Southwest Finland Research Articles

CHANGES IN AMBULATORY BLOOD PRESSURE DURING THE TRANSITION TO RETIREMENT

Objective: Retirement is a major life event characterized by removal of work-related stressors and changes in health behaviours. The association between retirement and changes in blood pressure (BP), and particularly in ambulatory BP, has been scarcely studied. We aimed to examine changes in ambulatory BP during retirement transition. Design and method: Two hundred and fifty ageing workers (mean age 63.2 years, 84% women) from the Finnish Retirement and Aging study participated in annual office BP measurements and 114 (mean age 63.1, 90% women) of them underwent annual ambulatory BP measurements before and after retirement. On average, the participants provided data on ambulatory BP at 2.7 (range 2 - 4) measurements. We used generalized linear models to examine BP changes at retirement. The FIREA study was conducted in accordance with the Helsinki declaration and was approved by the Ethics Committee of Hospital District of Southwest Finland (ETMK: 84/1801/2014). All participants gave written informed consent. Results: Most marked changes in BP during the follow-up were observed for asleep SBP, which decreased before retirement, increased during retirement transition and plateaued after retirement (before retirement vs. retirement transition P = 0.07 and after retirement vs. retirement transition P = 0.02). Awake SBP and 24-h SBP declined with most apparent decrease before retirement (before retirement vs. retirement transition P = 0.07 and P = 0.07). Awake DBP and 24-h DBP showed relatively consistent decline throughout the follow-up with no differences between the time periods. SBP and DBP dipping reduced before and during retirement transition, but not after retirement. Among shift workers, asleep BP increased and BP dipping decreased more than in regular day workers. Conclusions: Retirement was found to associate with beneficial changes in awake BP but unfavourable changes in asleep BP, especially in shift workers.

Childhood trauma and fear of childbirth: findings from a birth cohort study

The aim of this study is to investigate if experiencing childhood trauma (emotional abuse, emotional neglect, physical abuse, physical neglect, or sexual abuse) or a greater total burden of childhood trauma increase the risk of fear of childbirth (FOC). This study included 2556 women living in Southwest Finland. Women were recruited during routine ultrasound visits at gestational week (gwk) 12. Experiencing childhood trauma was assessed in retrospect with the Trauma and Distress Scale (TADS) questionnaire completed at gwk 14. Information on the diagnosis of FOC (ICD-10 diagnosis O99.80) was obtained from the Finnish Medical Birth Register. Associations between childhood trauma (domains and total TADS score) and FOC were analyzed with logistic regression in unadjusted and adjusted models. Emotional abuse (aOR 1.25, 95% CI 1.10–1.42), emotional neglect (aOR 1.26, 95% CI 1.08–1.46), and a greater total burden of trauma (TADS total score) (aOR 1.06, 95% CI 1.02–1.10) increased the risk for FOC. We found no evidence for physical abuse (aOR 1.15, 95% CI 1.00–1.32), physical neglect (aOR 1.06, 95% CI 0.92–1.22), and sexual abuse (aOR 1.24, 95% CI 0.99–1.56) associating with FOC. Childhood emotional abuse, emotional neglect, and a greater total burden of childhood trauma increase the risk for FOC. However, the childhood traumatic events were inquired in retrospect, which could distort the events.

Characterization of clinicopathological features, treatment practices, and outcomes among Finnish advanced breast cancer patients in real-life clinical practice.

