Dealing with Interval Scale Data in Data Envelopment Analysis

This papaer considers the problem of interval scale data in the most widely used models of Data Envelopment Analysis (DEA), the CCR, and the BCC models. Radial models require inputs and outputs measured on the ratio scale. Our focus is on how to deal with interval scale variables especially when the interval scale variable is a difference of two ratio scale variables like profit or the decrease/increase in bank accounts. Using these ratio scale variables as variables in the DEA model we suggest radial models. An approach to how to deal with interval scale variables when we relax the radiality assumption is also discussed

Value Efficiency Analysis for Incorporating Preference Information in Data Envelopment Analysis

We develop a procedure and the requisite theory for incorporating preference information in a novel way in the efficiency analysis of Decision Making Units. The efficiency of Decision Making Units is defined in the spirit of Data Envelopment Analysis (DEA), complemented with Decision Maker's preference information concerning the desirable structure of inputs and outputs. Our procedure begins by aiding the Decision Maker in searching for the most preferred combination of inputs and outputs of Decision Making Units (for short, Most Preferred Solution) which are efficient in DEA. Then, assuming that the Decision Maker's Most Preferred Solution maximizes his/her underlying (unknown) value function at the moment when the search is terminated, we approximate the indifference contour of the value function at this point with its possible tangent hyperplanes. Value Efficiency scores are then calculated for each Decision Making Unit comparing the inefficient units to units having the same value as the Most Preferred Solution. The resulting Value Efficiency scores are optimistic approximations of the true scores. The procedure and the resulting efficiency scores are immediately applicable to solving practical problems

Katsaus ongelmapelaamisen ja patologisen pelaamisen hoitoa koskevaan vaikuttavuustutkimukseen: tutkimus on vähäistä ja tulokset epävarmoja

Rahapelaamisen liittyvät ongelmat ja niiden hoitaminen ovat viime vuosina nousseet laajan kiinnostuksen kohteiksi Suomessa. Katsauksessa tarkastellaan diagnosoidusta pelaamishäiriöstä eli patologisesta pelaamisesta kärsiville tarkoitettujen hoitojen vaikuttavuutta kansainvälisten meta-analyysien ja katsausten perusteella. Katsauksessa tarkastellaan myös aihepiirin peruskäsitteitä. Katsauksen päätulos on, että mitään yhtä peliongelmaisten hoitomuotoa ei nykytiedon perusteella voida nimetä erityisen vaikuttavaksi, joskin kognitiivis-behavioraalisia menetelmiä voidaan pitää lupaavina. Tutkimusten perusteella ei voida kuitenkaan täsmällisesti sanoa, mikä tietty kognitiivis-behavioraalisten menetelmien suuntaus tai hoidon komponentti on vaikuttava. Lääkehoito havaitaan tutkimuksissa vaikuttavammaksi kuin lumehoito, mutta eri lääkeaineilla ei havaita keskimääräisiä eroja vaikutuksessa. Lisäksi peliongelmaisten hoitoon hakeutumisen aste on matala ja omaehtoinen toipuminen suhteellisen yleistä, minkä vuoksi on syytä panostaa myös erilaisten kevyiden interventioiden ja oma-apujärjestelmien kehittämiseen

Immune activation in the small intestine in patients with rheumatoid arthritis

Objectives: To determine whether inflammation in the gut associated immune system is activated in rheumatoid arthritis ( RA). The expression of chemokine receptor- (CCR4, CCR5) and cytokine- ( interleukin (IL) 2, IL10, interferon gamma (IFNgamma), tumour necrosis factor alpha (TNFalpha), and transforming growth factor beta (TGFbeta)) specific mRNA in intestinal biopsy samples from patients with RA was examined. Methods: Duodenal biopsy samples from 13 patients with RA and 15 control subjects were studied. The mRNA expression of CCR4, CCR5, IL2, IL10, IFNgamma, TNFalpha, and TGFb in intestinal biopsy samples was demonstrated by real time quantitative reverse transcriptase-polymerase chain reaction. Results: The mRNA expression of CCR4, CCR5, and IL10 in intestinal biopsy samples was increased in patients with RA in comparison with control subjects ( p = 0.001, p = 0.046, p = 0.019). No difference in the expression levels of IL2, IFNgamma, TNFalpha, or TGFbeta was seen between patients with RA and controls. Conclusions: The increased intestinal mRNA expression of IL10, CCR5, and CCR4 suggests that gut associated immune cells are activated in patients with RA.Peer reviewe

