| 1. |
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| 2. |
- Miyazaki, Celine, et al.
(författare)
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Real-world biologic treatment patterns and healthcare resource utilization in psoriasis patients using an insurance claims database in Japan
- 2024
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Ingår i: Journal of dermatological treatment (Print). - : Taylor & Francis. - 0954-6634 .- 1471-1753. ; 35:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: With advent of newer treatments for psoriasis, real-world use of biologics in Japan is evolving.Methods: This retrospective study utilized data from patients with ≥1 psoriasis-related biologic claims record between January 2016 and December 2020 in Japan to evaluate treatment patterns, healthcare resource utilization (HCRU), and associated costs. Data were analyzed using descriptive statistics.Results: Of 1,614 eligible patients, 72.5% were male, 29.2% had comorbid hypertension and 26.6% had comorbid cardiovascular disease. Interleukin (IL)-17 and tumor necrosis factor alpha (TNFα) inhibitors were commonly prescribed across lines of treatment, while IL-23 inhibitors were most considered for switches (92% of switches were from IL-12/23/IL-17/TNFα inhibitors). The overall mean adherence rate for all classes was 80.1%, but adherence varied across biologics. Infliximab and IL-23 inhibitor users exhibited optimal medical possession ratios, reflecting the best adherence rates. Overall HCRU (visits/patient-year) was 9.05 for outpatient visits, 0.09 for inpatient hospitalization, and 0.5 for psoriasis-related phototherapy. HCRU associated with hospitalization was slightly higher for bio-experienced patients and so was the overall costs per patient-year relative to bio-naïve patients.Conclusion: Variable adherence rates observed suggest the need for improvement in treatment management with different biologics. Bio-experienced patients burdened by disease progression and treatment switches may result in increased HCRU.
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| 3. |
- Nayeri, Fariba, 1958-, et al.
(författare)
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Hepatocyte growth factor may accelerate healing in chronic leg ulcers : a pilot study
- 2002
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Ingår i: Journal of dermatological treatment (Print). - : Informa UK Limited. - 0954-6634 .- 1471-1753. ; 13:2, s. 81-86
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND : Hepatocyte growth factor (HGF) is a heparin-binding protein with mitogenic, motogenic and morphogenic activities for various cell types. The regenerative properties of HGF have been the object of several animal and in vitro studies in recent years.OBJECTIVE : To investigate the physiological and therapeutic effects of HGF on chronic leg ulcers.METHODS : HGF in gel form was locally applied, once daily for 7 days, to 15 of 19 chronic leg ulcers in 11 elderly patients. All patients had previously been treated by conventional methods and their leg ulcers had been in stable conditions for between 1 and 14 years. Any signs of allergy, discomfort or pain were reported daily. Microcirculation perfusion in the ulcers, compared to the intact contiguous skin, was determined by laser Doppler at the beginning of the study, after 1 week and again after 3 months (in seven patients). Ulcer size and characteristics were also documented.RESULTS : It was observed that microcirculatory perfusion, which might reflect the angiogenic effect of HGF, was statistically significantly correlated ( r = 0.94, p < 0.002) to ulcer area reduction in the treated ulcers. Excellent (84-100% area reduction) or partial healing (58-59%) was seen in eight out of 11 patients. No control group was included in this pilot study, which must be completed by proper control studies.CONCLUSION : This study suggests that HGF may heal chronic leg ulcers, possibly by improving the microcirculation. Proper control studies need to be performed.
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| 4. |
- Norlin, J. M., et al.
