Mirror lightpipes: daylighting performance in real buildings

Mirror lightpipes are useful for providing healthy and energy-efficient daylight into buildings where windows and skylights are unsuitable, insufficient or generate too much heat gain. The lightpipes have been installed in dozens of buildings in the UK. Field monitoring has been carried out to assess their performance in four different buildings: the headquaters of a major insurance company, a health clinic, a residential building and a college dining hall In those cases where lighipipes with moderate aspect ratios were installed, good illuminance of up to 450 lux has been obtained with internal/external illuminance ratios around 1%. When long and narrow lightpipes with many bends are used, however, the ratio reduced to around 0.1%. These results showed that lightpipes can be effective daylighting devices provided that excessive aspect ratios and numbers of bends are avoided. Lightpipes with larger diameters should be used whenever possible. The lightpipes often improved signiScantly the visual quality af the interior environment, and high user satisfaction was found even in buildings where a relatively low level of daylight was admitted through the lightpipes

A battle of elephants: (I)legitimate ethical voices?

In this paper, we aim to distil myriad stakeholder voices through a Foucaudian theoretical apparatus in the establishment of ethical stakeholder voices amidst a takeover of a Ghanaian National Bank with ownership control by the state National Pension Fund and Insurance Company. Resonating with Foucault’s position that, the prove and an actual practice of ethical principles despite risk is non-existent within a democracy, this paper reveals how stakeholders in a takeover further their own interest to the neglect of the very germane societal expectation of a salient stakeholder role. We further fill an existing gap within the stakeholder literature that posit of stakeholders as always possessing the right and ethical voices. We conclude that, despite Foucault’s last lecture of The Courage of Truth: The Government of the Self and others having proven of a robust apparatus in distilling ethical voices from non-ethical within the realm of a democratic field, its idealist nature demands a counterfactual position.

Fundamentação técnica e atuarial dos seguros de vida : um estudo comparativo entre o seguro de vida individual e o seguro de vida em grupo no Brasil

A indústria de seguros é uma atividade econômica relativamente jovem, possuindo raízes na revolução industrial. O desenvolvimento dessa indústria ocorreu de forma bastante intensa durante o século passado, quando a atividade passou a ser inserida na área de gestão de riscos. As Companhias de Seguros que trabalham nesse ambiente de negócio fundamentam todo o processo de precificação dos seus produtos em rígidas bases técnicas e atuariais. O presente trabalho dedica-se ao estudo dessas questões, abordando especificamente os seguros de vida, com ênfase à cobertura de morte. A pesquisa tem por objetivo comparar duas modalidades distintas de seguros que são ofertadas ao mercado: o seguro de vida individual e o seguro de vida em grupo. Embora ofereçam aos consumidores coberturas bastante similares, ambas as modalidades devem obedecer a requisitos e princípios técnicos diferenciados por parte das instituições que fazem a sua gestão.

Evidências empírico-exploratórias de fatores críticos de sucesso em treinamentos corporativos a distância via web

The goal of this dissertation is to identify some of the relevant elements that are related to corporate in-house training programs via the worldwide web. An analysis of the way these factors act upon the success of these processes was conducted. To complete this assignment, one real case was studied using the methodology proposed and which in itself was actually used by an insurance company. The results obtained suggest that some components influence the accomplishment of this procedure. According to the results verified, they do bring a set of observations that must be considered by companies in their implementation strategies of this kind of training program.

Responsabilidade social empresarial no mercado de seguros brasileiro: influências culturais e implicações relacionais

The Brazilian insurance market is the ambience in which this research study takes place in search for a better understanding of how cultural characteristics are related with organizational signs, practices and expectations on social responsibility. The concepts of social responsibility as well as the concept of culture are presented and discussed from different points of view, in accordance with different authors and trough several methodological approaches, in order to establish a coherent theoretical basis for qualitative data analysis. The phenomenological attitude assumed by the researcher in especial dialogues situations during the field research phase added new possibilities of apprehension or emergence of each studied organization self orientation in terms of pre-occupation with social issues intimately related with their insurance activities in the market place. Final reflections show the complexity of the insurance cultural context in the studied Brazilian segment, in which cultural and subcultural national and organizational singularities appear. However leaving space for common values and coherent orientation toward the peculiar understanding of social responsibility as inherent to any insurance company activities, themselves. Last comments point out that future research studies may give additional contribution for the continuity of the discussions initiated in this dissertation, expecting that some changes in the organizational posture and practices may happen, especially those related with risk taking and broad processes of communication with clients and society as a whole.

