Sprekere eldre, rimeligere eldreomsorg? - Utgiftsbehovet i eldreomsorgen i perioden 2000-2030 under ulike forutsetninger om eldres funksjonsevne

Den gjennomsnittlige levealder øker. Både som følge av dette og som følge av variasjoner i fødselsrater, blir det i Norge, som i andre deler av den vestlige verden, flere eldre i årene framover. Endringene i demografi stiller store og økende krav til eldreomsorgen i framtiden. Vi vet imidlertid lite om hvor store utfordringene blir og hva som kreves av ressursinnsats framover. Årsakene til dette er flere. En årsak er at det samtidig med økningen i antall eldre ser ut til å skje en endringer i eldres helsetilstand og deres funksjonsevne. OECD har nylig gjennomført en studie av disse forholdene i 9 av sine medlemsland (Jacobzone, m fl 1999). I denne studien var Norge ikke med. Dette var noe av bakgrunnen for at Finansdepartementet og Sosial- og helsedepartementet i samarbeid utformet et prosjekt der målet var å se på framtidig behov for helse-, omsorgs- og pleietjenester blant eldre. Prosjektet utføres av Senter for helseadministrasjon, Universitetet i Oslo (SHA) og Statistisk Sentralbyrå (SSB). Den delen som utføres av Senter for helseadministrasjon, omfatter en analyse av endringer i demografi, helsetilstand, funksjonsevne og utgiftsbehov i pleie- og omsorgssektoren i Norge. Analysen omfatter framskrivninger av flere av disse forholdene til 2030 og rapporteres i foreliggende rapport.Eldreomsorg; aldrende befolkning; ressursbehov

Matching disease and phenotype ontologies in the ontology alignment evaluation initiative

Background: The disease and phenotype track was designed to evaluate the relative performance of ontology matching systems that generate mappings between source ontologies. Disease and phenotype ontologies are important for applications such as data mining, data integration and knowledge management to support translational science in drug discovery and understanding the genetics of disease. Results: Eleven systems (out of 21 OAEI participating systems) were able to cope with at least one of the tasks in the Disease and Phenotype track. AML, FCA-Map, LogMap(Bio) and PhenoMF systems produced the top results for ontology matching in comparison to consensus alignments. The results against manually curated mappings proved to be more difficult most likely because these mapping sets comprised mostly subsumption relationships rather than equivalence. Manual assessment of unique equivalence mappings showed that AML, LogMap(Bio) and PhenoMF systems have the highest precision results. Conclusions: Four systems gave the highest performance for matching disease and phenotype ontologies. These systems coped well with the detection of equivalence matches, but struggled to detect semantic similarity. This deserves more attention in the future development of ontology matching systems. The findings of this evaluation show that such systems could help to automate equivalence matching in the workflow of curators, who maintain ontology mapping services in numerous domains such as disease and phenotype

Optique: Zooming in on Big Data

Despite the dramatic growth of data accumulated by enterprises, obtaining value out of it is extremely challenging. In particular, the data access bottleneck prevents domain experts from getting the right piece of data within a constrained time frame. The Optique Platform unlocks the access to Big Data by providing end users support for directly formulating their information needs through an intuitive visual query interface. The submitted query is then transformed into highly optimized queries over the data sources, which may include streaming data, and exploiting massive parallelism in the backend whenever possible. The Optique Platform thus responds to one major challenge posed by Big Data in data-intensive industrial settings

Measuring Malnutrition

Summary The nutritional condition of an individual, or the extent of malnutrition in a population, can be measured either in terms of outcomes , i.e. current status, or in terms of inputs , i.e rates of consumption of nutrients and/or energy in diets. A review of the methods of measurement in common use for these two approaches, and of their technical limitations, is followed by an account of the problems of interpretation of these in the light of contemporary ideas about the causes of growth faltering in children. Also discussed is the basis for standards of normality for growth and for nutrient intake levels, and the extent to which adaptive changes in behaviour or physiology may compensate for low levels of intake. It is concluded that, provided these problems are recognised, nutritional indicators can play a useful role in assessing overall food and health situations, particularly when accompanied by other complementary measurements of the effects of the health environment of the households and their social and economic characteristics

Periprandial changes of the sympathetic–parasympathetic balance related to perceived satiety in humans

