Survey of Simulation Models of Long-Term Care Use and Expenditure

The objective of this study is to provide a technical overview of the main simulation tools that are used for the projections of future developments in long term care systems in developed countries. The main thrust of the present analysis is that aging and uncertainties with respect to future trends in disability across individuals, and in costs required to cater to future needs, are likely to raise significant challenges both for individuals and for policy makers in the not-so-distant future, and that the supply of long-term care (LTC) is unlikely to match future demand. The main concepts used in the long term care literature are illustrated, and modelling strategies employed by different investigators are reviewed. Each of the simulation models discussed in this survey is presented in detail in the Appendix together with the relevant references. Both macrosimulation models primarily based on aggregate data at country level and microsimulation models based on individual and household survey data are considered in the present study.JRC.G.3-Econometrics and applied statistic

The Macroeconomic Imbalance Procedure

This study employs statistical methods to further develop the Macroeconomic Imbalance Procedure (MIP) Scoreboard in line with the European Parliaments regulation of 2011, so as to make it an even better information aggregation, decision making and communication tool. The contribution to the literature and ongoing policy debate is threefold. First, we synthesize the current empirical literature and show that the predictive power of the MIP Scoreboard has so-far been limited. Second, we apply the methodology of composite indicators, step-by-step on the European Statistical Office (Eurostat) MIP Database (2005-11, 28 Member States, 11 MIP Indicators). By doing so, we spotted few outliers in the headline database, recommended normalised measures (red flag analysis, distance-to-target) already advocated by the European Commission, and conducted multivariate analysis revealing that MIP indicators are only weakly collinear and it is unlikely that they share common factors. Still, when applying the signals approach, which is a standard technique used by earlier empirical studies, a composite measure of threshold breaches was the available second best indicator to signal crisis events in advance. Third, we found that introducing two sided thresholds could be an obvious choice for some flow variables in the MIP scoreboard to identify imbalances both ex-ante and ex-post (in accordance with the prevention and correction goals of the MIP). Such two sided thresholds have been already introduced for two MIP indicators: for the current account deficit and for the real effective exchange rate. Real house prices, unemployment and private sector credit flow could be further candidates to consider for two sided thresholds.JRC.I.1-Modelling, Indicators and Impact Evaluatio

JRC Statistical Audit of the Sustainable Development Goals Index and Dashboards

In 2015, the United Nations adopted the 2030 Agenda for Sustainable Development with 17 Sustainable Development Goals (SDGs) and 169 associated targets. All 193 United Nations member states have committed to achieve sustainable development across its three dimensions – economic, social, and environmental – in a balanced and integrated manner. In order to assist countries in measuring their progress towards the achievement of the SDGs, Bertelsmann Stiftung and the United Nations Sustainable Development Solutions Network (SDSN) developed the Sustainable Development Goals Index and Dashboards (SDG Index) in 2016. Since then, the SDG Index has been annually updated and presently covers 162 countries. The European Commission’s Competence Centre on Composite Indicators and Scoreboards (COIN) at the Joint Research Centre (JRC) was invited by the SDSN to audit the 2019 edition of the SDG Index which will be launched on the sidelines of the 2019 United Nations High-level Political Forum on Sustainable Development. The audit presented herein aims to contribute to ensuring the transparency of the SDG Index methodology and the reliability of the results. The report touches upon data quality issues, the conceptual and statistical coherence of the framework and the impact of modelling assumptions on the results. The fact that the SDGs are universal and highly diverse in nature makes the work of aggregating into a single number quite challenging from a statistical point of view. Nevertheless, the SDG Index is a remarkable effort of synthetizing the 17 SDGs into a single measure. The index ranks are robust enough, allowing meaningful conclusions to be drawn from the index.JRC.I.1-Monitoring, Indicators & Impact Evaluatio

Echocardiography - a non-invasive alternative for assessing cardiac morphology and function in Atlantic salmon (Salmo salar L.)