(författare)
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Real-world outcomes in 2,646 psoriasis patients : one in five has PASI ≥ 10 and/or DLQI ≥ 10 under ongoing systemic therapy
- 2017
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Ingår i: Journal of dermatological treatment (Print). - : Informa UK Limited. - 0954-6634 .- 1471-1753. ; 28:6, s. 500-504
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although biologics introduced a new era in psoriasis care when available a decade ago, it is unclear to what extent the available systemic treatments treat patients adequately. Objective To analyse the clinical severity and quality of life of the psoriasis population in Sweden treated with systemics.Methods: Data included 2,646 patients from the Swedish Registry for Systemic Treatment of Psoriasis. Average Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), and EQ-5D were reported. A subgroup of persisting moderate-to-severe psoriasis as defined by PASI≥10 and/or DLQI≥10 after >12 weeks treatment was analysed.Results: Mean (SD) PASI, DLQI, and EQ-5D were 4.12 (4.57), 4.11 (5.24) and 0.79 (0.22). Eighteen percent had persisting moderate-to-severe psoriasis (n = 472). These patients were younger, had higher BMI, had psoriasis arthritis and were smoking to a larger extent (p < 0.01) compared to lower-severity patients (n = 2174). Mean (SD) EQ-5D was also considerably lower 0.63 (0.29) vs. 0.82 (0.19) (p < 0.01).Conclusion: Almost one in every five patients had persisting moderate-to-severe psoriasis, despite ongoing systemic treatment. Both comorbidities and life style factors were associated with persisting moderate-to-severe psoriasis. The considerably lower generic quality of life in these patients demonstrates an unmet need. Subsequently, improved access to biologics and continuous drug development is needed in psoriasis.
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| 5. |
- Polesie, Sam, et al.
(författare)
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A systematic review investigating the proportion of clinical images shared in prospective randomized controlled trials involving patients with atopic dermatitis and systemic pharmacotherapy
- 2024
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Ingår i: Journal of dermatological treatment. - 0954-6634 .- 1471-1753. ; 35
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: For individuals with atopic dermatitis (AD), interpreting scientific papers that present clinical outcomes including the Eczema Area and Severity Index (EASI) and Investigators Global Assessment may be difficult. When compared to tabulated data and graphs, images from before and after treatment are often far more meaningful to these patients that ultimately will be candidates for the treatment. This systematic review focused on determining the frequency of clinical image sharing in AD research. Materials and methods: Conducted in accordance with PRISMA guidelines, the review concentrated on randomized controlled trials that investigated predefined and available systemic treatments for AD. The search was performed in the MEDLINE database for studies published from the inception until 21 December 2023. Results: The review included 60 studies, encompassing 17,799 randomized patients. Across these studies, 16 images representing 6 patients were shared in the manuscripts, leading to a sharing rate of 0.3‰. Conclusions: The almost missing inclusion of patient images in clinical trial publications hinders patient understanding. Adding images to scientific manuscripts could significantly improve patients’ comprehension of potential treatment outcomes. This review highlights the need for authors, the pharmaceutical industry, study sponsors, and publishers to enhance and promote patient information through increased use of visual data.
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| 6. |
- Proksch, Ehrhardt, et al.
(författare)
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Dry skin management : practical approach in light of latest research on skin structure and function.
- 2020
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Ingår i: Journal of dermatological treatment (Print). - : Taylor & Francis. - 0954-6634 .- 1471-1753. ; 31:7, s. 716-722
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Tidskriftsartikel (refereegranskat)abstract
- Dry skin is a common condition that is attributed to a lack of water in the stratum corneum. With the availability of new technologies, light has been shed on the pathophysiology of dry skin at the molecular level. With the aim to discuss implications of this latest research for the optimal formulation of emollients designed to treat dry skin, five specialists met in November 2017. Research on three topics thereby provided particularly detailed new insights on how to manage dry skin: research on the lipid composition and organization of the stratum corneum, research on natural moisturizing factors, and research on the peripheral nervous system. There was consensus that latest research expands the rationale to include physiological lipids in an emollient used for dry skin, as they were found to be essential for an adequate composition and organization in the stratum corneum but are reduced in dry skin. Latest findings also confirmed the incorporation of carefully selected humectants into a topical emollient for dry skin, given the reduced activity of enzymes involved in the synthesis of moisturizing factors when skin is dry. Overall, the group of specialists concluded that the previous concept of the five components for an ideal emollient for dry skin is well in accordance with latest research.
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| 7. |
- Reich, Kristian, et al.
