997 resultados para Optimal insurance


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A number of studies show that New Public Management reforms have altered the current identity benchmarks of public officials, particularly by hybridizing values or management practices. However, existing studies have largely glossed over the sense of belonging of officials when their organization straddles the concerns of public service and private enterprise, so that the boundary between public and private sector is blurred. The purpose of this article is precisely to explore this sense of belonging in the context of organizational hybridization. It does so by drawing on the results of research conducted among the employees of a public unemployment insurance fund in Switzerland. On the one hand, the analysis shows how much their markers of belonging are hybrid, multiple and constructed in negative terms (with regard to the State), while indicating that the working practices of the employees point to an identity that is nevertheless closely bound with the public sector. On the other hand, the analysis shows that the organization plays strategically with its State status, by exploiting either its private or public identity in line with the needs related to its external image. The article concludes with a discussion of the results highlighting the strategic functionality of the hybrid identity of the actors.

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BACKGROUND: Optimal management of acute pulmonary embolism (PE) requires medical expertise, diagnostic testing, and therapies that may not be available consistently throughout the entire week. We sought to assess whether associations exist between weekday or weekend admission and mortality and length of hospital stay for patients hospitalized with PE. METHODS AND RESULTS: We evaluated patients discharged with a primary diagnosis of PE from 186 acute care hospitals in Pennsylvania (January 2000 to November 2002). We used random-effect logistic models to study the association between weekend admission and 30-day mortality and used discrete survival models to study the association between weekend admission and time to hospital discharge, adjusting for hospital (region, size, and teaching status) and patient factors (race, insurance, severity of illness, and use of thrombolytic therapy). Among 15 531 patient discharges with PE, 3286 patients (21.2%) had been admitted on a weekend. Patients admitted on weekends had a higher unadjusted 30-day mortality rate (11.1% versus 8.8%) than patients admitted on weekdays, with no difference in length of stay. Patients admitted on weekends had significantly greater adjusted odds of dying (odds ratio 1.17, 95% confidence interval 1.03 to 1.34) than patients admitted on weekdays. The higher mortality among patients hospitalized on weekends was driven by the increased mortality rate among the most severely ill patients. CONCLUSIONS: Patients with PE who are admitted on weekends have a significantly higher short-term mortality than patients admitted on weekdays. Quality-improvement efforts should aim to ensure a consistent approach to the management of PE 7 days a week.

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In the traditional actuarial risk model, if the surplus is negative, the company is ruined and has to go out of business. In this paper we distinguish between ruin (negative surplus) and bankruptcy (going out of business), where the probability of bankruptcy is a function of the level of negative surplus. The idea for this notion of bankruptcy comes from the observation that in some industries, companies can continue doing business even though they are technically ruined. Assuming that dividends can only be paid with a certain probability at each point of time, we derive closed-form formulas for the expected discounted dividends until bankruptcy under a barrier strategy. Subsequently, the optimal barrier is determined, and several explicit identities for the optimal value are found. The surplus process of the company is modeled by a Wiener process (Brownian motion).

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BACKGROUND AND OBJECTIVES: The SBP values to be achieved by antihypertensive therapy in order to maximize reduction of cardiovascular outcomes are unknown; neither is it clear whether in patients with a previous cardiovascular event, the optimal values are lower than in the low-to-moderate risk hypertensive patients, or a more cautious blood pressure (BP) reduction should be obtained. Because of the uncertainty whether 'the lower the better' or the 'J-curve' hypothesis is correct, the European Society of Hypertension and the Chinese Hypertension League have promoted a randomized trial comparing antihypertensive treatment strategies aiming at three different SBP targets in hypertensive patients with a recent stroke or transient ischaemic attack. As the optimal level of low-density lipoprotein cholesterol (LDL-C) level is also unknown in these patients, LDL-C-lowering has been included in the design. PROTOCOL DESIGN: The European Society of Hypertension-Chinese Hypertension League Stroke in Hypertension Optimal Treatment trial is a prospective multinational, randomized trial with a 3 × 2 factorial design comparing: three different SBP targets (1, <145-135; 2, <135-125; 3, <125 mmHg); two different LDL-C targets (target A, 2.8-1.8; target B, <1.8 mmol/l). The trial is to be conducted on 7500 patients aged at least 65 years (2500 in Europe, 5000 in China) with hypertension and a stroke or transient ischaemic attack 1-6 months before randomization. Antihypertensive and statin treatments will be initiated or modified using suitable registered agents chosen by the investigators, in order to maintain patients within the randomized SBP and LDL-C windows. All patients will be followed up every 3 months for BP and every 6 months for LDL-C. Ambulatory BP will be measured yearly. OUTCOMES: Primary outcome is time to stroke (fatal and non-fatal). Important secondary outcomes are: time to first major cardiovascular event; cognitive decline (Montreal Cognitive Assessment) and dementia. All major outcomes will be adjudicated by committees blind to randomized allocation. A Data and Safety Monitoring Board has open access to data and can recommend trial interruption for safety. SAMPLE SIZE CALCULATION: It has been calculated that 925 patients would reach the primary outcome after a mean 4-year follow-up, and this should provide at least 80% power to detect a 25% stroke difference between SBP targets and a 20% difference between LDL-C targets.

