18 research outputs found
Endometrioosiga naiste ravisündmused ja ravikulud aastatel 2012–2019
No full textEndometriosis is a chronic inflammatory condition in which tissue similar to the lining of the uterus grows outside the uterus, causing pain, adhesions, cysts, and often infertility. It affects approximately 1–10% of women of reproductive age and is difficult to diagnose due to its nonspecific symptoms, frequently leading to years of diagnostic delay. Treatment focuses on symptoms, but therapeutic options often have limited efficacy. The societal costs associated with endometriosis are substantial and comparable to those of other chronic illnesses.
To date, there has been limited research on real-world healthcare utilisation and costs among women with endometriosis, particularly in comparison to women without the diagnosis. There is also insufficient evidence on how the diagnosis itself alters treatment pathways and expenditures, or when disease-specific symptoms first emerge over time.
This study used electronic health data covering 10% of the Estonian population from 2012 to 2019. A cohort of women diagnosed with endometriosis (n = 631) was compared to an age-matched control cohort (n = 3780) without an endometriosis diagnosis. Healthcare events and costs were analysed using R packages developed for the OMOP common data model, along with supplementary SQL and R scripts.
The results showed that women with endometriosis had a higher risk of infertility, abdominal pain, and reproductive organ-related conditions. They underwent more surgeries and diagnostic procedures, and used more hormone therapies and other medications. Most symptoms associated with endometriosis began before the initial diagnosis—often years earlier.
Over a four-year period, the average healthcare costs for women with endometriosis were 1.7 times higher than for those in the control cohort. The mean per-person cost was €3411 in the endometriosis cohort and €1973 in the control cohort. Longer-term follow-up data are needed to investigate the earlier onset of symptoms and to more precisely estimate the total economic burden of the disease
Kisklusrisk ja elupaiga ajalugu päevaliblikate koosluste mõjutajatena
No full textVäitekirja elektrooniline versioon ei sisalda publikatsioone.Ökoloogia üks keskseid ülesandeid on kirjeldada ja seletada liigirikkuse varieeruvuse mustreid. Käesolevas doktoritöös uuriti kahe, sageli raskesti hinnatava elupaigaparameetri – kiskluse ning elupaikade hävimise määra – mõju päevaliblikate populatsioonidele ja kooslustele. Vaatamata sellele, et nende faktorite mõju peetakse liigirikkuse mustrite kujunemisel oluliseks, on vähemasti putukate kohta empiirilist infot looduslikes kooslustes minimaalselt. Töös keskenduti päevaliblikate kooslustele Lääne-Eesti loopealsetel. Konkreetsemalt küsiti, kuivõrd mõjutavad kiilid kui kiskjad päevaliblikate liigirikkuse mustreid ning kuivõrd päevaliblikate liigirikkuse tänapäevased mustrid on mõjutatud elupaiga ajaloolisest karakteristikutest. Tulemused näitavad, et nii kisklusrisk kui ka elupaiga ajaloolised parameetrid seletavad olulise osa päevaliblikate koosluste liigirikkuse varieerumisest. Kiilide ruumiliselt ja sesoonselt varieeruv kisklussurve on piisav, et mõjutada mitte ainult päevaliblikate arvukust, vaid ka liigirikkust ning liigilist koosseisu. Nimelt puudusid kõrgema kiilide arvukusega loopealsetelt suurema tõenäosusega need päevaliblikaliigid, kelle lennuaeg kattub kiilide arvukuse tippajaga ning liigirikkus kiilirohketel aladel oli madalam. Seega on kisklus oluline faktor, mida arvestada ka praktilises looduskaitses. Nii ajalooline kui tänapäeva elupaiga pindala seletas olulise osa kitsaste elupaigaspetsialistide liigirikkuse varieerumisest. Samal ajal ei sõltunud generalistde liigirikkus ei tänapäeva ega ajaloolise elupaiga pindalast, mis viitab nende kahe rühma erinevale tundlikkusele elupaiga pindala muutumise suhtes. Käesoleva töö tulemused näitavad, et ainult tänapäevase elupaiga parameetrite teadmisest ei pruugi piisata, hindamaks liigi seisundit dünaamilises tugeva inimmõjuga maastikus.Revealing major biotic and abiotic gradients along which species are spatially distributed is one of the major goals in ecology. In this thesis butterfly community structure along the gradients of dragonfly predation risk and habitat history was examined. In spite of the growing awareness of the importance of predation risk and habitat past characteristics in different ecosystems, community-level responses along these gradients have rarely been addressed in