Cost Control and Revenue Generation: The Case of Public-housing Companies' Experiences in Sweden

Lindbergh L., Larsson C.-G. and Wilson T. L. (2004) Cost control and revenue generation: the case of public-housing companies' experiences in Sweden, Regional Studies38, 803-815. Increased competition for funds associated with the provision of public-sector housing, stock privatization, and attempts to introduce more tenant-centred and effective housing management services are trends seen in social housing throughout the European Union. Consequently, studies have been done that compare programmes worldwide and in Europe, or analyse changes in single countries. The Swedish system has received attention because of its long-term viability. An ordinary least-squares analysis of financial information from providers in this system has been made with special regard to revenue generation capabilities, the ability to remain profitable, and the retention of asset values for both level and first difference approaches. If one general lesson can be drawn from the empirical results, it would be that expenditures on consolidated maintenance are associated not only with short- term rental revenues, but also undoubtedly with long-term viability. Further, first difference results suggested that negotiated rents produced operating profits that kept pace with revenues over that period of the study. The results should be especially relevant to the interests of a wide range of local governments where public housing is of concern. In particular, those individuals bearing greater responsibility for running self-sufficient systems and also policy-makers interested in running efficient, effective systems should be interested in these observations. Lindbergh L., Larsson C.-G. et Wilson T. L. (2004) La maitrise des couts et la production des revenus: etude de cas des logements sociaux en Suede, Regional Studies38, 803-815. La competition accrue pour les fonds associes a l'offre des logements sociaux, la privatisation du parc de logements, et les tentatives de fournir des services logement et de gestion plus efficaces et plus centres sur le locataire, representent des tendances qui sont evidentes partout dans l'Union europeenne. Par consequent, des etudes ont ete menees qui comparent des programmes d'action elabores sur le plan mondial aux programmes d'action d'envergure europeenne, ou bien qui analysent des changements dans des pays individuels. Le systeme suedois a attire beaucoup d'attention a cause de sa validite a long terme. On fait une estimation par les moindres carres ordinaire a partir des donnees financieres provenant des prestataires de services dans ce systeme, avec un egard particulier pour la capacite a produire des revenus, a assurer la rentabilite, et a maintenir la valeur des actifs immobiliers quant aux approches qui portent sur le niveau et sur la difference d'ordre premier. Une lecon a tirer potentiellement des resultats empiriques c'est la suivante. Les depenses pour l'entretien consolide s'associent non seulement aux revenus locatifs a court terme, mais aussi a la validite a long terme. En outre, les resultats provenant de l'approche qui porte sur la difference d'ordre premier laissent supposer que les loyers negocies produisent des resultats d'exploitation qui arrivent a suivre les revenus sur la periode etudiee. Ces resultats devraient avoir un rapport tres etroit aux interets de tout un eventail d'administrations ou les logements sociaux laissent a inquieter. En particulier, ceux qui sont charges de la direction des systemes autosuffisants ainsi que les decideurs interesses par la mise en oeuvre des systemes efficaces, devraient noter ces remarques. Lindbergh L., Larsson C.-G. und Wilson T. L. (2004) Kostenregulierung und Schaffung von Steuereinkommen: Erfahrungen der Gesellschaften fur Wohnungsfursorge in Schweden, Regional Studies38, 803-815. Zunehmende Konkurenz bei der Vergebung von Mitteln fur die Schaffung von Wohnraum durch die offentliche Hand, Verkauf bestehenden Wohnraums an private Eigentumer und Versuche, vermehrt auf Mieter zugeschnittene und effektive Hausverwaltungsdienste sind Tendenzen, die in der ganzen Europaischen Union auf dem Gebiet der Bereitstellung von Sozialwohnungen zu beobachten sind. Infolgedessen hat man Untersuchungen durchgefuhrt, die Programme auf der ganzen Welt und in Europa miteinander vegleichen, oder anderungen in einzelnen Landern. Dank seiner langfristigen Durchfuhrbarkeit hat das schwedische System Aufmerksamkeit erregt. Eine Analyse der gewohnlichen Methode der kleinsten Quadrate der Finanzinformation von Mittel zur Verfugung stellenden Korperschaften in diesem System wurde bei besonderer Berucksichtigung seiner Fahigkeiten der Steuerbeschaffung, der Fahigkeit wirtschaftlich zu bleiben, und der Erhaltung von Vermogungswerten fur gleichbleibende Ansatze wie auch erstmals abweichende Ansatze durchgefuhrt. Wenn eine allgemeingultige Lehre aus den empirischen Ergebnissen gezogen werden kann, so ware es die, dass Ausgaben fur Dauerpflege nicht nur mit kurzfristigen Mieteinkommen, sondern zweifellos auch mit langfristiger Lebensfahigkeit zu tun haben. Weiterhin legen erstmalig abweichende Ergebnisse nahe, dass vereinbarte Mieten laufend Gewinne abwerfen, die im fur diese Studie angesetzten Zeitraum mit den Steuern Schritt hielten. Diese Ergebnisse sollten besonders den Interessen der sehr verschiedenartigen Ortsverwaltungen sachdienlich sein, die sich mit offentlichem Wohnungsbau und - verwaltung befassen, insbesondere diejenigen, die fur Bereitstellung und Erhaltung eines sich selbst tragenden Systems hauptverantwortlich sind, wie auch Sozialpolitiker, die an gut funktionierenden, effektiven Systemen interessiert sind, diesen Befunden Aufmerksamkeit schenken durften. Lindbergh L., Larsson C.-G. y Wilson T. L. (2004) Control de costes y generacion de beneficios: el caso de las experiencias de las 'empresas constructoras de vivienda social' en Suecia, Regional Studies38, 803-815. El incremento de la competicion por fondos asociados con la provision de vivienda social, la privatizacion de capital y los intentos destinados a introducir servicios de administracion de la vivienda mas orientados hacia el arrendatario y mas eficaces son tendencias que se observan en la vivienda social a traves de la Union Europea. Consecuentemente, se han llevado a cabo estudios que comparan programas en todo el mundo y en Europa, o que analizan los cambios en paises individuales. El sistema sueco ha recibido atencion debido a su viabilidad a largo plazo. Se ha realizado un analisis ordinary least squares de la informacion financiera de los proveedores en este sistema especialmente con respecto a las capacidades de generacion de beneficios, la habilidad de permacer rentable, y la retencion de valor de los activos tanto para enfoques de nivel y de primera diferencia. Si se puediera derivar una leccion general de estos resultados empiricos, esta seria que los gastos en el mantenimiento consolidado no estan solamente asociados con los beneficios derivados de la renta a corto-plazo, pero sin duda tambien con la viabilidad a largo plazo. Ademas, los resultados de primera diferencia sugirieron que las rentas negociadas producieron beneficios de operacion que siguieron el ritmo de los beneficios a lo largo del periodo de estudio. Estos resultados deberian ser especialmente relevantes para los intereses de un amplio grupo de gobiernos locales donde la vivienda social es una causa de preocupacion. Particularmente, aquellos individuos que soportan una mayor responsabilidad en la direccion de sistemas autosuficientes y tambien los disenadores de politicas que estan interesados en dirigir sistemas efectivos y eficaces deberian estar interesados en estas observaciones.Public housing, Swedish system, Ordinary least squares, Quantitative analyses, Professional efficiency,

