113 resultados para non-life insurance


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Introduction: The motor and non-motor symptoms associated with idiopathic Parkinson’s disease (PD) may compromise the health-related quality of life (HRQOL) of some individuals living with this debilitating condition. Although growing evidence suggests that PD may be more prevalent in rural communities, there is little information about the life quality of these individuals. This study examines whether HRQOL ratings vary in relation to rural and metropolitan life settings.
Methods: An analytic cross-sectional study was conducted to compare the HRQOL of two separate samples of people with PD living in metropolitan Melbourne and rural Victoria. The metropolitan sample consisted of 210 individuals who had participated in the baseline assessment for an existing clinical trial. The rural sample comprised 24 participants who attended community-based rehabilitation programs and support groups in rural Victoria. Health-related quality of life was quantified using the Parkinson’s Disease Questionnaire-39 (PDQ-39).
Results:
The HRQOL of participants in rural Australia differed from individuals living in a large metropolitan city (p=0.025). Participants in rural Australia reported worse overall HRQOL, after controlling for differences in disease duration. Their overall HRQOL was lower than for city dwellers. Rural living was also found to be a significant negative predictor of HRQOL (β=0.14; 95% CI -1.27 to -0.08; p=0.027).
Conclusion:
The findings of this study suggest that some people with PD living in rural Victoria perceive their HRQOL to be relatively poor. In order to minimise the debilitating consequences of this disease, further studies examining the factors that may contribute to the HRQOL of individuals living in rural and remote areas are required.

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Life annuities offer retirees an assured income stream for as long as they live. This makes it surprising that they are unpopular in most markets where their purchase is not compelled by government policy. With the numbers of retirees in the population set to increase dramatically, this low take-up rate of life annuities could exacerbate financial insecurity. Consequently, it is in society’s interest to implement non-coercive policies that increase annuitization levels. Although there is research that has focused on the possible causes of low annuitization rates, much of this research falls short of suggesting comprehensive strategies for persuading retirees to annuitize their savings.


This article discusses what mix of policies would increase the attractiveness of life annuities. It does this by determining the salient characteristics of the few markets where life annuities are popular. It then suggests how the correct policy settings could make such characteristics a feature of the mainstream annuity market. It also discusses other policies, including limited tax incentives or subsidies on annuities that might play an important role. It is argued that policy innovations such as these are preferable to making the purchase of annuities compulsory. This is because the one-size-fits-all approach will not be ideal for everyone, and it interferes with freedom of choice, an important right in a capitalist society. An alternative is to make annuity purchases a default choice. But this is effectively compulsion by stealth as it relies on inertia and, therefore, carries some of the disadvantages of mandatory annuitization. The article concludes with a discussion of how the appropriate marketing and innovation of different life annuity products could supplement annuity-maximizing policies and further improve annuitization rates.

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As argued by Norman Bryson, the still-life genre is sorely neglected by theorists and critics, largely because its concern with ‘low-plane reality’ (everyday items and acts) has obscured its genuine relevance to material thinking. By reappraising rather than abandoning the genre’s traditional themes of death and time—using a cross-cultural, Chinese-Western approach—it is possible to re-energise materialisms of time, writing and death within still life. Such a move depends above all on a re-evaluation of still life as ‘Vanitas’—the term which to date has unified, and more to the point limited, traditional still-life understandings of death and time. This article tracks a more explosive and creative materialism of still life simultaneously through the specifically Chinese approach to death (which includes the ‘Yin Yang’ 阴阳 as a sort of author of time) and via Gilles Deleuze’s cinematic philosophy of the time-image; what connects these is the very Deleuzean notion of time that subtends Chinese engagements with death. In this way, the still-life genre may be recovered from its current critical and theoretical malaise. Reconnecting with practice is a crucial aspect of this recovery, and so in its early stages this article analyses an example of still-life, creative non-fiction (authored by Cher Coad), and it concludes by establishing the value of this potentially ‘new chapter of the “still life” genre’ (in Matilde Marcolli’s terms) for the cross-artform analysis of the short story ‘Nhill’ (authored by Patrick West). Analysis, though, is only half the picture: a fully recovered still-life genre would see theory and practice endlessly circulating through each other, spurring on practice and impelling theory. Coad’s and West’s literary examples are introduced in the hope that they might trigger fresh theoretical and practice-based, still-life discoveries in prose and also in poetry.

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Background
Cost-effectiveness analyses of interventions for older adults have traditionally focused on health status. There is increasing recognition of the need to develop new instruments to capture quality of life in a broader sense in the face of age-associated increasing frailty and declining health status, particularly in the economic evaluation of aged and social care interventions which may have positive benefits beyond health. 


Objective
To explore the relative importance of health and broader quality of life domains for defining quality of life from the perspective of older South Australians.