(författare)
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Network meta-analysis comparing the efficacy of biologic treatments for achieving complete resolution of nail psoriasis
- 2022
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Ingår i: Journal of Dermatological Treatment. - : Informa UK Limited. - 0954-6634 .- 1471-1753. ; 33:3, s. 1652-1660
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nail psoriasis (NP) is common and of high importance in patients with psoriasis. Complete resolution of NP at week 24‒26 is an unambiguous nail outcome accessible for indirect treatment comparison of biologics. Objective: To evaluate the comparative efficacy of approved biologics in achieving complete resolution of NP at week 24‒26. Methods: A network meta-analysis (NMA) was conducted to indirectly compare the efficacy of six biologics in achieving complete resolution of NP at week 24‒26 in patients with moderate-to-severe psoriasis and concomitant NP. Complete resolution of NP was defined as a score of zero on the Nail Psoriasis Severity Index (NAPSI), modified NAPSI (mNAPSI) or Physician’s Global Assessment of Fingernails (PGA-F). Results: The probability of achieving complete resolution of NP was highest for ixekizumab (46.5%; 95% credibility interval [CrI] 35.1‒58.0; Surface Under the Cumulative RAnking curve [SUCRA] 97%), followed by brodalumab (37.0%; 17.0‒61.0; 79%), adalimumab (28.3%; 24.4‒32.4; 62%), guselkumab (27.7%; 21.1‒35.1; 58%), ustekinumab (20.8%; 10.2‒35.2; 37%), and infliximab (0.8%; 0.0‒8.9; 17%). Conclusion: In patients with moderate-to-severe psoriasis and concomitant NP, ixekizumab has the greatest likelihood among approved biologics of achieving complete resolution of NP at week 24‒26. Findings should be interpreted carefully because of inherent study limitations.
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| 8. |
- Ring, Lena, et al.
(författare)
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Living with skin diseases and topical treatment: patients' and providers' perspectives and priorities.
- 2007
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Ingår i: The Journal of dermatological treatment. - : Informa UK Limited. - 0954-6634 .- 1471-1753. ; 18:4, s. 209-18
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Relationship-centred care stresses the importance of taking both patients' and health-care providers' values, expectations and preferences into account to improve health outcomes. The aim of this qualitative study was to identify patients' and providers' views and experiences of skin disease and topical treatment. METHODS: Two types of focus group were used: (i) patients with chronic dermatological diseases and (ii) doctors, nurses and pharmacists working in dermatological care. RESULTS: Three major categories emerged: (i) problems related to the disease, (ii) problems related to the treatment and (iii) strategies for improving everyday life for patients. CONCLUSION: Patients and providers made several suggestions for improving everyday life. Future research needs to focus on how to achieve preference-matched shared decision-making, or concordance, between patients and health-care providers, taking different perspectives into account and how to evaluate the effect of the final, clinical, economical and humanistic outcomes of care and treatment. More seamless care and an increasingly shared understanding between patients and providers of their values, expectations and preferences for care and treatment may contribute to better health and better daily lives for patients.
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| 9. |
- Segger, Dorte, et al.
(författare)
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Supplementation with Eskimo (R) Skin Care improves skin elasticity in women. A pilot study
- 2008
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Ingår i: Journal of dermatological treatment (Print). - : Informa UK Limited. - 0954-6634 .- 1471-1753. ; 19:5, s. 279-283
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the question of whether supplementation with an oral oil formulation rich in natural stable fish oil can alter skin elasticity, transepidermal water loss (TEWL), and skin roughness in healthy women. Methods: Twenty-four healthy women aged 40-60 years participated in a single-blind randomized trial for testing the effect of a proprietary oral supplement for skin nutrition (Eskimo Skin Care) on skin elasticity, TEWL, and skin roughness. Skin elasticity was measured by an optical cutometer, TEWL by a water-loss module based upon the vapour gradient principle, and skin roughness with a three-dimensional microtopography imaging system. Results: Skin elasticity increased by 10% after 3 months of treatment with the supplement, a statistically significant increase in comparison with the control group (p=0.0298). There was a trend, though not statistically significant, towards a positive influence on the skin's barrier function. No effect on the skin roughness was observed. Conclusion: Eskimo Skin Care, an oral preparation rich in natural stable fish oil, can improve skin elasticity.
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| 10. |
- Ulff, Eva, et al.
