsequent limitations in area coverage. Here we propose a novel approach to stream monitoring and management using a low-cost Unmanned Aerial Vehicle (UAV) platform to collect data comparable to that from traditional monitoring schemes. This technology provides high-resolution imagery while being easy to implement at a low cost along with providing data that represent the stream in both fine-scale and at landscape scale. The results show a significant correlation between results obtained by the two methods, with the largest difference in DFI values being 10, but in many cases being &lt;5. The UAV-method is especially strong in supporting geographical measurements of stream width and course along with certain stream parameters such as physical variation, water flow and gravel coverage. The results indicate that UAV mapping of streams is a feasible alternative or support to the traditional mapping of certain open stream types with the possibility of covering more area with the same time-use.</p

Matematiktest som prædiktor af ingeniørstuderendes studiesucces

Mangel på ingeniører og andre STEM-uddannede vækker bekymring i Europa. Og Danmark er blandt de lande, som er særligt udfordrede. Internationale studier tyder på, at matematiske evner har prædiktiv værdi i forhold til STEM-studerendes studiesucces – et begreb der omfatter både præstationer og progression på uddannelsen. I dette studie undersøges det, hvorvidt to matematiktests kan forudsige danske ingeniørstuderendes studieprogression; studiegennemførelse og beståelse af førsteårsprøven. De studerende havde ikke forberedt sig på test 1, mens de havde mulighed for at forberede sig på test 2. I forhold til den første test tyder studiets fund på, at det i højere grad er den frivillige deltagelse i undervisningen, hvori testen indgik end selve testscoren, der har sammenhæng med studiesuccesen. Pointscoren i den anden test viste sig at være en middelstærk prædiktor af både frafald og beståelse af førsteårsprøven. Studiet bidrager med input til diskussionen om optagelsestests på danske videregående uddannelser samt til ønsket om tidligt at kunne identificere frafaldstruede studerende