63 research outputs found

    Level of Living and Well-being as Measures of Welfare: Evidence from European Countries

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    The aim of the present study is to elaborate generalized indicators describing objective and subjective aspects of welfare and analyze the relationships between them based on the sample of European countries. While applying the quality of life approach we differentiate economic, human capital, social capital and emotional aspects of welfare. With help of confirmatory factor analysis generalized objective level of living and subjective well-being indicators to measure all mentioned aspects will be composed. Our results show that in countries with objectively lower positions the subjective assessments on welfare tend to be higher. Although an ideal situation could be imagined where objective and subjective assessments were equal, there are deviations from the equilibrium to both directions

    DoktoriĂ”ppe tulemuslikkuse analĂŒĂŒs

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    Uuringu 2.4 lĂ”ppraportUuringu eesmĂ€rgiks on analĂŒĂŒsida doktoriĂ”ppe tulemuslikkust Eesti avalik-Ă”iguslikes ĂŒlikoolides ning sellest tulenevalt teha ettepanekuid tulevaste doktoriĂ”ppe toetusmeetmete arendamiseks. Uuringus antakse ĂŒlevaade Eesti ĂŒlikoolide doktoriĂ”ppe vastuvĂ”tutingimuste eripĂ€radest ja doktoriĂ”ppe rahastamise skeemist, otsitakse seoseid doktoriĂ”ppe meetmete ja doktoriĂ”ppe tulemuslikkuse vahel Ă”ppeprotsessi, teadustegevuse ja doktorantide materiaalse toimetuleku aspektist, analĂŒĂŒsitakse pĂ”hjalikumalt doktorikoolide poolt antavat lisandvÀÀrtust ja nende tegevusega seonduvaid probleeme ja pakutakse vĂ€lja poliitikasoovitused doktoriĂ”ppe tulemuslikkuse tĂ”stmiseks.http://tips.ut.ee/index.php?module=32&op=1&id=366

    Rotaviirusinfektsioonivastaste vaktsiinide kulutÔhusus Eestis

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    Taust. Rotaviiruslik gastroenteriit (RVGE) on laialt levinud sooleviirusnakkushaigus, mis pĂ”hjustab suure osa vĂ€ikelaste suremusest arengumaades. Kuigi arenenud riikides esineb surmaga lĂ”ppevaid haigusjuhte harva, on kergemate haigusvormide sage esinemine koormaks nii lapsevanematele kui ka tervishoiusĂŒsteemile. Haigestumist on vĂ”imalik piirata vaktsineerimisega. EesmĂ€rk. Hinnata Eesti andmetel rotaviirusevastase vaktsineerimise kulutĂ”husust vĂ”rreldes mittevaktsineerimisega vaktsiinide Rotateq vĂ”i Rotarix kasutamisel tervishoiusĂŒsteemi rahastaja perspektiivist. Metoodika. Markovi mudeli abil kirjeldati ĂŒhe sĂŒnnikohordi laste haigestumist erineva raskusastmega RVGEdesse, kaasnevaid kulusid ja elukvaliteedi halvenemist viie aasta perspektiivis. AnalĂŒĂŒsil eeldati, et vaktsineeritakse 95% sihtrĂŒhma lastest. Tulemused. Kuna Rotateq ja Rotarix efektiivsuse poolest oluliselt ei erine, vĂ€lditaks ĂŒhe vĂ”i teisega vaktsineerimisel ligi 90% kĂ”igist haigusjuhtudest. Surmajuhte vaktsineerimise korral tĂ”enĂ€oliselt ei esineks. VĂ”rreldes mittevaktsineerimisega vĂ”idetaks vaktsineerimise korral viie aasta jooksul 55–57 kvaliteedile kohandatud eluaastat (QALY). KĂ”ige tĂ”enĂ€olisemate n-ö stsenaariumite korral oleks tĂ€iendkulu tĂ”hususe mÀÀr (incremental cost-effectiveness ratio, ICER) vaktsiini Rotateq vĂ”i Rotarix kasutamisel vahemikus 13 000 – 30 000 eurot iga lisanduva QALY kohta. KĂ”ige enam mĂ”jutab tĂ€iendkulu tĂ”hususe mÀÀra haiglaravi vajavate haigusjuhtude arvu prognoosi tĂ€psus ja vaktsiini hind. JĂ€reldused. Rotaviirusevastane vaktsineerimine aitaks Ă€ra hoida mĂ€rkimisvÀÀrsel hulgal RVGE-haigusjuhte. Samas ĂŒletavad kulutused vaktsineerimisele ravikuludelt saadava kokkuhoiu neli korda. Eesti Arst 2012; 91(10):530–53