Food intake regulation involves various central and peripheral mechanisms. In this study the relevance of physiological responses reflecting the autonomic nervous system were evaluated in relation to perceived satiety. Subjects were exposed to a lunch-induced hunger-satiety shift, while profiling diverse sensory, physiological, and biochemical characteristics at 15 min intervals. Sensory ratings comprised questionnaires with visual analogues scales about their feeling of satiety, desire to eat, fullness, and hunger. Physiological characteristics included heart rate, heart rate variability, and blood pressure, while biochemical markers such as cortisol levels and α-amylase activity were monitored in saliva. The four sensory ratings correlated with heart rate and salivary α-amylase suggesting a higher sympathetic tone during satiety. Furthermore, heart rate variability was associated with age and waist-to-hip ratio and cortisol levels negatively correlated with body mass index. Finally, neither chewing nor swallowing contributed to a heart rate increase at food consumption, but orosensory stimulation, as tested with modified sham feeding, caused a partial increase of heart rate. In conclusion, after meal ingestion critical physiological alterations reveal a elevated sympathetic tone, which is a potential measure of satiety

Tankyrase inhibition sensitizes melanoma to PD-1 immune checkpoint blockade in syngeneic mouse models

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Rapid increases in obesity in Jamaica, compared to Nigeria and the United States

<p>Abstract</p> <p>Background</p> <p>Weight gain in adulthood is now common in many populations, ranging from modest gains in developing countries to a substantial percentage of body weight in some Western societies. To examine the rate of change across the spectrum of low to high-income countries we compared rates of weight change in samples drawn from three countries, Nigeria, Jamaica and the United States.</p> <p>Methods</p> <p>Population samples from Nigeria (n = 1,242), Jamaica (n = 1,409), and the US (n = 809) were selected during the period 1995–1999 in adults over the age of 19; participation rates in the original survey were 96%, 60%, and 60%, respectively. Weight in (kg) was measured on 3 different occasions, ending in 2005. Multi-level regression models were used to estimate weight change over time and pattern-mixture models were applied to assess the potential effect of missing data on estimates of the model parameters.</p> <p>Results</p> <p>The unadjusted weight gain rate (standard error) was 0.34(0.06), 1.26(0.12), 0.34(0.19) kg/year among men and 0.43(0.06), 1.28(0.10), 0.40(0.15) kg/year among women in Nigeria, Jamaica, US, respectively. Regression-adjusted weight change rates were significantly different across country, sex, and baseline BMI. Adjusted weight gain in Nigeria, Jamaica and US was 0.31(0.05), 1.37(.04), and 0.52(0.05) kg/year respectively. Women in Nigeria and the US had higher weight gains than men, with the converse observed among Jamaicans. The obese experienced weight loss across all three samples, whereas the normal weight (BMI < 25) had significant weight gains. Missing data patterns had an effect on the rates of weight change.</p> <p>Conclusion</p> <p>Weight change in sample cohorts from a middle-income country was greater than in cohorts from either of the low- or high-income countries. The steep trajectory of weight gain in Jamaica, relative to Nigeria and the US, is most likely attributable to the accelerating effects of the cultural and behavioral shifts which have come to bear on transitional societies.</p

Serum levels of osteoprotegerin and receptor activator of nuclear factor -κB ligand in children with early juvenile idiopathic arthritis: a 2-year prospective controlled study

<p>Abstract</p> <p>Background</p> <p>The clinical relevance of observations of serum levels of osteoprotegerin (OPG) and receptor activator of nuclear factor -κB ligand (RANKL) in juvenile idiopathic arthritis (JIA) is not clear. To elucidate the potential role of OPG and RANKL in JIA we determined serum levels of OPG and RANKL in patients with early JIA compared to healthy children, and prospectively explored changes in relation to radiographic score, bone and lean mass, severity of the disease, and treatment.</p> <p>Methods</p> <p>Ninety children with early oligoarticular or polyarticular JIA (ages 6-18 years; mean disease duration 19.4 months) and 90 healthy children individually matched for age, sex, race, and county of residence, were examined at baseline and 2-year follow-up. OPG and RANKL were quantified by enzyme-immunoassay. Data were analyzed with the use of t-tests, ANOVA, and multiple regression analyses.</p> <p>Results</p> <p>Serum OPG was significantly lower in patients than controls at baseline, and there was a trend towards higher RANKL and a lower OPG/RANKL ratio. Patients with polyarthritis had significantly higher increments in RANKL from baseline to follow-up, compared to patients with oligoarthritis. RANKL was a significant negative predictor for increments in total body lean mass. Patients who were receiving corticosteroids (CS) or disease-modifying antirheumatic drugs (DMARDs) at follow-up had higher OPG/RANKL ratio compared with patients who did not receive this medication.</p> <p>Conclusions</p> <p>The data supports that levels of OPG are lower in patients with JIA compared to healthy children, and higher levels of RANKL is associated with more serious disease. RANKL was a significant negative predictor of lean mass in patients with JIA. The OPG/RANKL ratio was higher in patients on DMARDs or CS treatment.</p