Methods
Older adults (n=21) from a day rehabilitation facility in Southern Adelaide, South Australia attended one of two audiorecorded focus groups. A mixed methods (qualitative and quantitative) approach was adopted. The study included three main components. Firstly, a general group discussion on quality of life and the factors of importance in defining quality of life. Secondly, a structured ranking exercise in which individuals were asked to rank domains from the brief Older People’s Quality of Life questionnaire (OPQOL-brief) and Adult Social Care Outcomes Toolkit (ASCOT) in order of importance. Thirdly, participants were asked to self-complete the Euroqol (EQ-5D) a measure of health status, and two broader quality of life measures: the OPQOL-brief and ASCOT.

Results
Mean scores on the EQ-5D, OPQOL-brief and ASCOT were 0.71 (SD 0.20, range 0.06-1.00), 54.6 (SD 5.5, range 38-61) and 0.87 (SD 0.13, range 0.59-1.00) respectively, with higher scores reflecting better ratings of QOL. EQ-5D scores were positively associated with OPQOL-brief (rho: .730, p<.01), but not ASCOT. Approximately half (52.4%) of the respondents ranked either “health” or “psychological and emotional well- being” as the domain most important to their quality of life. However, one-third (33.3%) of the total sample ranked a non-health domain from the ASCOT or OPQOL-brief (safety, dignity, independence) as the most important contributing factor to their overall quality of life. Qualitative analysis of focus group transcripts supported the high value of both health-related (health, psychological well-being) and social (independence, safety) domains to quality of life.

Conclusions
Older adults value both health and social domains as important to their overall quality of life. Future economic evaluations of health, community and aged-care services for older adults should include assessment of both healthrelated and broader aspects quality of life.

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Recent findings suggest that not only the lack of physical activity, but also prolonged times of sedentary behaviour where major locomotor muscles are inactive, significantly increase the risk of chronic diseases. The purpose of this study was to provide details of quadriceps and hamstring muscle inactivity and activity during normal daily life of ordinary people. Eighty-four volunteers (44 females, 40 males, 44.1±17.3 years, 172.3±6.1 cm, 70.1±10.2 kg) were measured during normal daily life using shorts measuring muscle electromyographic (EMG) activity (recording time 11.3±2.0 hours). EMG was normalized to isometric MVC (EMGMVC) during knee flexion and extension, and inactivity threshold of each muscle group was defined as 90% of EMG activity during standing (2.5±1.7% of EMGMVC). During normal daily life the average EMG amplitude was 4.0±2.6% and average activity burst amplitude was 5.8±3.4% of EMGMVC (mean duration of 1.4±1.4 s) which is below the EMG level required for walking (5 km/h corresponding to EMG level of about 10% of EMGMVC). Using the proposed individual inactivity threshold, thigh muscles were inactive 67.5±11.9% of the total recording time and the longest inactivity periods lasted for 13.9±7.3 min (2.5–38.3 min). Women had more activity bursts and spent more time at intensities above 40% EMGMVC than men (p<0.05). In conclusion, during normal daily life the locomotor muscles are inactive about 7.5 hours, and only a small fraction of muscle's maximal voluntary activation capacity is used averaging only 4% of the maximal recruitment of the thigh muscles. Some daily non-exercise activities such as stair climbing produce much higher muscle activity levels than brisk walking, and replacing sitting by standing can considerably increase cumulative daily muscle activity.

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The present thesis found support for trait anxiety and experiential avoidance playing a part in repetitive non-suicidal self-injury. A cost-effective mindfulness and acceptance-based intervention was also found to be efficacious in improving trait anxiety; life disruption; mindfulness skills; ability to take action; emotional distress tolerance; and avoidant coping.

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 Since 1958 the hukou (household registration) system has assigned Chinese citizens either a rural or urban status. Some studies argue that the rural-to-urban migrants in China who do not have urban hukou are not entitled to urban social insurance schemes, due to institutional discrimination, which applies differing treatment to urban and rural hukou (chengxiang fenge). Although rural-urban migrants participate less in the social insurance system than their counterparts with urban hukou, a closer examination of recent policy developments shows that migrants actually do have the legal right to access the system. This implies that discrimination between rural and urban workers has been declining, and distinctions based on household registration status are less able to explain China's current urban transition. This paper provides a new way of examining Chinese migrants' social insurance participation, by adopting a framework that includes both rural-to-urban migrants and urban-to-urban migrants, which are an important, but less studied, migrant group. Among our key findings are that urban migrants are more likely to sign a labour contract than rural migrants; urban migrants have higher participation rates in social insurance than rural migrants; having a labour contract has a greater impact than hukou status in determining whether Beijing's floating population accesses social insurance; and urban migrants who have signed a labour contract have higher participation rates in social insurance than either rural migrants or urban migrants without a labour contract. © 2013 Elsevier Ltd.