The phenotype of concurrent chronic bronchitis and frequent exacerbations in patients with severe COPD attending Swedish secondary care units

Background: Chronic bronchitis and previous exacerbations are both well-known risk factors for new exacerbations, impaired health-related quality of life, and increased mortality in COPD. The aim of the study was to characterize the phenotype of concurrent chronic bronchitis and frequent exacerbation in severe COPD. Methods: Information on patient characteristics, comorbidity, and exacerbations from the previous year (total number and number requiring hospitalization) was collected from 373 patients with stage III and IV COPD attending 27 secondary care respiratory units in Sweden. Logistic regression used chronic bronchitis and frequent exacerbations (. 2 exacerbations or. 1 hospitalized exacerbations in the previous year) as response variables. Stratification and interaction analyses examined effect modification by sex. Results: Chronic bronchitis was associated with current smoking (adjusted odds ratio [OR] [95% CI], 2.75 [1.54-4.91]; P=0.001), frequent exacerbations (OR [95% CI], 1.93 [1.24-3.01]; P=0.004), and musculoskeletal symptoms (OR [95% CI], 1.74 [1.05-2.86]; P=0.031), while frequent exacerbations were associated with lung function (forced expiratory volume in 1 second as a percentage of predicted value [FEV1% pred]) (OR [95% CI] 0.96 [0.94-0.98]; P=0.001) and chronic bronchitis (OR [95% CI] 1.73 [1.11-2.68]; P=0.015). The phenotype with both chronic bronchitis and frequent exacerbations was associated with FEV1% pred (OR [95% CI] 0.95 [0.92-0.98]; P=0.002) and musculoskeletal symptoms (OR [95% CI] 2.55 [1.31-4.99]; P=0.006). The association of smoking with the phenotype of chronic bronchitis and exacerbations was stronger in women than in men (interaction, P=0.040). Conclusion: Musculoskeletal symptoms and low lung function are associated with the phenotype of combined chronic bronchitis and frequent exacerbations in severe COPD. In women, current smoking is of specific importance for this phenotype. This should be considered in clinical COPD care