(författare)
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Fluorescent cream used as an educational intervention to improve the effectiveness of self-application by patients with atopic dermatitis
- 2013
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Ingår i: Journal of dermatological treatment (Print). - : Informa Healthcare. - 0954-6634 .- 1471-1753. ; 24:4, s. 268-271
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of the study was to assess if a fluorescent cream, in a self-application educational session, could increase the effectiveness of cream application in practice and serve as a therapeutic intervention. Methods: 30 adults with atopic dermatitis were enrolled. They applied a fluorescent test cream on two occasions. Effectiveness of application was checked under ultraviolet illumination. At baseline, the patients greased their skin as they normally do. After 2 weeks, the patients were instructed to grease the whole body area. The results were commented on and visualised to the patients on both occasions. Results: At the baseline visit, 29% of the target skin was untreated, and at the follow-up visit after education, this improved to 13.6% (mean values, p andlt; 0.05). Women performed better than men at baseline; however, men performed similar to women at the follow-up visit. Conclusions: The Fluorescent-cream Educational Session (FES) is an educational instrument for therapeutic intervention based on interaction between patient and provider. It includes hard endpoints, that is, visualisation and measurement of treated area, time spend on treatment and amount of cream used.
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| 11. |
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| 12. |
- Waernulf, Lena, et al.
(författare)
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Patients' views on care and treatment after phototherapy for psoriasis and atopic eczema including a gender perspective
- 2008
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Ingår i: Journal of dermatological treatment (Print). - : Taylor & Francis. - 0954-6634 .- 1471-1753. ; 19:4, s. 233-240
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Psoriasis and atopic eczema are reportedly as common among women as among men and are not known to differ in severity between sexes. Research has shown that men get more treatment with ultraviolet (UV) light for longer periods than women. This fact, together with ongoing efforts to improve patient satisfaction with care and treatment at our department, prompted us to gather information from our patients.OBJECTIVE: The aim of this study was to explore patients' views of dermatological care and treatment methods.METHOD: A questionnaire-based survey was carried out, complemented with qualitative interviews.RESULTS: The main findings fall under three areas of clinical relevance: information to patients must be individually designed with a gender perspective; men and women have different attitudes towards greasing which must be kept in mind in clinical practice; and women often appear to be under-prescribed UV treatment.CONCLUSION: The information from our study can form a basis for new therapeutic strategies, taking a gender perspective into account.
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| 13. |
- Yasmeen, Najeeda, et al.
(författare)
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Targeted therapies for patients with moderate-to-severe psoriasis: a systematic review and network meta-analysis of PASI response at 1 year
- 2022
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Ingår i: Journal of dermatological treatment (Print). - : TAYLOR & FRANCIS LTD. - 0954-6634 .- 1471-1753. ; 33:1, s. 204-218
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Forskningsöversikt (refereegranskat)abstract
- Purpose: To compare PASI outcomes of approved biologics and apremilast after 1 year of treatment. Methods: A systematic review identified RCTs and long-term extensions reporting PASI 75, 90, and 100 responses in adults with moderate-to-severe psoriasis. Data for analysis were modeled using a Bayesian multinomial likelihood model with probit link. Results: Twenty-eight studies reporting PASI responses were included in the network meta-analysis. Differences in study design led to a stepwise approach to synthesis, consisting of two analyses. The primary analysis included nine RCTs investigating comparative efficacy at 1 year. Results indicated risankizumab, brodalumab, and guselkumab were the most effective therapies, followed by ixekizumab and secukinumab; all demonstrated superiority to ustekinumab and etanercept. The secondary analysis extended the primary analysis with 19 further studies comparing active interventions to placebo outcomes extrapolated from induction. The interventions generating the highest PASI response were the same as the primary analysis. These therapies were more effective than apremilast, ustekinumab, adalimumab, certolizumab, etanercept, and infliximab. Conclusions: This NMA demonstrated that evaluated IL-17 and IL-23 inhibitors outperformed other biological therapies after 1 year. Risankizumab had a higher probability of achieving PASI outcomes than all other biologics, except brodalumab and guselkumab, where no significant difference could be concluded.
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| 14. |
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| 15. |
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| 16. |
- Polesie, Sam, et al.
(författare)
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A systematic review investigating at what proportion clinical images are shared in prospective randomized controlled trials involving patients with psoriasis and biological agents.
