| 1. |
- Kehoe, Laura, et al.
(author)
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Make EU trade with Brazil sustainable
- 2019
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In: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 364:6438, s. 341-
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Journal article (other academic/artistic)
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| 2. |
- Afonso-Argilés, F. Javier, et al.
(author)
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Emergency department and hospital admissions among people with dementia living at home or in nursing homes : results of the European RightTimePlaceCare project on their frequency, associated factors and costs
- 2020
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In: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 20:1
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Journal article (peer-reviewed)abstract
- Background: Evidence is lacking on the differences between hospitalisation of people with dementia living in nursing homes and those living in the community. The objectives of this study were: 1) to describe the frequency of hospital admission among people with dementia in eight European countries living in nursing homes or in the community, 2) to examine the factors associated with hospitalisation in each setting, and 3) to evaluate the costs associated with it. Methods: The present study is a secondary data analysis of the RightTimePlaceCare European project. A cross-sectional survey was conducted with data collected from people with dementia living at home or who had been admitted to a nursing home in the last 3 months, as well as from their caregivers. Data on hospital admissions at 3 months, cognitive and functional status, neuropsychiatric symptoms, comorbidity, polypharmacy, caregiver burden, nutritional status, and falls were assessed using validated instruments. Multivariate regression models were used to investigate the factors associated with hospital admission for each setting. Costs were estimated by multiplying quantities of resources used with the unit cost of each resource and inflated to the year 2019. Results: The study sample comprised 1700 people with dementia living in the community and nursing homes. Within 3 months, 13.8 and 18.5% of people living in nursing homes and home care, respectively, experienced ≥1 hospital admission. In the nursing home setting, only polypharmacy was associated with a higher chance of hospital admission, while in the home care setting, unintentional weight loss, polypharmacy, falls, and more severe caregiver burden were associated with hospital admission. Overall, the estimated average costs per person with dementia/year among participants living in a nursing home were lower than those receiving home care. Conclusion: Admission to hospital is frequent among people with dementia, especially among those living in the community, and seems to impose a remarkable economic burden. The identification and establishment of an individualised care plan for those people with dementia with polypharmacy in nursing homes, and those with involuntary weight loss, accidental falls, polypharmacy and higher caregiver burden in the home care setting, might help preventing unnecessary hospital admissions.
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| 3. |
- Afram, Basema, et al.
(author)
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Reasons for Institutionalization of People With Dementia: Informal Caregiver Reports From 8 European Countries
- 2014
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In: Journal of the American Medical Directors Association. - : Elsevier BV. - 1525-8610. ; 15:2, s. 108-116
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Journal article (peer-reviewed)abstract
- Objectives: To explore reasons for institutionalization of people with dementia according to informal caregivers as well as variation in reasons between countries. Design: An explorative cross-sectional study was conducted in 8 European countries. Setting: Per country, a minimum of 3 long term care facilities, offering care and accommodation as a package, participated in this study. Participating countries were selected to represent different geographic areas in Europe. Participants: Of the 791 informal caregivers involved in the RightTimePlaceCare project of people with dementia who were recently admitted to a long term care facility, 786 were included for this study. Measurements: As part of a semistructured interview, informal caregivers were asked the main reason for institutionalization in an open-ended question. Answers were categorized according to a conventional coding approach. All reasons were then quantified and tested. Results: Mainly patient-related reasons were stated, such as neuropsychiatric symptoms (25%), care dependency (24%), and cognition (19%). Neuropsychiatric symptoms were among the most often mentioned reasons in most countries. Besides patient-related reasons, caregiver burden and the inability of the informal caregiver to care for the patient were stated as reasons (both 15%). Further analyses showed countries differ significantly in reasons according to informal caregivers. Additionally, reasons were analyzed for spouses and child-caregivers, showing that spouses more often stated reasons related to themselves compared with child-caregivers. Conclusion: Multiple reasons contribute to the institutionalization for people with dementia, with several factors that may influence why there were country differences. Variation in the organization of dementia care and cultural aspects, or the relationship between the informal caregiver and person with dementia may be factors influencing the reasons. Because of a wide variation in reasons between countries, no one-size-fits-all approach can be offered to guide informal caregivers when facing the possibility of institutionalization of the person with dementia. (C) 2014 - American Medical Directors Association, Inc. All rights reserved.
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| 4. |
- Birkhofer, Klaus, et al.
(author)
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General Relationships between Abiotic Soil Properties and Soil Biota across Spatial Scales and Different Land-Use Types.