Conflito de agência no consórcio DPVAT: uma análise à luz da nova economia institucional sob a perspectiva da teoria da agência

Diferentes arranjos institucionais resultam em diferentes incentivos para a realização de trocas econômicas. Com efeito, estruturas regulatórias implementadas em determinado contexto histórico-econômico podem resultar em consequências diversas daquelas originariamente pretendidas, impondo ao regulador a necessidade de constante monitoramento e de intervenções com vistas a diagnosticar e corrigir ou minimizar possíveis distorções nas relações entre os atores envolvidos. Assim, esta dissertação tem por objetivo analisar o funcionamento do Consórcio do Seguro DPVAT como mecanismo de conexão entre seus diversos stakeholders. Pretende-se analisar a existência de conflitos de interesses derivados das diversas relações entre as partes interligadas – geradas pelo arranjo institucional firmado para a gestão dos recursos arrecadados com os prêmios pagos pelos proprietários de veículo automotor para o Seguro de Danos Pessoais Causados por Veículos Automotores de Via Terrestre, ou por sua carga, a Pessoas Transportadas ou Não (DPVAT) – que possam suscitar intervenção regulatória no sentido de evitá-los, ou, ao menos, mitigá-los. A pesquisa é conduzida a partir da identificação dos comportamentos esperados de agentes econômicos autointeressados, tendo por referência os pressupostos da Nova Economia Institucional sob a perspectiva da Teoria da Agência, e do exame das principais mudanças legislativas havidas na estrutura do seguro obrigatório de trânsito no Brasil nos últimos 50 anos. Na sequência, com base em elementos teóricos e empíricos, foram identificados e analisados três conflitos de agência entre os stakeholders do Consórcio DPVAT: o primeiro seria aquele havido entre a entidade gestora do Consórcio DPVAT (agente) e as sociedades seguradoras consorciadas (principal); o segundo conflito observado refere-se à relação mantida entre a entidade gestora do Consórcio DPVAT (agente) e o órgão regulador (principal); e, por fim, o conflito de agência existente entre a seguradora que administra o referido consórcio (agente) e os proprietários de veículo automotor (principal).

Complementary and alternative medicine costs - a systematic literature review

Objective: The aim of this literature review, performed within the framework of the Swiss governmental Program of Evaluation of Complementary Medicine (PEK), was to investigate costs of complementary and alternative medicine (CAM). Materials and Methods: A systematic literature search was conducted in 11 electronic databases. All retrieved titles and reference lists were also hand-searched. Results: 38 publications were found: 23 on CAM of various definitions (medical and non-medical practitioners, over-the-counter products), 13 on homeopathy, 2 on phytotherapy. Studies investigated different kinds of costs (direct or indirect) and used different methods (prospective or retrospective questionnaires, data analyses, cost-effectiveness models). Most studies report 'out of pocket' costs, because CAM is usually not covered by health insurance. Costs per CAM-treatment / patient / month were AUD 7-66, CAD 250 and GBP 13.62 +/- 1.61. Costs per treatment were EUR 205 (range: 15-1,278), USD 414 +/- 269 and USD 1,127. In two analyses phytotherapy proved to be cost-effective. One study revealed a reduction of 1.5 days of absenteeism from work in the CAM group compared to conventionally treated patients. Another study, performed by a health insurance company reported a slight increase in direct costs for CAM. Costs for CAM covered by insurance companies amounted to approximately 0.2-0.5% of the total healthcare budget (Switzerland, 2003). Publications had several limitations, e.g. efficacy of therapies was rarely reported. As compared to conventional patients, CAM patients tend to cause lower costs. Conclusion: Results suggest lower costs for CAM than for conventional patients, but the limited methodological quality lowers the significance of the available data. Further well-designed studies and models are required.