empirical studies focusing on insects. Current thesis focused on these issues in butterfly communities in seminatural calcareous grasslands (alvars) in Western Estonia. The results show that the variation in predation risk and past habitat characteristics can explain a significant amount of variation in butterfly species composition and richness. Butterfly communities at predator rich sites were biased towards a greater proportion of species flying during off peak dragonfly abundance, and butterfly species richness in dragonfly-rich habitat patches was lower than in dragonfly-poor patches. The gradient of predation risk could thus be an important factor to consider in practical conservation work as well. Both historical and current habitat area explained a significant amount of variation in strict habitat specialist butterflies, whereas species richness of other grassland butterflies was associated neither with past nor current habitat area. These patterns imply differential sensitivity of these two groups to habitat changes. The results of the thesis show that relying on just current habitat characteristics may not be sufficient to assess the status of species diversity in dynamic, human-affected landscapes
Extracellular Dopamine Levels in Nucleus Accumbens after Chronic Stress in Rats with Persistently High vs. Low 50-kHz Ultrasonic Vocalization Response
No full textFifty-kHz ultrasonic vocalizations (USVs) in response to an imitation of rough-and-tumble play (‘tickling’) have been associated with positive affective states and rewarding experience in the rat. This USV response can be used as a measure of inter-individual differences in positive affect. We have previously shown that rats with persistently low positive affectivity are more vulnerable to the effects of chronic variable stress (CVS). To examine whether these differential responses are associated with dopaminergic neurotransmission in the nucleus accumbens (NAc), juvenile male Wistar rats were categorized as of high or low positive affectivity (HC and LC, respectively), and after reaching adulthood, extracellular dopamine (DA) levels in the NAc shell were measured using in vivo microdialysis after three weeks of CVS. Baseline levels of DA were compared as well as the response to K+-induced depolarization and the effect of glial glutamate transporter EAAT2 inhibition by 4 mM l-trans-pyrrolidine-2,4-dicarboxylate (PDC). DA baseline levels were higher in control LC-rats, and stress significantly lowered the DA content in LC-rats. An interaction of stress and affectivity appeared in response to depolarization where stress increased the DA output in HC-rats whereas it decreased it in LC-rats. These results show that NAc-shell DA is differentially regulated in response to stress in animals with high and low positive affect
Inventory of Good Practices to help people to take one step up
No full textThe Volume reports the analysis of the best European practices supporting low skilled citizens in their upskillin
Afforestation and abandonment of semi-natural grasslands lead to biodiversity loss and a decline in ecosystem services and functions
No full text1. During the past century, semi-natural grasslands, once widespread throughout Europe, have largely been converted into intensively managed agricultural areas, abandoned or afforested. These large-scale land-use changes have already resulted in considerable biodiversity loss but can also lead to a decline in ecosystem service provision and ecosystem multifunctionality.
2. We assessed the impact of afforestation and abandonment of semi-natural grasslands on the supply of ecosystem services in Western Estonia. We compared a wide array of services provided by open grasslands, abandoned grasslands, and afforested grasslands. Additionally, we analysed the impact of land-use change and species richness on ecosystem multifunctionality.
3. Significant declines in the supply of pollination service, natural pest regulation, forage production, soil quality, wild food, and cultural appreciation of landscape were detected as a result of overgrowing or afforestation.
4. There was a significant positive relationship between species richness and ecosystem multifunctionality, i.e. more biodiverse grasslands were able to support more services at a higher capacity.
5. Results show that both grassland degradation due to abandonment, as well as grassland afforestation, have significant negative impacts on biodiversity, on the supply of multiple important ecosystem services and on the ecosystem multifunctionality.