- 2012
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In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 7:8
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Journal article (peer-reviewed)abstract
- Very few principles have been unraveled that explain the relationship between soil properties and soil biota across large spatial scales and different land-use types. Here, we seek these general relationships using data from 52 differently managed grassland and forest soils in three study regions spanning a latitudinal gradient in Germany. We hypothesize that, after extraction of variation that is explained by location and land-use type, soil properties still explain significant proportions of variation in the abundance and diversity of soil biota. If the relationships between predictors and soil organisms were analyzed individually for each predictor group, soil properties explained the highest amount of variation in soil biota abundance and diversity, followed by land-use type and sampling location. After extraction of variation that originated from location or land-use, abiotic soil properties explained significant amounts of variation in fungal, meso- and macrofauna, but not in yeast or bacterial biomass or diversity. Nitrate or nitrogen concentration and fungal biomass were positively related, but nitrate concentration was negatively related to the abundances of Collembola and mites and to the myriapod species richness across a range of forest and grassland soils. The species richness of earthworms was positively correlated with clay content of soils independent of sample location and land-use type. Our study indicates that after accounting for heterogeneity resulting from large scale differences among sampling locations and land-use types, soil properties still explain significant proportions of variation in fungal and soil fauna abundance or diversity. However, soil biota was also related to processes that act at larger spatial scales and bacteria or soil yeasts only showed weak relationships to soil properties. We therefore argue that more general relationships between soil properties and soil biota can only be derived from future studies that consider larger spatial scales and different land-use types.
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| 5. |
- Broda, Anja, et al.
(author)
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Perspectives of policy and political decision makers on access to formal dementia care : expert interviews in eight European countries
- 2017
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In: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 17:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: As part of the ActifCare (ACcess to Timely Formal Care) project, we conducted expert interviews in eight European countries with policy and political decision makers, or representatives of relevant institutions, to determine their perspectives on access to formal care for people with dementia and their carers.METHODS: Each ActifCare country (Germany, Ireland, Italy, The Netherlands, Norway, Portugal, Sweden, United Kingdom) conducted semi-structured interviews with 4-7 experts (total N = 38). The interview guide addressed the topics "Complexity and Continuity of Care", "Formal Services", and "Public Awareness". Country-specific analysis of interview transcripts used an inductive qualitative content analysis. Cross-national synthesis focused on similarities in themes across the ActifCare countries.RESULTS: The analysis revealed ten common themes and two additional sub-themes across countries. Among others, the experts highlighted the need for a coordinating role and the necessity of information to address issues of complexity and continuity of care, demanded person-centred, tailored, and multidisciplinary formal services, and referred to education, mass media and campaigns as means to raise public awareness.CONCLUSIONS: Policy and political decision makers appear well acquainted with current discussions among both researchers and practitioners of possible approaches to improve access to dementia care. Experts described pragmatic, realistic strategies to influence dementia care. Suggested innovations concerned how to achieve improved dementia care, rather than transforming the nature of the services provided. Knowledge gained in these expert interviews may be useful to national decision makers when they consider reshaping the organisation of dementia care, and may thus help to develop best-practice strategies and recommendations.
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| 6. |
- Deckmyn, G., et al.
(author)
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Simulating ectomycorrhizal fungi and their role in carbon and nitrogen cycling in forest ecosystems
- 2014
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In: Canadian Journal of Forest Research. - : Canadian Science Publishing. - 0045-5067 .- 1208-6037. ; 44:6, s. 535-553
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Research review (peer-reviewed)abstract
- Although ectomycorrhizal fungi play an important role in forest ecosystem functioning, they are usually not included in forest growth or ecosystem models. Simulation is hampered by two main issues: a lack of understanding of the ecological functioning of the ectomycorrhizal fungi and a lack of adequate basic data for parameterization and validation. Concerning these issues, much progress has been made during the past few years, but this information has not found its way into the forest and soil models. In this paper, state-of-the-art insight into ectomycorrhizal functioning and basic values are described in a manner transparent to nonspecialists and modelers, together with the existing models and model strategies. As such, this paper can be the starting point and the motivator to include ectomycorrhizal fungi into existing soil and forest ecosystem models.
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| 7. |
- Demichev, Vadim, et al.
(author)
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A time-resolved proteomic and prognostic map of COVID-19
- 2021
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In: Cell Systems. - : Elsevier BV. - 2405-4712 .- 2405-4720. ; 12:8, s. 780-794.e7
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Journal article (peer-reviewed)abstract
- COVID-19 is highly variable in its clinical presentation, ranging from asymptomatic infection to severe organ damage and death. We characterized the time-dependent progression of the disease in 139 COVID-19 inpatients by measuring 86 accredited diagnostic parameters, such as blood cell counts and enzyme activities, as well as untargeted plasma proteomes at 687 sampling points. We report an initial spike in a systemic inflammatory response, which is gradually alleviated and followed by a protein signature indicative of tissue repair, metabolic reconstitution, and immunomodulation. We identify prognostic marker signatures for devising risk-adapted treatment strategies and use machine learning to classify therapeutic needs. We show that the machine learning models based on the proteome are transferable to an independent cohort. Our study presents a map linking routinely used clinical diagnostic parameters to plasma proteomes and their dynamics in an infectious disease.
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| 8. |
- Handels, Ron L. H., et al.