The phenotype of concurrent chronic bronchitis and frequent exacerbations in patients with severe COPD attending Swedish secondary care units

Background: Chronic bronchitis and previous exacerbations are both well-known risk factors for new exacerbations, impaired health-related quality of life, and increased mortality in COPD. The aim of the study was to characterize the phenotype of concurrent chronic bronchitis and frequent exacerbation in severe COPD. Methods: Information on patient characteristics, comorbidity, and exacerbations from the previous year (total number and number requiring hospitalization) was collected from 373 patients with stage III and IV COPD attending 27 secondary care respiratory units in Sweden. Logistic regression used chronic bronchitis and frequent exacerbations (. 2 exacerbations or. 1 hospitalized exacerbations in the previous year) as response variables. Stratification and interaction analyses examined effect modification by sex. Results: Chronic bronchitis was associated with current smoking (adjusted odds ratio [OR] [95% CI], 2.75 [1.54-4.91]; P=0.001), frequent exacerbations (OR [95% CI], 1.93 [1.24-3.01]; P=0.004), and musculoskeletal symptoms (OR [95% CI], 1.74 [1.05-2.86]; P=0.031), while frequent exacerbations were associated with lung function (forced expiratory volume in 1 second as a percentage of predicted value [FEV1% pred]) (OR [95% CI] 0.96 [0.94-0.98]; P=0.001) and chronic bronchitis (OR [95% CI] 1.73 [1.11-2.68]; P=0.015). The phenotype with both chronic bronchitis and frequent exacerbations was associated with FEV1% pred (OR [95% CI] 0.95 [0.92-0.98]; P=0.002) and musculoskeletal symptoms (OR [95% CI] 2.55 [1.31-4.99]; P=0.006). The association of smoking with the phenotype of chronic bronchitis and exacerbations was stronger in women than in men (interaction, P=0.040). Conclusion: Musculoskeletal symptoms and low lung function are associated with the phenotype of combined chronic bronchitis and frequent exacerbations in severe COPD. In women, current smoking is of specific importance for this phenotype. This should be considered in clinical COPD care

The phenotype of concurrent chronic bronchitis and frequent exacerbations in patients with severe COPD attending Swedish secondary care units

Background: Chronic bronchitis and previous exacerbations are both well-known risk factors for new exacerbations, impaired health-related quality of life, and increased mortality in COPD. The aim of the study was to characterize the phenotype of concurrent chronic bronchitis and frequent exacerbation in severe COPD. Methods: Information on patient characteristics, comorbidity, and exacerbations from the previous year (total number and number requiring hospitalization) was collected from 373 patients with stage III and IV COPD attending 27 secondary care respiratory units in Sweden. Logistic regression used chronic bronchitis and frequent exacerbations (. 2 exacerbations or. 1 hospitalized exacerbations in the previous year) as response variables. Stratification and interaction analyses examined effect modification by sex. Results: Chronic bronchitis was associated with current smoking (adjusted odds ratio [OR] [95% CI], 2.75 [1.54-4.91]; P=0.001), frequent exacerbations (OR [95% CI], 1.93 [1.24-3.01]; P=0.004), and musculoskeletal symptoms (OR [95% CI], 1.74 [1.05-2.86]; P=0.031), while frequent exacerbations were associated with lung function (forced expiratory volume in 1 second as a percentage of predicted value [FEV1% pred]) (OR [95% CI] 0.96 [0.94-0.98]; P=0.001) and chronic bronchitis (OR [95% CI] 1.73 [1.11-2.68]; P=0.015). The phenotype with both chronic bronchitis and frequent exacerbations was associated with FEV1% pred (OR [95% CI] 0.95 [0.92-0.98]; P=0.002) and musculoskeletal symptoms (OR [95% CI] 2.55 [1.31-4.99]; P=0.006). The association of smoking with the phenotype of chronic bronchitis and exacerbations was stronger in women than in men (interaction, P=0.040). Conclusion: Musculoskeletal symptoms and low lung function are associated with the phenotype of combined chronic bronchitis and frequent exacerbations in severe COPD. In women, current smoking is of specific importance for this phenotype. This should be considered in clinical COPD care