In recent years, several new targeted therapies have emerged for advanced breast cancer (aBC). However, real-life data specific to aBC and different breast cancer subtypes are scarce. This retrospective cohort study was designed to describe the distribution of aBC subtypes, incidence, treatment patterns, survival, and PIK3CA hotspot mutation frequency. The study included all patients in the Hospital District of Southwest Finland diagnosed with aBC between 2004 and 2013 and with a sample available in Auria Biobank. In addition to registry-based data collection, 161 HR+/HER2- aBCs were screened for PIK3CA mutations. Altogether, 54.7% of the 444 patients included in the study had luminal B subtype. The smallest representations were in HR-/HER2+ (4.5%) and triple-negative (5.6%) subgroups. The percentage of aBC among all diagnosed breast cancers increased until 2010, after which it remained stable. The triple-negative cancers were associated with shorter median overall survival (5.5months) compared to other subgroups (16.5-24.6months). Most (84%) triple-negative cancers also metastasized during the first two years, whereas this was more evenly distributed over time in other subgroups. Of the HR+/HER2- tumors, 32.3% harbored a PIK3CA hotspot mutation. These patients, however, did not have inferior survival compared to patients with PIK3CA wild-type cancers. This study described real-world aBC subgroups and indicated that the clinical outcomes of subgroups vary. Although PIK3CA hotspot mutations did not lead to inferior survival, they are relevant as possible treatment targets. Overall, these data could be utilized to further evaluate the subgroup-specific medical needs in breast cancer.

Signalling waiting times to citizens on public oral healthcare providers’ websites

Objective: The study aimed to analyse the usefulness of signalling waiting times to citizens on the websites of public primary oral healthcare providers in Finland. Finnish laws require this signalling. Material and methods: We gathered data with two cross-sectional surveys in 2021. One electronic questionnaire was for Finnish-speaking citizens in Southwest Finland. The other was for public primary oral healthcare managers (n = 159). We also gathered data on 15 public primary oral healthcare providers’ websites. For the theoretical framework, we combined the agency and signalling theories. Results: Of the citizen respondents (n = 411), 57% knew about the waiting time signalling on the websites. The respondents considered waiting time a high-priority criterion in choosing a dentist, but they rarely searched for information anywhere on the choice of a dentist, wanting to visit the dentist they had earlier visited. The quality of signalled waiting times was low. One out of five managers (response rate 62%) answered that signalled waiting times were based on speculation. Conclusions: Waiting times were signalled to comply with the legislation rather than to inform citizens and to reduce information asymmetry. Further research is needed to acquire information on rethinking waiting time signalling and its desired goals.

Soil organic carbon sequestration potential for croplands in Finland over 2021–2040 under the interactive impacts of climate change and agricultural management

CONTEXTCropland soil organic carbon (SOC) stock can be increased by agricultural management, but is subject to various factors. The extent and rates of SOC sequestration potential, as well as the controlling factors, under different climate and management practices across a region or country are important for policy-makers and land managers, however have been rarely known. OBJECTIVEWe aim to investigate the extent and rates of SOC sequestration potential over 2021–2040 under different scenarios of climate change and Sustainable Soil Management (SSM) practices, and quantify the impacts of climate change and SSM practices on the SOC sequestration potential, for croplands across Finland at a spatial resolution of 1 km. METHODSRothC model is run iteratively to equilibrium to calculate the size of the SOC pools and the annual plant carbon inputs. Then, it is applied to investigate the SOC sequestration potential over 2021–2040 under different scenarios of climate change and SSM practices. Finally, facorial simulation experiments are conducted to quantify the impacts of climate change and SSM practices, alone and in combination, on SOC sequestration potential. RESULTS AND CONCLUSIONUnder the combined impacts of climate change and SSM practices, the SOC sequestration potential during 2021–2040 relative to 2020 will be on average − 0.03, 0.007, 0.05, and 0.13 t C ha−1 yr−1, respectively, with carbon input being business as usual, 5%, 10%, and 20% increase. This is equivalent to an annual change rate of −0.04%, 0.009%, 0.07%, and 0.17%, respectively. Therefore, a 20% increase in C input to soil will not be enough to obtain a 4‰ increase per year over the 20-year period in Finland. Carbon input will promote SOC sequestration potential; however, climate change will reduce it on average by 0.28 t C ha−1 yr−1. Across the cropland in Finland, on average, the relative contributions of C input, temperature, and precipitation to SOC sequestration potential in 2021–2040 will be 56%, 24%, and 20%, respectively, however there is a spatially explicit pattern. The SOC sequestration potential will be relatively high and dominated by C input in west and southwest Finland. By contrast, it will be relatively low and dominated by climate in north and east Finland, and the central part of southern Finland. SIGNIFICANCEOur findings provide the information as to where, how much, and which SSM practices could be applied for enhancing SOC sequestration at a high spatial resolution, which is essential for stakeholders to increase cropland SOC sequestration efficiently.