The Amplifier - v. 7, no. 3

In this issue...Nuclear Reactor Testing Station, Arco, Idaho, Wesley club, Northern Pacific Railroad, Newman Club, geology, Russell Barthell, Main Hall, Thanksgiving, Montana Power

Three-year cost analysis of function-centred versus pain-centred inpatient rehabilitation in patients with chronic non-specific low back pain

OBJECTIVE: To compare costs of function- and pain-centred inpatient treatment in patients with chronic low back pain over 3 years of follow-up. DESIGN: Cost analysis of a randomized controlled trial. PATIENTS: A total of 174 patients with chronic low back pain were randomized to function- or pain-centred inpatient treatment. METHODS: Data on direct and indirect costs were gathered by questionnaires sent to patients, health insurance providers, employers, and the Swiss Disability Insurance Company. RESULTS: There was a non-significant difference in total medical costs after 3 years' follow-up. Total costs were 77,305 Euros in the function-centred inpatient treatment group and 83,085 Euros in the pain-centred inpatient treatment group. Likewise, indirect costs after 3 years from lost work days were non-significantly lower in the function-centred in-patient treatment group (6354 Euros; 95% confidence interval -20,892, 8392) and direct medical costs were non-significantly higher in the function-centred inpatient treatment group (574 Euros; 95% confidence interval -862, 2011). CONCLUSION: The total costs of function-centred and pain-centred inpatient treatment were similar over the whole 3-year follow-up.

A shift from oral to intravenous iron supplementation therapy is observed over time in a large swiss cohort of patients with inflammatory bowel disease

BACKGROUND In 2007, leading international experts in the field of inflammatory bowel disease (IBD) recommended intravenous (IV) iron supplements over oral (PO) ones because of superior effectiveness and better tolerance. We aimed to determine the percentage of patients with IBD undergoing iron therapy and to assess the dynamics of iron prescription habits (IV versus PO). METHODS We analyzed anonymized data on patients with Crohn's disease and ulcerative colitis extracted from the Helsana database. Helsana is a Swiss health insurance company providing coverage for 18% of the Swiss population (1.2 million individuals). RESULTS In total, 629 patients with Crohn's disease (61% female) and 398 patients with ulcerative colitis (57% female) were identified; mean observation time was 31.8 months for Crohn's disease and 31.0 months for ulcerative colitis patients. Of all patients with IBD, 27.1% were prescribed iron (21.1% in males; 31.1% in females). Patients treated with steroids, immunomodulators, and/or anti-tumor necrosis factor drugs were more frequently treated with iron supplements when compared with those not treated with any medications (35.0% versus 20.9%, odds ratio, 1.94; P < 0.001). The frequency of IV iron prescriptions increased significantly from 2006 to 2009 for both genders (males: from 2.6% to 10.1%, odds ratio = 3.84, P < 0.001; females: from 5.3% to 12.1%, odds ratio = 2.26, P = 0.002), whereas the percentage of PO iron prescriptions did not change. CONCLUSIONS Twenty-seven percent of patients with IBD were treated with iron supplements. Iron supplements administered IV were prescribed more frequently over time. These prescription habits are consistent with the implementation of guidelines on the management of iron deficiency in IBD.

Zu den Ergebnissen des Modellprojektes der Techniker-Krankenkasse zum Qualitätsmonitoring in der ambulanten Psychotherapie - eine Replik des wissenschaftlichen Beirats

Zur Versachlichung der Diskussion über die TK-Studie zum Effekt eines Qualitätsmonitorings in der ambulanten Psychotherapie hat der wissenschaftliche Beirat die Ergebnisse aus seiner Sichtweise dargestellt. Zur Hauptfragestellung wird der Abschlussbericht zitiert, der bestätigt, dass es sich um eine konfirmatorische Untersuchung handelte. Im Kern sollte sie die Hypothesen zur Überlegenheit des TK-Modells gegenüber dem Verfahren der Gutachterverfahren überprüfen. Beim TK-Modell handelt es sich um eine „Komplexintervention“, die aus mehreren Bausteinen bestand. Die Studienergebnisse lassen somit nur die Aussage zu, dass diese Komplexintervention in ihrer Kombination keine Überlegenheit gezeigt hat. Ob einzelne Bausteine Wirksamkeit hatten, bedarf weiterer Forschung. Schließlich werden das Repräsentativitäts- und das Selektivitätsproblem der Studie bzw. der verwertbaren Stichproben erläutert und mit Verweis auf die Literatur wird deren Relevanz dargelegt.