6. Synthesis and applications. Temperate semi-natural grasslands have high biodiversity and capacity to deliver multiple important ecosystem services simultaneously. Conservation and restoration of grassland habitats must be considered as an important part of sustainable landscape planning.Funding provided by: Estonian Research Competency CouncilCrossref Funder Registry ID: http://dx.doi.org/10.13039/501100005189Award Number: PRG874Funding provided by: Estonian Research Competency CouncilCrossref Funder Registry ID: http://dx.doi.org/10.13039/501100005189Award Number: PSG649Funding provided by: European CommissionCrossref Funder Registry ID: http://dx.doi.org/10.13039/501100000780Award Number: LIFE13NAT/EE/000082Funding provided by: Marie CurieCrossref Funder Registry ID: http://dx.doi.org/10.13039/501100000654Award Number: "Happybee" (101027920)Funding provided by: European Regional Development FundCrossref Funder Registry ID: http://dx.doi.org/10.13039/501100008530Award Number:Data were collected during LIFE+ Nature project LIFE to alvars (LIFE13 NAT/EE/000082), a large-scale restoration project of calcareous grasslands in Estonia that restored 2500 ha of overgrown and afforested grasslands. Fieldworks were carried out in 2014–2016, prior to the restoration activities. Collected data was used to analyse the effect of overgrowing and afforestation on biodiversity, ecosystem services and their indicator values for the manuscript "Afforestation and abandonment of semi-natural grasslands lead to biodiversity loss and a decline in ecosystem services and functions" by Prangel et al. 2023. Analysis was carried out using R
The EU Butterfly Indicator for Grassland species: 1990-2017. Technical report
No full textThe EU Grassland Butterfly Indicator is one of the indicators of the status of biodiversity in the European Union. It is an abundance indicator based on data recording the population trends of seventeen butterfly species in 16 (see below) EU countries. This report presents the seventh version of this indicator now covering 28 years. At the Convention on Biological Diversity meeting in Nagoya (Japan) the Strategic Plan for Biodiversity 2011– 2020 was adopted. It proposed five goals and 20 “Aichi” biodiversity targets. In line with this plan a new EU biodiversity strategy was adopted by the European Commission in May 2011. This provided a framework for the EU to meet its own biodiversity objectives and its global commitments as a party to the CBD. The Headline Target is to halt the loss of biodiversity and the degradation of ecosystem services in the EU by 2020, and restore them, in so far as feasible, while stepping up the EU contribution to averting global biodiversity loss. Under Target 3A the EU is committed to increase the contribution of agriculture to biodiversity recovery. Europe now has one year left to intensify action to achieve this. The EU biodiversity strategy includes the development of a coherent framework for monitoring, assessing and reporting on progress in implementing actions. Such a framework is needed to link existing biodiversity data and knowledge systems with the strategy, to help assess achievement of the goals and to streamline EU and global monitoring, reporting and review obligations. Some of the EU biodiversity indicators provide specific measurements and trends on genetic, species and ecosystem/landscape diversity, but many have a more indirect link to biodiversity. Very few have been established specifically to assess biodiversity. The status indicators on species only cover birds, bats and butterflies, since these are the only taxa/species groups for which harmonized European monitoring data are available (EEA, 2012). For the EU Grassland Butterfly Indicator the trends of seventeen widespread and characteristic grassland butterflies were assessed in 16 countries in the European Union. This technical report gives an overview of the method and results, and presents the indicator
The database of the PREDICTS (Projecting Responses of Ecological Diversity In Changing Terrestrial Systems) project
No full textThe PREDICTS project—Projecting Responses of Ecological Diversity In Changing Terrestrial Systems (www.predicts.org.uk)—has collated from published studies a large, reasonably representative database of comparable samples of biodiversity from multiple sites that differ in the nature or intensity of human impacts relating to land use. We have used this evidence base to develop global and regional statistical models of how local biodiversity responds to these measures. We describe and make freely available this 2016 release of the database, containing more than 3.2 million records sampled at over 26,000 locations and representing over 47,000 species. We outline how the database can help in answering a range of questions in ecology and conservation biology. To our knowledge, this is the largest and most geographically and taxonomically representative database of spatial comparisons of biodiversity that has been collated to date; it will be useful to researchers and international efforts wishing to model and understand the global status of biodiversity
Development of Activity-Based Science Learning Models with Inquiry Approaches
No full textThis study aims to develop an activity-based science learning model with an inquiry learning approach for early childhood that can be used to increase the sense of curiosity and sci-entific thinking in children aged 5-6 years. This study was conducted with research and de-velopment / R & D research methods. Data was collected through interviews, observations, questionnaires, pre-test and post-test for children. Data analysis using paired t-test. The re-sults showed that children were interested and enthusiastic in the learning process by using a science-based learning model with the inquiry approach, Sig. (2-tailed) showing results of 0.000, so the value of 0.000 <0.05 was different from before and after the use of learning models . Results show children can understand the material, more confident and has initiative to find answers for the teacher's questions about science, the child's curiosity increases to ex-amine the information provided by the teacher, the child's understanding of work processes and procedures from science learning with the inquiry approach getting bet-ter. It was con-cluded that an activity-based science learning model with an inquiry approach for children aged 5-6 years used an activity model with an inquiry learning approach based on children's interests and children's needs so that children's curiosity would emerge and continue to be optimally stimulated.