(author)
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Quality of Life, Care Resource Use, and Costs of Dementia in 8 European Countries in a Cross-Sectional Cohort of the Actifcare Study
- 2018
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In: Journal of Alzheimer's Disease. - 1387-2877 .- 1875-8908. ; 66:3, s. 1027-1040
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Journal article (peer-reviewed)abstract
- Background: With 10.5 million people with dementia in Europe and $301 billion associated costs, governments face challenges organizing access to care. Objective: To examine the costs related to formal and informal care use and quality of life for people with dementia in eight European countries, and explore the association with unmet needs. Methods: Cross-sectional data from 451 persons with dementia and their informal caregivers of the Actifcare cohort study were obtained. Formal and informal care use was multiplied by country specific unit prices of services. Needs were measured using the CANE and health-related quality of life (HRQOL) of the person with dementia (both self- and proxy-rated) and informal caregiver's quality of life using EQ-5D-5L, ICECAP-O, DEMQOL-U, and CarerQol utility scores. The association between costs and country, European region, and unmet needs was assessed using multi-level linear regression. Results: Self-rated EQ-5D-5L utility score was higher than proxy-rated (0.84 and 0.71, respectively). Informal caregivers' utility score was 0.84. Across eight countries annual mean costs of formal and informal care were approximately (sic)17,000. Unmet needs were not associated with annual costs of care, nor with proxy-rated HRQOL, but were associated with self-rated HRQOL. Conclusion: We found varying relationships between unmet needs and quality of life, and no association between unmet needs and care costs, although the results were sensitive to various factors. Future research should further investigate the relation between unmet needs, quality of life and costs to generate a better understanding of the effects of (un)timely access to care.
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| 9. |
- He, Hongxing, 1987, et al.
(author)
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Factors controlling Nitrous Oxide emission from a spruce forest ecosystem on drained organic soil, derived using the CoupModel
- 2016
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In: Ecological Modelling. - : Elsevier. - 0304-3800 .- 1872-7026. ; 321, s. 46-63
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Journal article (peer-reviewed)abstract
- High Nitrous Oxide (N2O) emissions have been identified in hemiboreal forests in association with draining organic soils. However, the specific controlling factors that regulate the emissions remain unclear. To examine the importance of different factors affecting N2O emissions in a spruce forest on drained organic soil, a process-based model, CoupModel, was calibrated using the generalized likelihood uncertainty estimation (GLUE) method. The calibration also aims to estimate parameter density distributions, the covariance matrix of estimated parameters and the correlation between parameters and variables information, useful when applying the model on other peat soil sites and for further model improvements. The calibrated model reproduced most of the high resolution data (total net radiation, soil temperature, groundwater level, net ecosystem exchange, etc.) very well, as well as cumulative measured N2O emissions (simulated 8.7±1.1kgN2Oha-1year-1 (n=97); measured 8.7±2.7kgN2Oha-1year-1 (n=6)), but did not capture every measured peak. Parameter uncertainties were reduced after calibration, in which 16 out of 20 parameters changed from uniform distributions into normal distributions or log normal distributions. Four parameters describing bypass water flow, oxygen diffusion and soil freezing changed significantly after calibration. Inter-connections and correlations between many calibrated parameters and variables reflect the complex and interrelated nature of pedosphere, biosphere and atmosphere interactions. This also highlights the need to calibrate a number of parameters simultaneously. Model sensitivity analysis indicated that N2O emissions during growing seasons are controlled by competition between plants and microbes for nitrogen, while during the winter season snow melt periods are important. Our results also indicate that N2O is mainly produced in the capillary fringe close to the groundwater table by denitrification in the anaerobic zone. We conclude that, in afforested drained peatlands, the plants and groundwater level have important influences on soil N availability, ultimately controlling N2O emissions.
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| 10. |
- He, Hongxing, 1987, et al.
(author)
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Modeling Nitrous Oxide emissions and identifying emission controlling factors for a spruce forest ecosystem on drained organic soil
- 2013
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In: European Geosciences Union, Vienna Austria 07 – 12 April 2013.
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Conference paper (other academic/artistic)abstract
- High nitrous oxide (N2O) emission potential has been identified in hemiboreal forest on drained Histosols. However, the environmental factors regulating the emissions were unclear. To investigate the importance of different factors on the N2O emission, a modeling approach was accomplished, using CoupModel with Monti-Carlo based multi-criteria calibration method. The model was made to represent a forest on drained peat soil in south-west Sweden where data of fluxes combined with soil properties and plant conditions were used. The model outcome was consistent with measurements of abiotic (soil temperature, net radiation, groundwater level and soil moisture) and biotic responses (net ecosystem exchange and soil respiration). Both dynamics and magnitude of N2O emissions were well simulated compared to measurements (8.7±2.1 kg N/ha/year). The performance indicators for an ensemble of accepted simulations of N2O emission dynamics and magnitudes were correlated to calibrated parameters related to soil anaerobic fraction and atmospheric nitrogen deposition (correlation coefficient, r≥0.4). A weak correlation with N2O emission dynamics was also found for biotic responses (r≥0.3). However, the ME of simulated and measured N2O emissions was better correlated to the ME of soil moisture (r=-0.6), and also to the ME of both the soil temperature (r=0.53) and groundwater level (r=-0.7). Groundwater level (range from -0.8m to -0.13m) was identified as the most important environmental factor regulating the N2O emissions for present forest soil. Profile analysis indicated that N2O was mainly produced in the deeper layers (≥0.35m) of the soil profile. The optimum soil moisture for N2O production was around 70%.
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| 11. |
- He, Hongxing, 1987, et al.