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The Cultural and Creative Cities Monitor: 2019 Edition

This second edition of the Cultural and Creative Cities Monitor shows how well 190 cities in 30 European countries perform on a range of measures describing the ‘Cultural Vibrancy’, the ‘Creative Economy’ and the ‘Enabling Environment’ of a city. In 2018, Madrid, Geneva and Győr used the Monitor to pursue different objectives, such as analysing investment needs and re-designing creative industries’ strategies. A paper was also published in a top-level journal in the field of urban studies (Cities) to offer policy insights to the scholarly community. As one of the 65 actions of the European Framework for Action on Cultural Heritage, the Monitor wants to support the European Commission’s efforts to put culture at the heart of its policy agenda through evidence and success stories in cities.JRC.I.1-Monitoring, Indicators & Impact Evaluatio

Building a monitoring system for the EU bioeconomy

The new EU Bioeconomy Strategy, adopted in 2018 is more relevant within the actual political, environmental and social context than ever before. In these times of acute awareness of global climate change impacts and related challenges for sustainable development, the EU Bioeconomy is perceived a crucial stepping stone to changing our whole development paradigm and to trigger systemic change. Bioeconomy is intended to contribute to the decarbonisation of our economy, to catalyse changes in consumer habits and will modernise our industries throughout the value chain. But is it all good? At what cost to primary productions systems? Can the bioeconomy really deliver on its promises while ensuring biodiversity enhancement and the improvement of our planet’s overall health? To what extent will societies benefit from a transition from a fossil-based to a bio-based economy? This document describes the first year of the development of the EU Bioeconomy Monitoring System by the European Commission’s Joint Research Centre (JRC) in collaboration with experts throughout European and International organisations, EU Member States, Commission Services and other stakeholders to assess questions such as those posed above. The framework is designed to house several basic indicators that are, analogous to the instruments of a symphony, in themselves useful and meaningful but whose value is enhanced once they are placed within an orchestra. Only when the indicators interplay jointly the ensemble is capable of estimating the progress of EU bioeconomy and its contribution towards the Sustainable Development Goals, highlighting related trade-offs and synergies. In this first year, the development of the monitoring system has focused on structuring the framework, thus creating a better understanding of the bioeconomy as it is presented in various sources at national, EU and international levels. Criteria have been established to assess indicator quality, which is relevant to the final decision on indicator inclusion. This document represents a status report on the development of the EU-wide monitoring system for the Bioeconomy and by no means does it constitute the finished work. Comments are always welcome, please write to: [email protected]

COIN Tool User Guide

The COIN Tool is a free Microsoft Excel-based tool designed to help users from research institutions, international organisations, European Union institutions, national and local governments, among others, in the process of building and analysing composite indicators. It was developed by the European Commission's Competence Centre on Composite Indicators and Scoreboards (COIN), at the Joint Research Centre. There are two versions of the COIN Tool: the Full version, and the Lite version. The Lite version is the same as the Full version but has some functionalities removed in order to make it run faster. Both versions, with and without example data, can be downloaded at https://composite-indicators.jrc.ec.europa.eu/. How to use this manual: • If you want to begin building your composite indicator as quickly as possible, read the Quick-Start Guide in Section 1. • For more depth, a longer introduction can be found in Section 2, followed by a detailed description of each tab in Sections 3 to 9, grouped under headings which relate to the overall steps in the construction and analysis process. • Troubleshooting and FAQ are can be found at the end of this Guide. Note that data used to illustrate the COIN tool (i.e. the screenshots) has been altered to illustrate particular cases.JRC.I.1-Monitoring, Indicators & Impact Evaluatio

Efficacy and tolerability of pegloticase for the treatment of chronic gout in patients refractory to conventional treatment: Two randomized controlled trials