Supporting Immigrants’ Employability? Experiences in Digital Pedagogy Applied with Immigrant Learners in Turku in Southwest Finland

Abstract Labor shortages and labor mismatches are common emergent problems in Finland, ones which will occur on a much broader scale in the future in an aging society. Immigrants constitute an important pool of labor, but sometimes it is difficult for them to find even a first job in local labor markets. Studies have shown that mastering the language of the host country is a crucial factor in the success of immigrants’ employment. The AboaNova development project in Turku, Southwest Finland, funded by the European Social Fund, aimed to promote two-way integration by developing new methods and pedagogical tools to speed up employment and support the linguistic skills of immigrants in the Finnish language. As one example, the project applied interactive digital pedagogy and learning analytics to support both language learning and guidance for on-the-job learning to enter the labor market. However, the challenge in implementing new tools often has to do with resistance and suspicious attitudes encountered at different organizational levels during development projects.

The role of cross‐sector partnerships in the dynamics between places and innovation ecosystems

The dynamics between places and innovation ecosystems and the role that cross‐sector partnerships (CSPs) can play in regenerating places and in revitalizing innovation ecosystems remain poorly theorized. In this study we use two cases – Humber (UK) and Southwest Finland – to develop a conceptual model that demonstrates the vicious and virtuous dynamics between places and innovation ecosystems. We show that CSPs can act as herding spaces – arenas where actors from different organizations get together to address a common purpose and connect with the institutional context – and alter these vicious and virtuous dynamics. Specifically, our findings shed light on four mechanisms that enable CSPs to act as herding spaces and so to help break away from the vicious (vitalizing role) and reinforce the virtuous (nurturing role) dynamics between places and innovation ecosystems: recognition of place‐based challenges, improvement or utilization of place attachment, development of purpose ecosystems, and direct engagement in place regeneration activities.

Effect of inflammatory bowel diseases on household chores.

More than a half of inflammatory bowel disease (IBD) patients experienced a moderate negative effect on their household chores due to their IBD. The negative effect was more common amongst women.

Comparison of three common tonsil surgery techniques: cold steel with hot hemostasis, monopolar and bipolar diathermy

PurposeTo analyze the risk of postoperative hemorrhage in tonsil surgery with different surgical methods, instruments, indications, and age groups. Monopolar diathermy compared to bipolar diathermy was of particular interest.MethodsThe data from tonsil surgery patients were retrospectively collected between 2012 and 2018 in the Hospital District of Southwest Finland. The surgical method, instruments, indication, sex and age and their association with a postoperative hemorrhage were analyzed.ResultsA total of 4434 patients were included. The postoperative hemorrhage rate for tonsillectomy was 6.3% and for tonsillotomy 2.2%. The most frequently used surgical instruments were monopolar diathermy (58.4%) cold steel with hot hemostasis (25.1%) and bipolar diathermy (6.4%) with the overall postoperative hemorrhage rates 6.1%, 5.9% and 8.1%, respectively. In tonsillectomy patients, the risk for a secondary hemorrhage was higher with bipolar diathermy compared to both monopolar diathermy (p = 0.039) and the cold steel with hot hemostasis technique (p = 0.029). However, between the monopolar and the cold steel with hot hemostasis groups, the difference was statistically non-significant (p = 0.646). Patients aged > 15 years had 2.6 times higher risk for postoperative hemorrhage. The risk of a secondary hemorrhage increased with tonsillitis as the indication, primary hemorrhage, tonsillectomy or tonsillotomy without adenoidectomy, and male sex in patients aged ≤ 15 years.ConclusionBipolar diathermy increased the risk for secondary bleedings compared to both monopolar diathermy and the cold steel with hot hemostasis technique in tonsillectomy patients. Monopolar diathermy did not significantly differ from the cold steel with hot hemostasis group regarding the bleeding rates.