(author)
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Modeling Nitrous Oxide emissions and identifying emission controlling factors for a spruce forest ecosystem on drained organic soil
- 2015
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In: Geophysical Research Abstracts. ; 17:EGU2015-10451
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Conference paper (other academic/artistic)abstract
- High Nitrous Oxide (N2O) emission has been identified in hemiboreal forests on drained organic soils. However, the controlling factors regulating the emissions have been unclear. To examine the importance of different factors on the N2O emission in a spruce forest on drained organic soil, a process-based model, CoupModel, was calibrated by the generalized likelihood uncertainty estimation (GLUE) method. The calibrated model reproduced most of the high resolution data (total net radiation, soil temperature, groundwater level, net ecosystem exchange, etc.) very well, as well as accumulated measured N2O emissions, but showed difficulties to capture all the measured emission peaks. Parameter uncertainties could be reduced by combining selected criteria with the measurement data. The model showed the N2O emissions during the summer to be controlled mainly by the competition between plants and microbes while during the winter season snow melt periods are important. The simulated N budget shows >100 kg N ha-1 yr-1 to be in circulation between soil and plants and back again. Each year the peat mineralization adds about 60 kg N ha-1 and atmospheric deposition 12 kg N ha-1. Most of the mineralized litter and peat N is directly taken up by the plants but only a part accumulates in the plant biomass. As long as no timber is harvested the main N loss from the system is through nitrate leaching (30 kg N ha-1 yr-1) and gas emissions (20 kg N ha-1 yr-1), 55% as NO, 27% as N2O and 18% as N2. Regarding N2O gas emissions, our modeling indicates denitrification to be the most responsible process, of the size 6 kg N ha-1 yr-1, which could be compared to 0.04 kg N ha-1 yr-1 from nitrification. Our modelling also reveal 88% of the N2O mainly to be produced by denitrification in the capillary fringe (c.a. 40-60 cm below soil surface) of the anaerobic zone using nitrate produced in the upper more aerobic layers. We conclude N2O production/emission to be controlled mainly by the complex interaction between soil N availability, mediated by mineralization, nitrification, and plant growth together with soil anaerobicity controlled by the groundwater level. The model is currently used for modelling greenhouse gas emissions from drained organic soils over the entire forest cycle, from plantation to harvest. Different land use and plant production are compared like Spruce, Willow and Reed Canary Grass as well as rewetting options.
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| 12. |
- He, Hongxing, 1987, et al.
(author)
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Simulating ectomycorrhiza in boreal forests: implementing ectomycorrhizal fungi model MYCOFON in CoupModel (v5)
- 2018
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In: Geoscientific Model Development. - : Copernicus GmbH. - 1991-959X .- 1991-9603. ; 11:2, s. 725-751
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Journal article (peer-reviewed)abstract
- The symbiosis between plants and Ectomycorrhizal fungi (ECM) is shown to considerably influence the carbon (C) and nitrogen (N) fluxes between the soil, rhizosphere, and plants in boreal forest ecosystems. However, ECM are either neglected or presented as an implicit, undynamic term in most ecosystem models, which can potentially reduce the predictive power of models. In order to investigate the necessity of an explicit consideration of ECM in ecosystem models, we implement the previously developed MYCOFON model into a detailed process-based, soil-plant-atmosphere model, Coup-MYCOFON, which explicitly describes the C and N fluxes between ECM and roots. This new Coup-MYCOFON model approach (ECM explicit) is compared with two simpler model approaches: one containing ECM implicitly as a dynamic uptake of organic N considering the plant roots to represent the ECM (ECM implicit), and the other a static N approach in which plant growth is limited to a fixed N level (nonlim). Parameter uncertainties are quantified using Bayesian calibration in which the model outputs are constrained to current forest growth and soil C / N ratio for four forest sites along a climate and N deposition gradient in Sweden and simulated over a 100-year period. The "nonlim" approach could not describe the soil C / N ratio due to large overestimation of soil N sequestration but simulate the forest growth reasonably well. The ECM "implicit" and "explicit" approaches both describe the soil C / N ratio well but slightly underestimate the forest growth. The implicit approach simulated lower litter production and soil respiration than the explicit approach. The ECM explicit Coup-MYCOFON model provides a more detailed description of internal ecosystem fluxes and feedbacks of C and N between plants, soil, and ECM. Our modeling highlights the need to incorporate ECM and organic N uptake into ecosystem models, and the nonlim approach is not recommended for future long-term soil C and N predictions. We also provide a key set of posterior fungal parameters that can be further investigated and evaluated in future ECM studies.
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| 13. |
- Horikoshi, Momoko, et al.
(author)
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New loci associated with birth weight identify genetic links between intrauterine growth and adult height and metabolism.
- 2013
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In: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 45:1
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Journal article (peer-reviewed)abstract
- Birth weight within the normal range is associated with a variety of adult-onset diseases, but the mechanisms behind these associations are poorly understood. Previous genome-wide association studies of birth weight identified a variant in the ADCY5 gene associated both with birth weight and type 2 diabetes and a second variant, near CCNL1, with no obvious link to adult traits. In an expanded genome-wide association meta-analysis and follow-up study of birth weight (of up to 69,308 individuals of European descent from 43 studies), we have now extended the number of loci associated at genome-wide significance to 7, accounting for a similar proportion of variance as maternal smoking. Five of the loci are known to be associated with other phenotypes: ADCY5 and CDKAL1 with type 2 diabetes, ADRB1 with adult blood pressure and HMGA2 and LCORL with adult height. Our findings highlight genetic links between fetal growth and postnatal growth and metabolism.