    Pneumokokkinfektsioonivastaste vaktsiinide kulutÔhusus Eestis

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    Taust. Streptococcus pneumoniae ehk pneumokokk pĂ”hjustab otiiti, pĂ”skkoopapĂ”letikku, pneumooniat, meningiiti ja baktereemiat. Nende haiguste vastu on vĂ”imalik lapsi vaktsineerida alates esimestest elukuudest pneumokoki konjugeeritud polĂŒsahhariidvaktsiinidega. EesmĂ€rk. Hinnata Eesti andmete alusel ja tervishoiusĂŒsteemi rahastaja perspektiivist pneumokokkinfektsioonivastase vaktsineerimise kulutĂ”husust 7-, 10- vĂ”i 13valentse vaktsiini (PCV7, PCV10, PCV13) kasutamisel vĂ”rreldes mittevaktsineerimisega. Metoodika. Vaktsiinide kulutĂ”hususe hindamiseks koostati Markovi mudel, mille abil kirjeldati vastsĂŒndinute aastase sĂŒnnikohordi (16 000 last) haigestumist pneumokokkinfektsioonidesse, elukvaliteedi halvenemist ja haigestumisega kaasnevaid kulusid viie aasta perspektiivis. Eeldati, et vaktsineeritakse 95% sihtrĂŒhma lastest. Tulemused. VĂ”rreldes mittevaktsineerimisega vĂ€hendab vaktsineerimine viie aasta jooksul otiidi ja pneumoonia haigusjuhtusid 11–33% vĂ”rra ning invasiivse pneumokokkinfektsiooni haigusjuhtusid ligikaudu 65%. SĂ”ltuvalt vaktsiinist vĂ”idetakse 16 000 lapse vaktsineerimise korral viie aasta jooksul kokku 35–37 tĂ€iskvaliteetset eluaastat (quality-adjusted life year, QALY). TĂ€iendkulu tĂ”hususe mÀÀr (incremental cost-effectiveness ratio, ICER) jÀÀb vaktsiinide kasutamisel vahemikku 29 000 – 62 000 eurot iga lisanduva QALY kohta. JĂ€reldused. Pneumokokknakkuste vastu vaktsineerimine vĂ”imaldab oluliselt vĂ€hendada haigestumist erineva raskusastmega otiiti, pneumooniasse ning invasiivsesse pneumokokkinfektsiooni. Vaktsiinide kĂ”rge hinna tĂ”ttu ĂŒletavad kulutused vaktsineerimisele enam kui kĂŒmme korda ravikuludelt saavutatava kokkuhoiu. Eesti Arst 2012; 91(10):539–54

    Uurimisprojekti "SĂŒstemaatiline kirjanduse ĂŒlevaade Ă”pikĂ€situse nĂŒĂŒdisaegsuse hindamiseks sobivate mÔÔtevahendite leidmiseks" raport