Integrating Health and Social Services in Finland: Regional Approaches and Governance Models

Introduction: The study explores regional approaches to integrated care, focusing on regions with regular municipality-based and integrated unified health and social care administration. The aim is to describe a governance approach that supports care integration in the regions. Methods: The study draws on analysis of integrated care governance using an extensive collection of administrative documents (n = 176) on regional health and social services within 20 specialised care authorities. The document data were supplemented with interviews of national health and social system evaluation officers. In our analysis, we used deductive content analysis and identified conceptual approaches of social and health care integration according to elements of integrated care governance. Results: Overall, integrated care governance was relatively well advanced. All regional authorities had established at least some preconditions for integrated governance. The stage of integration varied in the different elements of integrated care governance. The regions with unified integrated administrations enabled the more advanced models of integrated care. Conclusions: Various models for cooperation between regional health and social care authorities have emerged in the regions to identify good integrated care practices. The study suggests that the applied theoretical framework and presented elements of integrated care governance can be used to monitor development of care integration

Rahapelaamisen tiheys on yhteydessä terveysriskeihin työikäisillä suomalaisilla

Tutkimuksessa tarkasteltiin, miten rahapelaamisen tiheys oli yhteydessä päivittäiseen tupakointiin sekä alkoholin viikkokulutukseen ja humalajuomiseen työikäisillä suomalaisilla. Suomalaisen aikuisväestön terveyskäyttäytyminen ja terveys (AVTK) -postikyselytutkimuksen vuoden 2008 vastausaktiivisuus oli 64 prosenttia (n=3216, otoskoko 5000). Täman tutkimuksen aineiston koko oli 3203. Menetelminä käytettiin ristiintaulukointeja ja logistisia regressiomalleja, joiden avulla tutkittiin miten rahapeleihin osallistuminen ja rahapelaamisen tiheyden eri tasot olivat yhteydessä päivittäiseen tupakointiin, alkoholin suurkulutukseen, humalajuomiseen ja itsearvioituun terveyteen. Pelanneet olivat pelaamattomia useammin päivittäisiä tupakoitsijoita, mutta alkoholin suurkulutuksessa ei ollut eroa. Rahapelejä pelanneilla (68 % vastaajista) päivittäinen tupakointi ja alkoholin suurkulutus olivat sitä yleisempiä mitä tiheämmin henkilö pelasi. Runsasta rahapelaamista onkin syytä tarkastella kansanterveydellisenä huolenaiheena

Granulomatous cheilitis associated with exacerbations of Crohn's disease: a case report

<p>Abstract</p> <p>Introduction</p> <p>Crohn's disease is a disease involving the whole gastrointestinal tract from the mouth to the anus. Oral lesions are considered to be an important extraintestinal manifestation. Granulomatous cheilitis has been recognized as an early manifestation of Crohn's disease. It may follow, coincide with or precede the onset of Crohn's disease. The aim of this presentation is to describe a rare case of a patient with Crohn's disease in whom significant swelling of the lower lip not only preceded the diagnosis of Crohn's disease for two years, but it manifested as an early clinical index of the recurrence of the intestinal disease as well.</p> <p>Case presentation</p> <p>A man aged 25 was admitted in our department on August 1999 with chronic diarrhea and loss of weight. His bowel symptoms started in 1998 at the age of 24. However, two years previously (June 1996) he noticed a swelling of the lower lip, which contrasted significantly with the previously normal appearance of his mouth. A lip biopsy performed at that time was compatible with granulomatous cheilitis. Crohn's disease involving the terminal ileum and large bowel was diagnosed in 1998 and confirmed on the basis of colonoscopy, enteroclysis and histology findings of the small and large bowel. Conservative treatment resulted in clinical and laboratory improvement of the bowel symptoms and lip swelling. During the following years the disease was active with exacerbations and remissions of mild to moderate severity. The swelling of the lower lip occurred in parallel with the exacerbations of the bowel disease, returning to normal during periods of remission.</p> <p>Conclusion</p> <p>Significant swelling of the lower lip due to granulomatous cheilitis could be the first manifestation of Crohn's disease, preceding intestinal symptoms. Exacerbation of the lip lesion could be an early clinical sign of a relapse of the underlying intestinal disease.</p