Keywords: Inquiry approach, Learning model, Science Learning
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Butterfly indicators 1990-2018. Technical report
No full textThere is mounting evidence of widespread declines in the diversity and abundance of insects from across the globe (Sanchez-Bayo and Wyckhuys 2019, Seibold et al. 2019, van Klink et al. 2020, Wagner 2020). This gives a stark warning for the perilous state of biodiversity (Diaz et al. 2019), and demonstrates that addressing the gap in knowledge of the status of insects is vital (Cardoso et al. 2020, Samways et al. 2020). Insects are estimated to comprise more than half of all described species and are a dominant component of biodiversity in most ecosystems (Bar-On et al. 2018). Insects also provide a crucial role in the functioning of ecosystems. They are not only related to the supply of many ecosystem services such as pollination, biological control, soil fertility regulation and diverse cultural ecosystem services but also to disservices such as damage to crops and spread of diseases to livestock and humans (Gutierrez-Arellano and Mulligan 2018, Noriega et al. 2018). There is a pressing need to assess the status of insects to set and evaluate conservation targets. At the Convention on Biological Diversity (CBD) meeting in Nagoya (Japan), the Strategic Plan for Biodiversity 2011-2020 was adopted. It proposed five goals and 20 "Aichi" biodiversity targets. In line with this plan, a new EU biodiversity strategy was adopted by the European Commission in May 2011. This strategy provided a framework for the EU to meet its biodiversity targets and global commitments as a party to the CBD. The Headline Target in the existing EU Biodiversity Strategy 2020 is to halt the loss of biodiversity and the degradation of ecosystem services in the EU by 2020, and restore them, in so far as feasible, while stepping up the EU contribution to averting global biodiversity loss. Under Target 3A the EU is committed to increasing the contribution of agriculture to biodiversity recovery. Further, the EU Biodiversity Strategy 2030 includes the development of a coherent framework for monitoring, assessing and reporting on progress in implementing actions. Such a framework is needed to link existing biodiversity data and knowledge systems with the strategy, to help assess achievement of the goals and to streamline EU and global monitoring, reporting and review obligations. Some of the EU biodiversity indicators provide specific measurements and trends on genetic, species and ecosystem/landscape diversity, but many have a more indirect link to biodiversity. Very few have been explicitly established to assess biodiversity. The status indicators on species only cover birds, bats and butterflies, since these are the only taxa/species groups for which reasonably harmonized European monitoring data are available (EEA, 2012). This technical report builds upon previous technical reports for the EU Grassland Butterfly Indicator (e.g. van Swaay et al., 2019) to: 1. Describe a new approach for assessing butterfly trends and developing indicators of European butterflies; 2. Give an overview of the main results, and present a range of butterfly indicators; 3. Discuss the next steps to improve butterfly indicators for Europe. Butterflies are ideal biological indicators: they are well-documented, measurable, sensitive to environmental change, occur in a wide range of habitat types, represent many other insects, and are popular with the public because of their beauty. Field monitoring is essential to assess changes in their abundance. Indicators based on butterfly monitoring data are valuable to understand the state of the environment and help evaluate policy and implementation. Trained volunteers are a cost-effective way of gathering robust data on butterflies, more so when supported by informative materials and efficient online recording
Integrating national Red Lists for prioritising conservation actions for European butterflies
No full textRed Lists are very valuable tools in nature conservation at global, continental and (sub-) national scales. In an attempt to prioritise conservation actions for European butterflies, we compiled a database with species lists and Red Lists of all European countries, including the Macaronesian archipelagos (Azores, Madeira and Canary Islands). In total, we compiled national species lists for 42 countries and national Red Lists for 34 of these. The most species-rich countries in Europe are Italy, Russia and France with more than 250 species each. Endemic species are mainly found on the Macaronesian archipelagos and on the Mediterranean islands. By attributing numerical values proportionate to the threat statuses in the different national Red List categories, we calculated a mean Red List value for every country (cRLV) and a weighted Red List value for every species (wsRLV) using the square root of the country’s area as a weighting factor. Countries with the highest cRLV were industrialised (NW) European countries such as the Netherlands, Belgium, the Czech Republic and Denmark, whereas large Mediterranean countries such as Spain and Italy had the lowest cRLV. Species for which a Red List assessment was available in at least two European countries and with a relatively high wsRLV (≥ 50) are Colias myrmidone, Pseudochazara orestes, Tomares nogelii, Colias chrysotheme and Coenonympha oedippus. We compared these wsRLVs with the species statuses on the European Red List to identify possible mismatches. We discuss how this complementary method can help to prioritise butterfly conservation on the continental and/or the (sub-)national scale