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| 14. |
- Jelley, Hannah, et al.
(author)
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Carers' experiences of timely access to and use of dementia care services in eight European countries
- 2021
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In: Ageing & Society. - : Cambridge University Press. - 0144-686X .- 1469-1779. ; 41:2, s. 403-420
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Journal article (peer-reviewed)abstract
- Timely access to care services is crucial to support people with dementia and their family carers to live well. Carers of people with dementia (N = 390), recruited from eight countries, completed semi-structured interviews about their experiences of either accessing or not using formal care services over a 12-month period in the Access to Timely Formal Care (Actifcare) study. Participant responses were summarised using content analysis, categorised into clusters and frequencies were calculated. Less than half of the participants (42.3%) reported service use. Of those using services, 72.8 per cent reported timely access and of those not using services 67.2 per cent were satisfied with this situation. However, substantial minorities either reported access at the wrong time (27.2%), or feeling dissatisfied or mixed feelings about not accessing services (32.8%). Reasons for not using services included use not necessary yet, the carer provided support or refusal. Reasons given for using services included changes in the condition of the person with dementia, the service's ability to meet individual needs, not coping or the opportunity to access services arose. Facilitators and barriers to service use included whether participants experienced supportive professionals, the speed of the process, whether the general practitioner was helpful, participant's own proactive attitude and the quality of information received. To achieve timely support, simplified pathways to use of formal care services are needed.
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| 15. |
- Kerpershoek, Liselot, et al.
(author)
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Needs and quality of life of people with middle-stage dementia and their family carers from the European Actifcare study. When informal care alone may not suffice
- 2018
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In: Aging & Mental Health. - : ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD. - 1360-7863 .- 1364-6915. ; 22:7, s. 897-902
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Journal article (peer-reviewed)abstract
- Objective: The Actifcare (Access to timely formal care) study investigated needs of people with dementia and their families during the phase in which formal care is being considered, and examined whether higher need levels are related to lower quality of life (QOL).Method: From eight European countries 451 people with dementia and their carers participated. Needs were measured with the Camberwell Assessment of Need for the Elderly. QOL was measured with the QOL-AD, and carer quality of life was measured with the CarerQol. The relationship between needs and QOL was analysed with multiple regression analyses.Results: Needs were expressed in the domains of psychological distress, daytime activities, company and information. People with dementia rated their unmet needs significantly lower than their carers: the mean number of self-rated unmet needs was 0.95, whereas the mean proxy ratings were 1.66. For met needs, the self-rated mean was 5.5 and was 8 when proxy-rated. The level of needs reported was negatively associated with QOL for both.Conclusion: The study results show that informal carers reported almost twice as many needs as people with dementia. The domains in which needs are expressed should be the primary focus for interventions to support QOL.The perspectives of people with dementia are informative when identifying needs.
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| 16. |
- Marques, Maria J., et al.
(author)
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Relationship quality and sense of coherence in dementia : results of a European cohort study
- 2019
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In: International Journal of Geriatric Psychiatry. - : John Wiley & Sons. - 0885-6230 .- 1099-1166. ; 34:5, s. 745-755
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Journal article (peer-reviewed)abstract
- Objective: Quality of life of people with dementia and their family carers is strongly influenced by interpersonal issues and personal resources. In this context, relationship quality (RQ) and sense of coherence (SOC) potentially protect and promote health. We aimed to identify what influences RQ in dyads of people with dementia and their carers and to examine differences in their perspectives.Methods: Cross-sectional data from the Actifcare cohort study of 451 community-dwelling people with dementia and their primary carers in eight European countries. Comprehensive assessments included the Positive Affect Index (RQ) and the Orientation to Life Questionnaire (SOC).Results: Regression analyses revealed that RQ as perceived by people with dementia was associated with carer education, stress and spouse caregiving. RQ as perceived by carers was associated with carer stress, depression, being a spouse, social support, reported neuropsychiatric symptoms of dementia and carer SOC. Neuropsychiatric symptoms and carer stress contributed to discrepancies in RQ ratings within the dyad. The only factor associated with both individual RQ ratings and with discrepancies was carer stress (negative feelings sub-score). No significant differences in the overall perception of RQ were evident between spouses and adult children carers, but RQ determinants differed between the two.Conclusions: In this European sample, carer SOC was associated with carer-reported RQ. RQ determinants differed according to the perspective considered (person with dementia or carer) and carer subgroup. A deeper understanding of RQ and its determinants will help to tailor interventions that address these distinct perspectives and potentially improve dementia outcomes.
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| 17. |
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| 18. |
- Meyer, Astrid, et al.