Smoking is an Independent Marker of Poor Prognosis in Cutaneous Melanoma.

Previous studies have suggested that persistent tobacco smoking impairs survival in cutaneous melanoma, but the effects of smoking and other prognostic factors have not been described in detail. This study examined the association of smoking (persistent, former, or never) with melanoma-specific (MSS) and overall survival (OS) in patients with cutaneous melanoma treated in Southwest Finland during 2005 to 2019. Clinical characteristics were obtained from electronic health records for 1,980 patients. Smoking status was available for 1,359 patients. Patients were restaged according to the 8th edition of the tumour-node-metastasis (TNM) classification. Smoking remained an independent prognostic factor for inferior melanoma-specific survival regardless of age, sex, stage, and comorbidities. The hazard ratio of death from melanoma was 1.81 (1.27-2.58, p = 0.001) in persistent and 1.75 (1.28-2.40, p = 0.001) in former smokers compared with never smokers. In 351 stage IV patients, smoking was associated with increased melanoma-specific and overall mortality: median MSS 10.4 (6.5-14.3), 14.6 (9.1-20.1), and 14.9 (11.4-18.4) months, p = 0.01 and median OS 10.4 (6.5-14.3), 13.9 (8.6-19.2), and 14.9 (11.7-18.1) months, p = 0.01 in persistent, former, and never smokers, respectively. In conclusion, since smoking represents an independent modifiable poor prognostic factor in patients with cutaneous melanoma, smoking habits should be proactively asked about by healthcare professionals, in order to support smoking cessation.

Cardiac symptoms and yield of diagnostic tests among primary care patients with and without diabetes

AimsTo compare the symptoms, diagnostic tests used, and clinical diagnoses made among diabetic and non-diabetic patients. MethodsThis is a register-based study of 704 primary care patients referred electively to cardiology specialists in the city of Turku, Finland, during the year 2016. The patient's medical history, cardiovascular medication use, risk factors, cardiac symptoms, diagnostic tests applied, and diagnoses made were gathered from the medical records. The angiography data was derived from the Hospital District of Southwest Finland data pool. ResultsOf the cohort, 120 (17 %) patients had diabetes mellitus. They were on average older (67 vs. 63 years, p = 0.009) and more often females (62 % vs. 38 %, p = 0.042) than the non-diabetic patients. Chest pain or discomfort was the most prevalent symptom in the diabetic patients and a sense of arrhythmia in the non-diabetic subjects. Ischemic heart disease was diagnosed more often in the person with diabetes (15 %) than in the non-diabetic (6 %) patients (p = 0.004). Cardiac arrhythmias were diagnosed in 26 % of the non-diabetic and 20 % of the diabetic subjects (p = 0.021). ConclusionsSymptoms that might indicate heart disease, especially chest pain/discomfort, are common in both the diabetic and the non-diabetic patients in primary care. Several diagnostic tests are applied, possibly not to miss a life-threatening disease. However, many patients do not get a specific diagnosis for their concerns.

Hydrogeological Characterization of Crystalline Bedrock Using Borehole Magnetic Resonance.