The phenotype of concurrent chronic bronchitis and frequent exacerbations in patients with severe COPD attending Swedish secondary care units

Background: Chronic bronchitis and previous exacerbations are both well-known risk factors for new exacerbations, impaired health-related quality of life, and increased mortality in COPD. The aim of the study was to characterize the phenotype of concurrent chronic bronchitis and frequent exacerbation in severe COPD. Methods: Information on patient characteristics, comorbidity, and exacerbations from the previous year (total number and number requiring hospitalization) was collected from 373 patients with stage III and IV COPD attending 27 secondary care respiratory units in Sweden. Logistic regression used chronic bronchitis and frequent exacerbations (. 2 exacerbations or. 1 hospitalized exacerbations in the previous year) as response variables. Stratification and interaction analyses examined effect modification by sex. Results: Chronic bronchitis was associated with current smoking (adjusted odds ratio [OR] [95% CI], 2.75 [1.54-4.91]; P=0.001), frequent exacerbations (OR [95% CI], 1.93 [1.24-3.01]; P=0.004), and musculoskeletal symptoms (OR [95% CI], 1.74 [1.05-2.86]; P=0.031), while frequent exacerbations were associated with lung function (forced expiratory volume in 1 second as a percentage of predicted value [FEV1% pred]) (OR [95% CI] 0.96 [0.94-0.98]; P=0.001) and chronic bronchitis (OR [95% CI] 1.73 [1.11-2.68]; P=0.015). The phenotype with both chronic bronchitis and frequent exacerbations was associated with FEV1% pred (OR [95% CI] 0.95 [0.92-0.98]; P=0.002) and musculoskeletal symptoms (OR [95% CI] 2.55 [1.31-4.99]; P=0.006). The association of smoking with the phenotype of chronic bronchitis and exacerbations was stronger in women than in men (interaction, P=0.040). Conclusion: Musculoskeletal symptoms and low lung function are associated with the phenotype of combined chronic bronchitis and frequent exacerbations in severe COPD. In women, current smoking is of specific importance for this phenotype. This should be considered in clinical COPD care

Comorbidity and health-related quality of life in patients with severe chronic obstructive pulmonary disease attending Swedish secondary care units

Introduction: Our understanding of how comorbid diseases influence health-related quality of life (HRQL) in patients with chronic obstructive pulmonary disease (COPD) is limited and in need of improvement. The aim of this study was to examine the associations between comorbidities and HRQL as measured by the instruments EuroQol-5 dimension (EQ-5D) and the COPD Assessment Test (CAT). Methods: Information on patient characteristics, chronic bronchitis, cardiovascular disease, diabetes, renal impairment, musculoskeletal symptoms, osteoporosis, depression, and EQ-5D and CAT questionnaire results was collected from 373 patients with Forced Expiratory Volume in one second (FEV1) <50% of predicted value from 27 secondary care respiratory units in Sweden. Correlation analyses and multiple linear regression models were performed using EQ-5D index, EQ-5D visual analog scale (VAS), and CAT scores as response variables. Results: Having more comorbid conditions was associated with a worse HRQL as assessed by all instruments. Chronic bronchitis was significantly associated with a worse HRQL as assessed by EQ-5D index (adjusted regression coefficient [95% confidence interval] -0.07 [-0.13 to -0.02]), EQ-5D VAS (-5.17 [-9.42 to -0.92]), and CAT (3.78 [2.35 to 5.20]). Musculoskeletal symptoms were significantly associated with worse EQ-5D index (-0.08 [-0.14 to -0.02]), osteoporosis with worse EQ-5D VAS (-4.65 [-9.27 to -0.03]), and depression with worse EQ-5D index (-0.10 [-0.17 to -0.04]). In stratification analyses, the associations of musculoskeletal symptoms, osteoporosis, and depression with HRQL were limited to female patients. Conclusion: The instruments EQ-5D and CAT complement each other and emerge as useful for assessing HRQL in patients with COPD. Chronic bronchitis, musculoskeletal symptoms, osteoporosis, and depression were associated with worse HRQL. We conclude that comorbid conditions, in particular chronic bronchitis, depression, osteoporosis, and musculoskeletal symptoms, should be taken into account in the clinical management of patients with severe COPD

Impaired Coupling of Glucose Signal to the Exocytotic Machinery in Diabetic GK Rats