(author)
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A fertile peatland forest does not constitute a major greenhouse gas sink
- 2013
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In: Biogeosciences. - : Copernicus GmbH. - 1726-4170 .- 1726-4189. ; 10, s. 7739-7758
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Journal article (peer-reviewed)abstract
- Afforestation has been proposed as a strategy to mitigate the often high greenhouse gas (GHG) emissions from agricultural soils with high organic matter content. However, the carbon dioxide (CO2) and nitrous oxide (N2O) fluxes after afforestation can be considerable, depending predominantly on site drainage and nutrient availability. Studies on the full GHG budget of afforested organic soils are scarce and hampered by the uncertainties associated with methodology. In this study we etermined the GHG budget of a spruce-dominated forest on a drained organic soil with an agricultural history. Two different approaches for determining the net ecosystem CO2 exchange (NEE) were applied, for the year 2008, one direct (eddy covariance) and the other indirect (analyzing the different components of the GHG budget), so that uncertainties in each method could be evaluated. The annual tree production in 2008 was 8.3±3.9 tC ha−1 yr−1 due to the high levels of soil nutrients, the favorable climatic conditions and the fact that the forest was probably in its phase of maximum C assimilation or shortly past it. The N2O fluxes were determined by the closed-chamber technique and amounted to 0.9±0.8 tCeq ha−1 yr−1. According to the direct measurements from the eddy covariance technique, the site acts as a minor GHG sink of −1.2±0.8 t Ceq ha−1 yr−1. This contrasts with the NEE estimate derived from the indirect approach which suggests that the site is a net GHG emitter of 0.6±4.5 tCeq ha−1 yr−1. Irrespective of the approach applied, the soil CO2 effluxes counter large amounts of the C sequestration by trees. Due to accumulated uncertainties involved in the indirect approach, the direct approach is considered the more reliable tool. As the rate of C sequestration will likely decrease with forest age, the site will probably become a GHG source once again as the trees do not compensate for the soil C and N losses. Also forests in younger age stages have been shown to have lower C assimilation rates; thus, the overall GHG sink potential of this afforested nutrient-rich organic soil is probably limited to the short period of maximum C assimilation.
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| 19. |
- Meyer, Astrid, et al.
(author)
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Integrating mycorrhiza in a complex model system: effects on ecosystem C and N fluxes
- 2012
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In: European Journal of Forest Research. - : Springer Science and Business Media LLC. - 1612-4669 .- 1612-4677. ; 131:6, s. 1809-1831
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Journal article (peer-reviewed)abstract
- During the last decades, ectomycorrhiza has been identified to be of major importance for ecosystem carbon (C) and nitrogen (N) cycling and tree growth. Despite this importance, mycorrhiza has largely been neglected in ecosystem models or regarded only implicitly by a static mycorrhiza term. In order to overcome this limitation, we integrated the dynamic mycorrhiza model MYCOFON (Meyer et al. in Plant Soil 327:493-517, 2010a, Plant Soil 327:519, 2010b) into the ecosystem modelling framework MoBiLE (Modular Biosphere simuLation Environment) and coupled it to available forest growth and development process models. Model testing was done for different beech and spruce forest sites in Germany. Simulation results were compared to a standard model set-up, that is, without explicit consideration of mycorrhiza. Parameters were set in order not to violate previous findings about C partitioning into aboveground and belowground biomasses. Nevertheless, the explicit consideration of mycorrhiza let to considerable differences between sites and deposition scenarios with respect to simulated root biomass, plant nitrogen supply, and gaseous soil C and N emissions. The latter was mainly a result of differences in soil N concentration and dynamics. Our simulation results also show that the C supply to mycorrhizal fungi by plants as well as the importance of mycorrhizal fungi for plant N uptake, that is, the allocation of C and N between plants and fungi, depends on the magnitude of N deposition. This effect is neglected by standard model approaches so far. Therefore, explicit consideration of mycorrhiza in ecosystem models has a high potential to improve model simulations of ecosystem C and N cycling and associated biosphere-hydrosphere-atmosphere exchange processes and consequently simulation of soil CO2 and N trace gas emissions from forest sites.
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| 20. |
- Meyer, Käthe B., et al.
(author)
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Long-term experiences of Norwegian live kidney donors: Qualitative in-depth interviews
- 2017
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In: BMJ Open. - : BMJ. - 2044-6055. ; 7:2
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Journal article (peer-reviewed)abstract
- Objective: Live kidney donation is generally viewed as a welcome treatment option for severe kidney disease. However, there is a disparity in the body of research on donor experiences and postdonation outcome, and lack of knowledge on long-term consequences described by the donors. This study was conducted to provide insight into donorsī subjective meanings and interpretation of their experiences ∼10 years after donation. Design: Qualitative explorative in-depth interviews. The sampling strategy employed maximum variation. Setting Oslo University Hospital is the national centre for organ transplantation and donation in Norway, and there are 26 local nephrology centres. Participants: 16 donors representing all parts of Norway who donated a kidney in 2001-2004 participated in the study. The interviews were analysed using an interpretative approach. Results: The analysis resulted in 4 main themes; the recipient outcome justified long-term experiences, family dynamics-tension still under the surface, ambivalence-healthy versus the need for regular follow-up, and life must go on. These themes reflect the complexity of live kidney donation, which fluctuated from positive experiences such as pride and feeling privileged to adverse experiences such as altered family relationships or reduced health. Conclusions: Live kidney donors seemed to possess resilient qualities that enabled them to address the long-term consequences of donation. The challenge is to provide more uniform information about long-term consequences. In future research, resilient qualities could be a topic to explore in live donation.