We aimed to test borehole magnetic resonance (BMR) method for determining hydraulic parameters (porosity, permeability, and hydraulic conductivity) required for hydrogeological modeling in two distinct crystalline rock environments. These sites comprise Proterozoic basement rocks of different compositions: mafic rocks at the Sakatti mining development site in northern Finland and felsic rocks at the Olkiluoto Island nuclear repository site in southwest Finland. Although BMR is widely used for determining storage and hydraulic properties in sedimentary environments, there have been few studies in crystalline bedrocks. The results indicate that BMR is a suitable tool for studying lithologically and hydrogeologically heterogeneous fractured crystalline bedrocks. It can produce continuous data from hydraulic properties of bedrock in addition to more time-consuming methods such as flowmeter and packer tests and can provide guidance on where to focus additional flow measurements. The intervals display fracture and reduced matrix porosity characteristics, both of which can be enhanced or reduced locally by chemical alteration and by tectonic processes. Flow parameters vary significantly throughout the studied intervals: independently from the lithological composition, these intervals locally display relatively high porosities, and may be correlated to the more intensely fractured and/or brecciated zones. However, due to the heterogeneity in mineralogy, grain/pore arrangement, and the variability of fracture flow-driven transport in each borehole, the challenge remains in finding a unique set of permeability constants for these crystalline rock types. The permeability models could be calibrated by laboratory measurements of the core, and possibly a new permeability model suitable for crystalline bedrock could be created.

Territorial males have larger wing spots than non-territorial males in the damselfly Calopteryx splendens (Zygoptera: Calopterygidae)

Males of Calopteryx splendens use two alternative mating tactics, territoriality, and non-territoriality. These different mating tactics are shown to vary between males within the same population and previous studies have shown that territorial males have considerably higher fitness than non-territorial males. In this paper, we tested whether the wing spot size as sexual ornament, wing length, relative wing spot size, asymmetry in wing length, asymmetry in wing spot size, or asymmetry in relative wing spot size differed between the territorial and non-territorial males. We sampled C. splendens males, representing both mating tactics, from a river system in south-west Finland. According to our results, territorial males have larger wing spot than non-territorial males. In contrast, there were no differences in the other tested traits between the territorial and non-territorial males. In conclusion, our data show that the size of pigmented wing spots may predict the alternative mating tactic of C. splendens males.

Observational study on the evolution of systemic treatments for advanced renal cell carcinoma in Southwest Finland between 2010 and 2021

Background: Novel receptor tyrosine kinase inhibitors and immune checkpoint inhibitors have been introduced to the treatment of advanced renal cell carcinoma (aRCC) during the past decade. However, the adoption of novel treatments into clinical practice has been unknown in Finland. Objectives: Our aim was to evaluate the use of systemic treatments and treatment outcomes of aRCC patients in Southwest Finland during 2010–2021. Design and Methods: Clinical characteristics, treatments for aRCC, healthcare resource utilization, and overall survival (OS) were retrospectively obtained from electronic medical records. Patients were stratified using the International Metastatic RCC Database Consortium (IMDC) risk classification. Results: In total, 1112 RCC patients were identified, 336 (30%) patients presented with aRCC, and 57% of them ( n = 191) had received systemic treatment. Pre-2018, sunitinib (79%) was the most common first-line treatment, and pazopanib (17%), axitinib (17%), and cabozantinib (5%) were frequently used in the second-line. Post-2018, sunitinib (52%), cabozantinib (31%), and the combination of ipilimumab and nivolumab (10%) were most commonly used in the first-line, and cabozantinib (23%) in the second-line. Median OS for patients with favorable, intermediate, and poor risk were 61.9, 28.6, and 8.1 months, respectively. A total of 73%, 74%, and 35% of the patients with favorable, intermediate, and poor risk had received second-line systemic treatment. In poor-risk patients, the number of hospital inpatient days was twofold higher compared to intermediate and fourfold higher compared to favorable-risk patients. Conclusion: New treatment options were readily adopted into routine clinical practice after becoming reimbursed in Finland. OS and the need for hospitalization depended significantly on the IMDC risk category. Upfront combination treatments are warranted for poor-risk patients as the proportion of patients receiving second-line treatment is low. Registration: Clinical trial identifier: ClinicalTrials.gov NCT05363072.