AN EMPIRICAL ESTIMATION OF MEDICAL AND NON-MEDICAL INPUTS IN THE PRODUCTION OF CARDIO-RESPIRATORY PHYSICAL HEALTH STATUS

The purpose of this study was to examine, in the context of an economic model of health production, the relationship between inputs (health influencing activities) and fitness.^ Primary data were collected from 204 employees of a large insurance company at the time of their enrollment in an industrially-based health promotion program. The inputs of production included medical care use, exercise, smoking, drinking, eating, coronary disease history, and obesity. The variables of age, gender and education known to affect the production process were also examined. Two estimates of fitness were used; self-report and a physiologic estimate based on exercise treadmill performance. Ordinary least squares and two-stage least squares regression analyses were used to estimate the fitness production functions.^ In the production of self-reported fitness status the coefficients for the exercise, smoking, eating, and drinking production inputs, and the control variable of gender were statistically significant and possessed theoretically correct signs. In the production of physiologic fitness exercise, smoking and gender were statistically significant. Exercise and gender were theoretically consistent while smoking was not. Results are compared with previous analyses of health production. ^

American fishes; a popular treatise upon the game and food fishes of North America, with especial reference to habits and methods of capture, by G. Brown Goode...with numerous illustrations.

1st ed.

Entre a saúde e a repressão - políticas públicas na região da \'Cracolândia\' SP

Um território, uma substância e três Políticas Públicas atuando sobre uma mesma população. O trabalho tem como objetivo oferecer uma análise das Políticas Públicas para usuários de Crack instaladas no território da \"Cracolândia\" paulista, localizado no Bairro da Luz (São Paulo-SP). A criação do Programa Crack É Possível Vencer em 2010, articulada à emergência de discursos que especulavam sobre uma possível epidemia e crescente interesse dos meios de comunicação sobre a população usuária, abriu a possibilidade de criação de espaços institucionais para que o Estado intervisse sobre os usuários de crack. Dentro desse contexto, e articuladas a esse Programa do Governo Federal, surgem duas Políticas Públicas: Programa Recomeço de gestão Estadual e Programa De Braços Abertos de gestão Municipal. As ações dessas duas políticas durante os anos 2014 e 2015 constituem o foco do recorte empírico do presente trabalho. O esforço de pesquisa foi no sentido de investigar como as novas Políticas Públicas que se propunham a operar no campo da Saúde Pública e do cuidado iriam se materializar no território, como o discurso institucional iria se traduzir enquanto práticas. Em especial, interessava observar se as novas ações iriam inibir o movimento histórico de higienização do território e expulsão dos usuários. Visando contemplar na pesquisa ponto de vistas, experiências e discursos que não se limitassem ao relato institucional, foram utilizadas três fontes de dados: pesquisas realizadas na região, reportagens e documentos lançados pela mídia e pesquisa de campo. Foi realizada uma leitura e descrição detalhada de três etnografias feitas na região, com o objetivo de comparar as intervenções passadas com o contexto atual; através da análise de duas personagens midiáticas, que surgiram nos meios de comunicação em 2015, traçou-se a imagem do usuário de crack que é veiculada socialmente. E através de observação participante no território, foram descritos os eventos acontecidos durante o período de tempo delimitado, distribuídos em três eixos: Saúde, Repressão e Resistência. À partir desse itinerário de pesquisa, foi elaborada uma discussão que pontua as diferenças entre o discurso e a prática. Dentre as considerações finais, destaca-se a diferença dos modelos de tratamentos propostos pelas Políticas Públicas internação e Redução de Danos e a forma como essa disputa se materializa no cuidado aos usuários de crack. Embora tenha ocorrido um crescimento de ofertas de saúde, também ocorreu um aumento progressivo no número de agentes de segurança e equipamentos de vigilância na Cracolândia, instaurando aquilo que é chamado de Confinamento dos usuários, composto de práticas de limpeza das ruas, retirada de bens dos usuários e filmagem dos usuários. Uma estratégia de gentrificação foi detectada e descrita, ação cujo protagonista é uma empresa de seguros que, no período delimitado, se mostrou excessivamente atuante no território, mobilizando as ações estatais. E por fim, também foram descritas as ações de resistência dos usuários frente à criação das Políticas Públicas e das outras formas de intervenção estatal, ações tais como a construção das favelinhas e a atuação dos profissionais e militantes da região. Espera-se que esse trabalho contribua para uma maior compreensão da Cracolândia paulista e forneça subsídios para que melhores Políticas Públicas sejam criadas no território.