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| 21. |
- Renom-Guiteras, Anna, et al.
(author)
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Potentially inappropriate medication among people with dementia in eight European countries
- 2018
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In: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 47:1, s. 68-74
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Journal article (peer-reviewed)abstract
- Objectives: to evaluate the frequency of potentially inappropriate medication (PIM) prescription among older people with dementia (PwD) from eight countries participating in the European study 'RightTimePlaceCare', and to evaluate factors and adverse outcomes associated with PIM prescription.Methods: survey of 2,004 PwD including a baseline assessment and follow-up after 3 months. Interviewers gathered data on age, sex, prescription of medication, cognitive status, functional status, comorbidity, setting and admission to hospital, fall-related injuries and mortality in the time between baseline and follow-up. The European Union(7)-PIM list was used to evaluate PIM prescription. Multivariate regression analysis was used to investigate factors and adverse outcomes associated with PIM prescription.Results: overall, 60% of the participants had at least one PIM prescription and 26.4% at least two. The PIM therapeutic subgroups most frequently prescribed were psycholeptics (26% of all PIM prescriptions) and 'drugs for acid-related disorders' (21%). PwD who were 80 years and older, lived in institutional long-term care settings, had higher comorbidity and were more functionally impaired were at higher risk of being prescribed two PIM or more. The prescription of two or more PIM was associated with higher chance of suffering from at least one fall-related injury and at least one episode of hospitalisation in the time between baseline and follow-up.Conclusions: PIM use among PwD is frequent and is associated with institutional long-term care, age, advanced morbidity and functional impairment. It also appears to be associated with adverse outcomes. Special attention should be paid to psycholeptics and drugs for acid-related disorders.
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| 22. |
- Roos, Elin, et al.
(author)
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Amyotrophic Lateral Sclerosis After Exposure to Manganese from Traditional Medicine Procedures in Kenya
- 2021
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In: Biological Trace Element Research. - : Springer Science and Business Media LLC. - 0163-4984 .- 1559-0720. ; 199, s. 3618-3624
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Journal article (peer-reviewed)abstract
- Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by motor neuron loss and widespread muscular atrophy. Despite intensive investigations on genetic and environmental factors, the cause of ALS remains unknown. Recent data suggest a role for metal exposures in ALS causation. In this study we present a patient who developed ALS after a traditional medical procedure in Kenya. The procedure involved insertion of a black metal powder into several subcutaneous cuts in the lower back. Four months later, general muscle weakness developed. Clinical and electrophysiological examinations detected widespread denervation consistent with ALS. The patient died from respiratory failure less than a year after the procedure. Scanning electron microscopy and X-ray diffraction analyses identified the black powder as potassium permanganate (KMnO4). A causative relationship between the systemic exposure to KMnO4 and ALS development can be suspected, especially as manganese is a well-known neurotoxicant previously found to be elevated in cerebrospinal fluid from ALS patients. Manganese neurotoxicity and exposure routes conveying this toxicity deserve further attention.
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| 23. |
- Rütting, Tobias, 1977, et al.
(author)
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Reduced global warming potential after wood ash application in drained Northern peatland forests
- 2014
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In: Forest Ecology and Management. - : Elsevier BV. - 0378-1127. ; 328, s. 159-166
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Journal article (peer-reviewed)abstract
- Past land use change has converted vast areas of Northern peatland by drainage to agricultural or forested land. This change often reduces the greenhouse gas (GHG) sink strength of peatlands or turns them even from sinks to sources, which affects the global climate. Therefore, there is a need for suitable mitigation options for GHG emissions from drained peatlands. Addition of wood ash to peatland forests has been suggested as such a measure, but the overall effect on the global warming potential (GWP) of these ecosystems is still unclear. In order to fill this knowledge gap, we investigated three drained peatland forests in Sweden that had been fertilized with wood ash and monitored stand growth as well as the GHG emissions from soil, i.e. net effluxes of carbon dioxide (CO2), methane (CH4) and nitrous oxide (N2O). Our results show that over the first five to eight years after wood ash application, tree growth was enhanced at all sites. This was accompanied by generally little changes in the GHG emissions. Overall, we found that wood ash application reduced the GWP of drained peatland forests. Even though that our study was limited to eight years after wood ash application, we can conclude that in the short term wood ash application may be a suitable mitigation option for GHG emissions from Northern drained peatland forests.
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| 24. |
- Römhild, Josephine, et al.