The GK rat is a spontaneous model of NIDDM. The insulin response to 16.7 mmol/l glucose was markedly impaired in both isolated perfused pancreas and isolated islets from GK rats compared with control Wistar rats. Depolarization with 30 mmol/l KC1 in the presence of 3.3 mmol/l glucose and 250 μmol/l diazoxide induced similar insulin responses in perfused pancreases of GK and control rats. In contrast, the glucose-stimulated insulin release was also severely impaired in GK pancreases in the depolarized state. Forskolin (1 μmol/l) markedly enhanced insulin release at 3.3 mmol/l glucose in GK but not control pancreases (54 ± 15 vs. 3 ± 1 pmol/l0 min, P < 0.001). Dibutyryl cAMP (1 mmol/l) exerted effects similar to forskolin on insulin release in the perfused pancreas. In depolarized pancreases of GK but not control rats, forskolin also induced a marked insulin response at 3.3 mmol/l glucose (163 ± 48 vs. 16 ± 1 pmol/20 min,< P < 0.03). Similarly, in studies on isolated islets from GK rats cultured in 5.5 or 16.7 mmol/l glucose for 48 h, forskolin (5 μmol/l) restored insulin release in response to 16.7 mmol/l glucose but had no effect on islet glucose utilization at 3.3 or 16.7 mmol/l glucose. Forskolin markedly stimulated insulin release at 3.3 mmol/l glucose in GK but not control rat islets cultured for 48 h in 5.5 mmol/l glucose, whereas 20 mmol/l arginine had an almost identical effect in both islet varieties. However, in islets cultured in 16.7 mmol/l glucose, forskolin stimulated insulin release similarly both in control and GK islets at 3.3 mmol/l glucose. In conclusion, this study suggests that the insulinotropic effects of glucose are coupled to a direct regulation of the exocytotic machinery in the pancreatic 3-cell. This pathway is markedly impaired in GK rats, contributing to defective insulin response to glucose. In this model, cAMP generation restores the insulin response to 16.7 mmol/l glucose and exerts a marked insulin release even at 3.3 mmol/l glucose

Accurate mapping of mitochondrial DNA deletions and duplications using deep sequencing

Deletions and duplications in mitochondrial DNA (mtDNA) cause mitochondrial disease and accumulate in conditions such as cancer and age-related disorders, but validated high-throughput methodology that can readily detect and discriminate between these two types of events is lacking. Here we establish a computational method, MitoSAlt, for accurate identification, quantification and visualization of mtDNA deletions and duplications from genomic sequencing data. Our method was tested on simulated sequencing reads and human patient samples with single deletions and duplications to verify its accuracy. Application to mouse models of mtDNA maintenance disease demonstrated the ability to detect deletions and duplications even at low levels of heteroplasmy. Author summary Deletions in the mitochondrial genome cause a wide variety of rare disorders, but are also linked to more common conditions such as neurodegeneration, diabetes type 2, and the normal ageing process. There is also a growing awareness that mtDNA duplications, which are also relevant for human disease, may be more common than previously thought. Despite their clinical importance, our current knowledge about the abundance, characteristics and diversity of mtDNA deletions and duplications is fragmented, and based to large extent on a limited view provided by traditional low-throughput analyses. Here, we describe a bioinformatics method, MitoSAlt, that can accurately map and classify mtDNA deletions and duplications using high-throughput sequencing. Application of this methodology to mouse models of mitochondrial deficiencies revealed a large number of duplications, suggesting that these may previously have been underestimated

Serum 25-Hydroxyvitamin D Concentration in Subclinical Carotid Atherosclerosis

<p>Objective Vitamin D deficiency has been implicated in cardiovascular disease and is associated with multiple cardiovascular risk factors. We investigated the serum 25-hydroxyvitamin D (25(OH)D) concentration in relation to latitude, baseline carotid intima-media thickness (IMT), and IMT progression, the carotid IMT measures being surrogate markers of subclinical atherosclerosis and cardiovascular disease risk.</p><p>Approach and Results Serum 25(OH)D concentration was related to high-resolution carotid IMT measures in 3430 middle-aged and elderly subjects with high cardiovascular risk but no prevalent disease, who were recruited at 7 centers in Finland, Sweden, The Netherlands, France, and Italy. Participants underwent carotid ultrasound examination at baseline and at months 15 and 30 after entry into the study, whereas blood samples, clinical data, and information about lifestyle were collected at baseline. Serum 25(OH)D levels were positively associated with latitude (Jonckheere-Terpstra =166.643; P</p><p>Conclusions Levels of 25(OH)D differed across Europe, were highest in the North, showed multiple associations with established and emerging cardiovascular risk factors but were not consistently, independently related to measures of carotid IMT. This argues against a protective role of vitamin D against subclinical atherosclerosis in high-risk individuals.</p>