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Plumbagin (PLB) has shown anti-cancer activity but the mechanism is unclear. This study has found that PLB has a potent pro-apoptotic and pro-autophagic effect on A549 and H23 cells. PLB arrests cells in G2/M phase, and increases the intracellular level of reactive oxygen species in both cell lines. PLB dose-dependently induces autophagy through inhibition of PI3K/Akt/mTOR pathway as indicated by reduced phosphorylation of Akt and mTOR. Inhibition or induction of autophagy enhances PLB-induced apoptosis. There is crosstalk between PLB-induced apoptosis and autophagy. These findings indicate that PLB initiates both apoptosis and autophagy in NSCLC cells through coordinated pathways.

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Patient-reported outcomes (PROs) are particularly relevant in influenza vaccine trials in the elderly where reduction in symptom severity could prevent illness-related functional impairment.

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Afforestation of agricultural land provides an important opportunity to mitigate climate change by storing carbon (C) in both plant biomass and the soil. Here we present results of a study in which we sought to determine whether soil under nitrogen(N)-fixing trees contained more C than soil under non-N-fixing trees in mixed-species plantings, and thus if inclusion of N-fixers is beneficial in terms of increasing soil C sequestration. Soils were sampled directly beneath N-fixing and non-N-fixing tree species in riparian and upland mixed-species plantings in southeastern Australia. Soil C and N contents were assessed at both the landscape and individual planting scales. At the landscape scale, there were higher levels of soil C and N under N-fixing trees compared with non-N-fixing trees. At the individual planting scale, the patterns were less clear with both large increases and decreases occurring across the range of sites. The results presented here indicate that the inclusion of N-fixers may help to increase soil C, and N, but that the response may be site- and species-specific. © 2014 Elsevier B.V.

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Negative attitudes towards insulin are commonly reported by people with type 2 diabetes mellitus (T2DM) and can act as a barrier to timely insulin initiation. The Insulin Treatment Appraisal Scale (ITAS) is a widely used 20-item measure of attitudes towards insulin. While designed for completion by both insulin using and non-insulin using adults with T2DM, its psychometric properties have not been investigated separately for these groups. Furthermore, the total score is routinely reported in preference to the published two-factor structure (negative/positive appraisals). Further psychometric validation of the ITAS is required to examine its properties.

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Current computational methods used to analyze changes in DNA methylation and chromatin modification rely on sequenced genomes. Here we describe a pipeline for the detection of these changes from short-read sequence data that does not require a reference genome. Open source software packages were used for sequence assembly, alignment, and measurement of differential enrichment. The method was evaluated by comparing results with reference-based results showing a strong correlation between chromatin modification and gene expression. We then used our de novo sequence assembly to build the DNA methylation profile for the non-referenced Psammomys obesus genome. The pipeline described uses open source software for fast annotation and visualization of unreferenced genomic regions from short-read data.

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Background: Our objective was to investigate associations between adulthood fracture and quality of life (QOL) in men. Methods: For 448 men aged 50-85 years and enrolled in the Geelong Osteoporosis Study, we measured QOL using the validated (Australian) World Health Organization Quality of Life-Brief Version (WHOQOL-Bref) in the domains of physical health, psychological health, social relationships, and the environment. Self-reported adulthood fractures were categorized as recent or non-recent ( ≤ 10 years or > 10 years pre-QOL assessment, respectively). Lifestyle and health information were self-reported. Results: One hundred seventy four men (38.8%) sustained at least one fracture, 26% of which had occurred within the last 10 years. Compared with men who had never had an adulthood fracture, a non-recent fracture was more likely associated with poorer QOL in the physical health domain (age-adjusted odds ratio [OR] 0.47, 95% confidence interval [95%CI] 0.27-0.83), but not in any other domain. Men who had sustained a recent fracture reported a lower QOL in the domain of psychological health (age-adjusted OR 0.48, 95%CI 0.24-0.97), with a trend observed for lower QOL in the domains of physical health and environment. No further associations were observed. All results were sustained in further models that were adjusted for smoking, alcohol, physical inactivity, and body mass index. Conclusions: We present novel data examining associations between fracture status and QOL in a populationbased sample of Australian men using the WHOQOL-Bref. Recent fractures were associated with poorer QOL in the domain of psychological health while non-recent fractures were more likely associated poorer QOL for physical health. These findings have important implications for healthcare post-fracture.

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Non-suicidal self-injury has been classed as having both impulsive and compulsive characteristics (Simeon & Favazza, 2001). These constructs have been related to disordered eating behaviors such as vomiting (Favaro & Santonastaso, 1998). Utilizing an international sample of adult females, this paper further explored this model, aiming to identify whether all types of disordered eating could be classified as impulsive or compulsive, and whether the impulsive and compulsive groupings reflect underlying trait impulsivity and compulsivity. The hypothesized impulsive and compulsive dimensions did not emerge from the data. Notably however, all self-injurious and disordered eating behaviors were linked to Urgency (an impulsivity facet) to varying degrees; no relationship with trait compulsivity was found. These findings are discussed, study limitations are noted, and relevance for clinical practice is outlined.