(author)
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Inter-rater agreement of the Quality of Life-Alzheimer's Disease (QoL-AD) self-rating and proxy rating scale : Secondary analysis of RightTimePlaceCare data
- 2018
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In: Health and Quality of Life Outcomes. - 1477-7525. ; 16:1
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Journal article (peer-reviewed)abstract
- Background: To assess the quality of life of people with dementia, measures are required for self-rating by the person with dementia, and for proxy rating by others. The Quality of Life in Alzheimer's Disease scale (QoL-AD) is available in two versions, QoL-AD-SR (self-rating) and QoL-AD-PR (proxy rating). The aim of our study was to analyse the inter-rater agreement between self- and proxy ratings, in terms of both the total score and the items, including an analysis specific to care setting, and to identify factors associated with this agreement. Methods: Cross-sectional QoL-AD data from the 7th Framework European RightTimePlaceCare study were analysed. A total of 1330 cases were included: n = 854 receiving home care and n = 476 receiving institutional long-term nursing care. The proxy raters were informal carers (home care) and best-informed professional carers (institutional long-term nursing care). Inter-rater agreement was investigated using Bland-Altman plots for the QoL-AD total score and by weighted kappa statistics for single items. Associations were investigated by regression analysis. Results: The overall QoL-AD assessment of those with dementia revealed a mean value of 33.2 points, and the proxy ratings revealed a mean value of 29.8 points. The Bland-Altman plots revealed a poor agreement between self- and proxy ratings for the overall sample and for both care settings. With one exception (item 'Marriage' weighted kappa 0.26), the weighted kappa values for the single QoL-AD items were below 0.20, indicating poor agreement. Home care setting, dementia-related behavioural and psychological symptoms, and the functional status of the person with dementia, along with the caregiver burden, were associated with the level of agreement. Only the home care setting was associated with an increase larger than the predefined acceptable difference between self- and proxy ratings. Conclusions: Proxy quality of life ratings from professional and informal carers appear to be lower than the self-ratings of those with dementia. QoL-AD-SR and QoL-AD-PR are therefore not interchangeable, as the inter-rater agreement differs distinctly. Thus, a proxy rating should be judged as a complementary perspective for a self-assessment of quality of life by those with dementia, rather than as a valid substitute.
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| 25. |
- Stephan, Astrid, et al.
(author)
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Barriers and facilitators to the access to and use of formal dementia care : findings of a focus group study with people with dementia, informal carers and health and social care professionals in eight European countries
- 2018
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In: BMC Geriatrics. - : BioMed Central. - 1471-2318. ; 18:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: People with dementia and informal carers often access formal care late in the process of dementia. The barriers and facilitators to service use from the perspectives of different stakeholders involved are not well understood. Thus, we aimed to explore the barriers and facilitators of access to and utilisation of formal care from the perspectives of people with dementia, their informal carers and health and social care professionals.METHOD: Focus groups with people with dementia, informal carers and professionals were conducted in eight European countries. Recruitment targeted people with dementia, informal carers with experience of formal care and professionals involved in providing (access to) formal care. Qualitative content analysis using open coding was used on a national level. Cross-national synthesis was based on the translated national reports.RESULTS: Overall, 55 focus groups with 261 participants were conducted, involving 51 people with dementia, 96 informal carers and 114 professionals. Sixteen categories describing barriers and facilitators were identified, referring to three global themes: Aspects related to 1) individuals involved, 2) the system or 3) overarching aspects. The attitudes and beliefs of people with dementia and their carers may have a major impact, and they often serve as barriers. Formal care was perceived as a threat to the individual independence of people with dementia and was thus avoided as long as possible. A healthcare professional serving as a constant key contact person could be an essential facilitator to overcome these barriers. Contact should be initiated proactively, as early as possible, and a trusting and consistent relationship needs to be established. Beyond that, the findings largely confirm former research and show that barriers to accessing and using formal care still exist across Europe despite a number of national and European initiatives.CONCLUSION: Further investigations are needed to elaborate how the concept of a key contact person could be integrated with existing case management approaches and how the independence and autonomy of people with dementia can be strengthened when formal care needs to be accessed and used. These may be meaningful facilitators regarding enhanced access to formal care for people with dementia and their families.
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| 26. |
- Tucker, S., et al.
(author)
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Improving the mix of institutional and community care for older people with dementia : an application of the balance of care approach in eight European countries
- 2016
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In: Aging and Mental Health. - Abingdon : Informa UK Limited. - 1360-7863 .- 1364-6915. ; 20:12, s. 1327-1338
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Journal article (peer-reviewed)abstract
- Objectives: To examine whether the mix of community and institutional long-term care (ILTC) for people with dementia (PwD) in Europe could be improved; assess the economic consequences of providing alternative services for particular groups of ILTC entrants and explore the transnational application of the ‘Balance of Care’ (BoC) approach. Method: A BoC study was undertaken in Estonia, Finland, France, Germany, the Netherlands, Spain, Sweden, and the UK as part of the RightTimePlaceCare project. Drawing on information about 2014 PwD on the margins of ILTC admission, this strategic planning framework identified people whose needs could be met in more than one setting, and compared the relative costs of the possible alternatives. Results: The findings suggest a noteworthy minority of ILTC entrants could be more appropriately supported in the community if enhanced services were available. This would not necessarily require innovative services, but more standard care (including personal and day care), assuming quality was ensured. Potential cost savings were identified in all countries, but community care was not always cheaper than ILTC and the ability to release resources varied between nations. Conclusions: This is believed to be the first transnational application of the BoC approach, and demonstrates its potential to provide a consistent approach to planning across different health and social care systems. Better comparative information is needed on the number of ILTC entrants with dementia, unit costs and outcomes. Nevertheless, the findings offer important evidence on the appropriateness of current provision, and the opportunity to learn from different countries' experience.
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