Fucoid brown algae inject fucoidan carbon into the ocean

Brown algae annually convert gigatons of carbon dioxide into carbohydrates, including the complex extracellular matrix polysaccharide fucoidan. Due to its persistence in the environment, fucoidan is potentially a pathway for marine carbon sequestration. Rates of fucoidan secretion by brown algae remain unknown due to the challenge of identifying and quantifying complex polysaccharides in seawater. We adapted the techniques of anion exchange chromatography, enzyme-linked immunosorbent assay, and biocatalytic enzyme-based assay for detection and quantification of fucoidan. We found the brown alga Fucus vesiculosus at the Baltic Sea coast of south-west Finland to secrete 0.3% of their biomass as fucoidan per day. Dissolved fucoidan concentrations in seawater adjacent to algae reached up to 0.48 mg L-1. Fucoidan accumulated during incubations of F. vesiculosus, significantly more in light than in darkness. Maximum estimation by acid hydrolysis indicated fucoidan secretion at a rate of 28 to 40 mg C kg-1 h-1, accounting for 44 to 50% of all exuded dissolved organic carbon. Composed only of carbon, oxygen, hydrogen, and sulfur, fucoidan secretion does not consume nutrients enabling carbon sequestration independent of algal growth. Extrapolated over a year, the algae sequester more carbon into secreted fucoidan than their biomass. The global utility of fucoidan secretion is an alternative pathway for carbon dioxide removal by brown algae without the need to harvest or bury algal biomass.

Whole genome sequencing reveals new links between spa t172/CC59 methicillin-resistant Staphylococcus aureus cases in low-endemicity region of Southwest Finland, 2007‒2016

Methicillin-resistant Staphylococcus aureus (MRSA) rates have remained relatively low in Finland. In Southwest Finland, however, annual MRSA incidence increased from 12 to 25/100,000 between 2007 and 2016 with spa t172 strain causing one fourth (237/983) of all cases. This provoked us to study the molecular epidemiology of t172-MRSA, aiming to better understand the transmission of this strain type. We combined epidemiological data and whole genome sequencing (WGS) of a set of 64 (27%, 64/237) t172-MRSA isolates covering 10years. Isolates represented sporadic and index cases of all identified healthcare-associated outbreaks (HAOs) and family clusters (FCs). Among the included 62 isolates, core-genome MLST analysis revealed eight genomic clusters comprising 24 (38.7%) isolates and 38 (61.3%) non-clustered isolates. Cluster 1 comprised ten and the remaining seven clusters two isolates each, respectively. Two epidemiologically distinct HAOs were linked in cluster 1. FCs were involved in all clusters. All strains were associated with epidemic clonal complex CC59. We were able to confirm the spread of several successful t172-MRSA subclones in regional healthcare and the community. WGS complemented routine surveillance by revealing undetected links between t172-MRSA cases. Targeted, WGS-based typing could enhance MRSA surveillance without the need for routine WGS diagnostics.

RWD109 The Burden of R/R DLBCL in Finland: PFS of The First-Line Immunochemotherapy and HCRU of The Patients Diagnosed in 2015–2017 in The Hospital District of Southwest Finland

Outcomes of the first-line immunochemotherapy (1L ICT) in DLBCL are heavily influenced by the patient characteristics. The burden of relapsed/primary refractory (R/R) DLBCL has remained unclear. This study characterized DLBCL patients treated in 1L ICT and evaluated the burden of R/R DLBCL in a real-world setting. Adult patients diagnosed in the Hospital District of Southwest Finland (HDSF) in 2015–2017 were included.