Context Patients with chronic disabling gout refractory to conventional urate-lowering therapy need timely treatment to control disease manifestations related to tissue urate crystal deposition. Pegloticase, monomethoxypoly(ethylene glycol)–conjugated mammalian recombinant uricase, was developed to fulfill this need. Objective To assess the efficacy and tolerability of pegloticase in managing refractory chronic gout. Design, Setting, and Patients Two replicate, randomized, double-blind, placebo-controlled trials (C0405 and C0406) were conducted between June 2006 and October 2007 at 56 rheumatology practices in the United States, Canada, and Mexico in patients with severe gout, allopurinol intolerance or refractoriness, and serum uric acid concentration of 8.0 mg/dL or greater. A total of 225 patients participated: 109 in trial C0405 and 116 in trial C0406. Intervention Twelve biweekly intravenous infusions containing either pegloticase 8 mg at each infusion (biweekly treatment group), pegloticase alternating with placebo at successive infusions (monthly treatment group), or placebo (placebo group). Main Outcome Measure Primary end point was plasma uric acid levels of less than 6.0 mg/dL in months 3 and 6. Results In trial C0405 the primary end point was reached in 20 of 43 patients in the biweekly group (47%; 95% CI, 31%-62%), 8 of 41 patients in the monthly group (20%; 95% CI, 9%-35%), and in 0 patients treated with placebo (0/20; 95% CI, 0%-17%; P < .001 and <.04 for comparisons between biweekly and monthly groups vs placebo, respectively). Among patients treated with pegloticase in trial C0406, 16 of 42 in the biweekly group (38%; 95% CI, 24%-54%) and 21 of 43 in the monthly group (49%; 95% CI, 33%-65%) achieved the primary end point; no placebo-treated patients reached the primary end point (0/23; 95% CI, 0%-15%; P = .001 and < .001, respectively). When data in the 2 trials were pooled, the primary end point was achieved in 36 of 85 patients in the biweekly group (42%; 95% CI, 32%-54%), 29 of 84 patients in the monthly group (35%; 95% CI, 24%-46%), and 0 of 43 patients in the placebo group (0%; 95% CI, 0%-8%; P < .001 for each comparison). Seven deaths (4 in patients receiving pegloticase and 3 in the placebo group) occurred between randomization and closure of the study database (February 15, 2008). Conclusion Among patients with chronic gout, elevated serum uric acid level, and allopurinol intolerance or refractoriness, the use of pegloticase 8 mg either every 2 weeks or every 4 weeks for 6 months resulted in lower uric acid levels compared with placebo

Epithelial-Associated Inflammatory Pathways Underlie Residual Asthma Exacerbations in Urban Children Treated with Mepolizumab Therapy

Rationale: Identification of airway inflammatory pathways in asthma has proven essential to understanding mechanisms of disease and has led to effective personalized treatment with biologic therapies. However, relatively little is known about patterns of airway inflammation at the time of respiratory illnesses and how such patterns relate to responsiveness to biologic therapies. Methods: The MUPPITS-1 (n=106) and MUPPITS-2 (n=290) studies investigated asthma exacerbations in urban children with exacerbation-prone asthma and ≥150/microliter blood eosinophils. Children in both studies received guidelines-based asthma care; in MUPPITS-2, participants were additionally randomized (1:1) to placebo or mepolizumab. Nasal lavage samples were collected during respiratory illnesses for RNA-sequencing and analyzed by modular analysis to assess genome-wide expression patterns associated with exacerbation illnesses. Results: Among 284 illnesses, exacerbations that occurred in the absence of mepolizumab therapy showed significantly higher upregulation of eosinophil associated inflammatory pathways (fold change values [FC]=1.27-1.43, p-values\u3c0.05), including a Type-2 inflammation module composed of eosinophil, mast cell, and IL-13 response genes. In contrast, exacerbations that occurred while on mepolizumab therapy showed significantly higher upregulation of several epithelial inflammatory pathways (FC=1.36-1.64, p-values\u3c0.05) including TGF-β/Smad3 signaling, extracellular matrix production, and epidermal growth factor receptor signaling. Conclusions: These results indicate that novel inflammatory pathways, likely originating from the airway epithelium and distinct from Type-2 or eosinophilic inflammation, drive residual exacerbations that occur in children treated with mepolizumab therapy added to guideline-based care. These findings identify likely mechanisms of persistent disease expression in these children despite significant depletion of eosinophils and can identify novel treatment targets for future studies