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    Raportis koosneb kahest erinevast peatĂŒkist: 1) nĂŒĂŒdisaegne Ă”pikĂ€situs - vaatleb Ă”ppimist lĂ€bi viie erineva metafoori (omandamine, osalemine, avastamine, tajumine ja harjutamine) ning esitab nĂŒĂŒdisaegse Ă”pikĂ€situse mudeli, milles on mÀÀratletud nii Ă”pikĂ€situse elemendid kui nende kaudu saavutatavd eesmĂ€rgid ja sihid. 2) nĂŒĂŒdisaegse Ă”pikĂ€situse mÔÔtmine, milles kirjeldatakse Ă”pikĂ€situse hindamise vĂ”imalusi ning antakse sĂŒstemaatilised kirjanduse ĂŒlevaated kahe Ă”pikĂ€situse hindamise parameetri (emotsioonid ja eneseregulatsioon) kohta

    Anti-Fibrotic Effect of SDF-1ÎČ Overexpression in Bleomycin-Injured Rat Lung.

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    Rational: Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease and is associated with high mortality due to a lack of effective treatment. Excessive deposition of the extracellular matrix by activated myofibroblasts in the alveolar space leads to scar formation that hinders gas exchange. Therefore, selectively removing activated myofibroblasts with the aim to repair and remodel fibrotic lungs is a promising approach. Stromal-derived growth factor (SDF-1) is known to stimulate cellular signals which attract stem cells to the site of injury for tissue repair and remodeling. Here, we investigate the effect of overexpression of SDF-1ÎČ on lung structure using the bleomycin-injured rat lung model. Methods: Intratracheal administration of bleomycin was performed in adult male rats (F344). Seven days later, in vivo electroporation-mediated gene transfer of either SDF-1ÎČ or the empty vector was performed. Animals were sacrificed seven days after gene transfer and histology, design-based stereology, flow cytometry, and collagen measurement were performed on the tissue collected. For in vitro experiments, lung fibroblasts obtained from IPF patients were used. Results: Seven days after SDF-1ÎČ gene transfer to bleomycin-injured rat lungs, reduced total collagen, reduced collagen fibrils, improved histology and induced apoptosis of myofibroblasts were observed. Furthermore, it was revealed that TNF-α mediates SDF-1ÎČ-induced apoptosis of myofibroblasts; moreover, SDF-1ÎČ overexpression increased alveolar epithelial cell numbers and proliferation in vivo and also induced their migration in vitro. Conclusions: Our study demonstrates a new antifibrotic mechanism of SDF-1ÎČ overexpression and suggests SDF-1ÎČ as a potential new approach for the treatment of lung fibrosis

    Basal-Like Cell-Conditioned Medium Exerts Anti-Fibrotic Effects In Vitro and In Vivo.

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    In idiopathic pulmonary fibrosis (IPF), basal-like cells are atypically present in the alveolar region, where they may affect adjacent stromal cells by paracrine mechanisms. We here aimed to confirm the presence of basal-like cells in peripheral IPF lung tissue in vivo, to culture and characterize the cells in vitro, and to investigate their paracrine effects on IPF fibroblasts in vitro and in bleomycin-injured rats in vivo. Basal-like cells are mainly localized in areas of pathological bronchiolization or honeycomb cysts in peripheral IPF lung tissue. Single-cell RNA sequencing (scRNA-seq) demonstrated an overall homogeneity, the expression of the basal cell markers cytokeratin KRT5 and KRT17, and close transcriptomic similarities to basal cells in the majority of cells cultured in vitro. Basal-like cells secreted significant levels of prostaglandin E2 (PGE2), and their conditioned medium (CM) inhibited alpha-smooth muscle actin (α-SMA) and collagen 1A1 (Col1A1) and upregulated matrix metalloproteinase-1 (MMP-1) and hepatocyte growth factor (HGF) by IPF fibroblasts in vitro. The instillation of CM in bleomycin-injured rat lungs resulted in reduced collagen content, improved lung architecture, and reduced α-SMA-positive cells. Our data suggested that basal-like cells may limit aberrant fibroblast activation and differentiation in IPF through paracrine mechanisms
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