Adolescents’ interpersonal cognition and self-appraisal of their own anxiety in an imagined anxiety-provoking classroom presentation scenario: Gender differences

Oral class presentations are regularly assigned to adolescents, but often provoke social anxiety, due to the importance of peer approval and need to appraise oneself as normal. Also, little is known about gender differences in girls’ and boys’ interpersonal cognition and appraisals of anxiety and self in anxiety-provoking speech situations. We examined gender differences in interpersonal cognition and appraisals of anxiety in an imagined class presentation scenario in a normative sample of 687 adolescents, 14-16-years-old, from Southwest Finland. Measures included the Classroom Questionnaire of Social Anxiety and Interpersonal Cognition and the Social Anxiety Scale for Adolescents. T-tests examined gender differences in interpersonal cognition, and chi-square tests examined adolescents’ appraisals of the likelihood of their own presentation anxiety and self as anxious. Girls more frequently reported positive, and less frequently reported negative, responses toward the depicted, anxious peer than boys. Also, a higher percentage of girls predicted that becoming anxious in the situation was likely, and non-acceptance of self as anxious was more frequent among girls. Boys predicted negative overt classmate reactions (e.g., laughing) towards the depicted, anxious peer, and towards themselves more frequently than did girls. Results are discussed in the context of gender-specific development and procedures for reducing adolescent social anxiety.

Epidemiological Study of p16 Incidence in Head and Neck Squamous Cell Carcinoma 2005-2015 in a Representative Northern European Population.

The incidence of human papillomavirus (HPV)-associated head and neck squamous cell carcinomas (HNSCC) has increased globally. Our research goal was to study HNSCC incidence in a representative Northern European population and evaluate the utility of the HPV surrogate marker p16 in clinical decision-making. All new HNSCC patients diagnosed and treated in Southwest Finland from 2005-2015 (n = 1033) were identified and analyzed. During the follow-up period, the incidence of oropharyngeal (OPSCC) and oral cavity squamous cell carcinoma (OSCC) increased, while the incidence of laryngeal squamous cell carcinoma (LSCC) decreased. This clinical cohort was used to generate a population-validated tissue microarray (PV-TMA) archive for p16 analyses. The incidence of p16 positivity in HNSCC and OPSCC increased in southwest Finland between 2005 and 2015. p16 positivity was mainly found in the oropharynx and was a significant factor for improved survival. p16-positive OPSCC patients had a better prognosis, regardless of treatment modality. All HNSCC patients benefited from a combination of chemotherapy and radiotherapy, regardless of p16 expression. Our study reaffirms that p16 expression offers a prognostic biomarker in OPSCC and could potentially be used in cancer treatment stratification. Focusing on p16 testing for only OPSCC might be the most cost-effective approach in clinical practice.

Contrasting responses of vascular plants and bryophytes to present and past connectivity in unmanaged grasslands

The area of semi-natural grasslands has decreased dramatically causing many grassland specialist species to persist in small habitat fragments. Furthermore, ecological communities once shaped by disturbances related to traditional agriculture now face the impacts of modern agriculture and urbanization. Many of the species have become endangered due to the combined effects of habitat destruction and degradation. We studied the responses of vascular plants and bryophytes to present and past connectivity in semi-natural grasslands, while accounting for the effects of local environmental conditions. We conducted vegetation surveys in 33 fragmented, unmanaged dry grasslands in Southwest Finland. A total of 191 vascular plant species and 60 bryophyte species were recorded. Higher vascular plant diversity was associated with higher historical connectivity, whereas bryophyte diversity declined with increasing current connectivity. Edaphic conditions, microclimate and disturbances were found to structure both vascular plant and bryophyte communities, but the responses to individual environmental variables were very different. The contrasting responses could be explained by the differences between the typical life-history strategies in vascular plants and bryophytes as well as resource competition between the two groups. These results highlight the need to consider different species groups when planning conservation measures. Vascular plant richness may best be conserved in connected grasslands whereas bryophyte richness in isolated ones. The results also indicated that trampling by humans could result in positive disturbance and to some extent help maintain richness of grassland specialist species.