- 2023
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Ingår i: The Journal of dermatological treatment. - 1471-1753. ; 34:1
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Tidskriftsartikel (refereegranskat)abstract
- For many patients including those with psoriasis, scientific manuscripts comprising clinical outcomes including psoriasis area severity index (PASI) and/or physician global assessment (PGA) may be difficult to understand. However, most patients can relate to images at baseline and follow-up, particularly for dermatological diseases. This study aimed to assess the proportion of shared clinical images in psoriasis trials. A systematic review adhering to the PRISMA guidelines was performed. The review was limited to randomized controlled trials, and among these, only investigations involving biological agents for treatment of psoriasis were included. The Embase, MEDLINE and Scopus databases were searched for eligible studies published from inception to October 26, 2021. In total, 152 studies were included. When combining these, 62,871 patients were randomized. Overall, 203 images were shared depicting 60 patients in the manuscripts yielding an overall sharing rate of 0.1%. Patient images are seldom incorporated in clinical trial manuscripts which impairs interpretation for patients. Inclusion of image material would strengthen the patients' perspective and understanding on what treatment effects that can be expected. As such, this systematic review should be an invitation to the pharmaceutical industry, other sponsors, and editorial offices to improve easy transfer of information to patients using image data.
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| 17. |
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| 18. |
- Saveman, Britt-Inger, et al.
(författare)
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Unintentional injuries among older adults in northern Sweden : a one-year population-based study
- 2011
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 25:1, s. 185-193
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Tidskriftsartikel (refereegranskat)abstract
- Scand J Caring Sci; 2011; 25; 185-193 Unintentional injuries among older adults in northern Sweden - a one-year population-based study Aim: To study the epidemiology of unintentional injuries in a population of 21 000 Swedish older adults (65+) and to compare the injury incidence with similar data collected two decades earlier. Method: This is a retrospective epidemiologic cross-sectional study based on a 1-year data set of all the 1753 registered injury events from a well-defined population. Result: The injury rate per 1000 individuals was three times higher in the 85+ age group than in the 65-74 age group. The rate was also higher in women than in men aged 75 and older. Fractures, especially on lower and upper extremities, were the most common injuries. Falls in residential care facilities caused the most serious injuries. In transport areas, pedestrian falls and bicyclist crashes were much more common than car crashes. Of the 1753 people injured, 42% were treated as inpatients for a total of 11 569 days; 86% of these days were caused by injury events in the home (57%) or in residential care facilities (29%). Our 65+ age group occupied 69% of all hospital bed-days for trauma in all ages (0-102 years). Conclusion: Over the last two decades, the injury and fracture rate per 1000 individuals has increased by 40-50%, especially in the older age groups. During this time, the nursing strategy for older adults has changed in Sweden. As a result, more people live in their homes nowadays. This increase is distressing especially when we consider the current knowledge of preventive measures. The high number and proportion (>2/3) of inpatient trauma days for these age groups are a heavy burden for the medical sector. These facts call for more effective preventive measures, especially in the home and in residential care facilities, to minimize the negative health effects and the rising health costs.
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| 19. |
- Büntgen, Ulf, et al.
(författare)
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Plants in the UK flower a month earlier under recent warming
- 2022
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Ingår i: Proceedings of the Royal Society of London. Biological Sciences. - : The Royal Society. - 0962-8452 .- 1471-2954. ; 289:1968
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Tidskriftsartikel (refereegranskat)abstract
- Global temperatures are rising at an unprecedented rate, but environmental responses are often difficult to recognize and quantify. Long-term observations of plant phenology, the annually recurring sequence of plant developmental stages, can provide sensitive measures of climate change and important information for ecosystem services. Here, we present 419 354 recordings of the first flowering date from 406 plant species in the UK between 1753 and 2019 CE. Community-wide first flowering advanced by almost one month on average when comparing all observations before and after 1986 (p < 0.0001). The mean first flowering time is 6 days earlier in southern than northern sites, 5 days earlier under urban than rural settings, and 1 day earlier at lower than higher elevations. Compared to trees and shrubs, the largest lifeform-specific phenological shift of 32 days is found in herbs, which are generally characterized by fast turnover rates and potentially high levels of genetic adaptation. Correlated with January-April maximum temperatures at -0.81 from 1952-2019 (p < 0.0001), the observed trends (5.4 days per decade) and extremes (66 days between the earliest and latest annual mean) in the UK's first flowering dataset can affect the functioning and productivity of ecosystems and agriculture.
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