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The purpose of this study was to estimate the energy cost of linear (EC) and vertical displacement (ECvert), mechanical efficiency and main stride parameters during simulated ski mountaineering at different speeds and gradients, to identify an optimal speed and gradient that maximizes performance. 12 subjects roller skied on a treadmill at three different inclines (10, 17 and 24 %) at three different speeds (approximately 70, 80 and 85 % of estimated peak heart rate). Energy expenditure was calculated by indirect calorimetry, while biomechanical parameters were measured with an inertial sensor-based system. At 10 % there was no significant change with speed in EC, ECvert and mechanical efficiency. At 17 and 24 % the fastest speed was significantly more economical. There was a significant effect of gradient on EC, ECvert and mechanical efficiency. The most economical gradient was the steepest one. There was a significant increase of stride frequency with speed. At steep gradients only, relative thrust phase duration decreased significantly, while stride length increased significantly with speed. There was a significant effect of gradient on stride length (decrease with steepness) and relative thrust phase duration (increase with steepness). A combination of a decreased relative thrust phase duration with increased stride length and frequency decreases ECvert. To minimize the energy expenditure to reach the top of a mountain and to optimize performance, ski-mountaineers should choose a steep gradient (~24 %) and, provided they possess sufficient metabolic scope, combine it with a fast speed (~6 km h(-1)).

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Optimal challenge occurs when an individual perceives the challenge of the task to be equaled or matched by his or her own skill level (Csikszentmihalyi, 1990). The purpose of this study was to test the impact of the OPTIMAL model on physical education students' motivation and perceptions of optimal challenge across four games categories (i. e. target, batting/fielding, net/wall, invasion). Enjoyment, competence, student goal orientation and activity level were examined in relation to the OPTIMAL model. A total of 22 (17 M; 5 F) students and their parents provided informed consent to take part in the study and were taught four OPTIMAL lessons and four non-OPTIMAL lessons ranging across the four different games categories by their own teacher. All students completed the Task and Ego in Sport Questionnaire (TEOSQ; Duda & Whitehead, 1998), the Intrinsic Motivation Inventory (IMI; McAuley, Duncan, & Tanmien, 1987) and the Children's Perception of Optimal Challenge Instrument (CPOCI; Mandigo, 2001). Sixteen students (two each lesson) were observed by using the System for Observing Fitness Instruction Time tool (SOFTT; McKenzie, 2002). As well, they participated in a structured interview which took place after each lesson was completed. Quantitative results concluded that no overall significant difference was found in motivational outcomes when comparing OPTIMAL and non-OPTIMAL lessons. However, when the lessons were broken down into games categories, significant differences emerged. Levels of perceived competence were found to be higher in non-OPTIMAL batting/fielding lessons compared to OPTIMAL lessons, whereas levels of enjoyment and perceived competence were found to be higher in OPTIMAL invasion lessons in comparison to non-OPTIMAL invasion lessons. Qualitative results revealed significance in feehngs of skill/challenge balance, enjoyment and competence in the OPTIMAL lessons. Moreover, a significance of practically twice the active movement time percentage was found in OPTIMAL lessons in comparison to non-OPTIMAL lessons.

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A receipt for Royal Insurance Company British and Foreign, dated 12 April 1884. The receipt reads" Royal Insurance Company British and Foreign Assets: Upwards of $27,000,000 No. 133848 Grimsby Agency, April 12th 1884 Received from Mrs. Adolphus Nelles the sum of Ten Dollars, being the premium for an Insurance against Loss or Damage by Fire, effected with this Company, to the extent of $1200.00 on Property described in Application of this date, for 36 months, subject to the "Statutory" Conditions (endorsed hereon) of the Policy which will be issued within Thirty Days unless the Application is declined within that period, in which case the amount received will be refunded, less the Premium for the time so insured. Premium $9.00 this receipt not valid unless countersigned by N.V. Hare Sub-Agt. Countersigned by David McLellan Agent.

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A fire insurance policy in the amount of one thousand dollars through Aetna Insurance Company of Utica, New York. The cost of twenty two dollars and twenty five cents would give them a one year insurance policy from August 1851 through August 1852.

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Accelerated life testing (ALT) is widely used to obtain reliability information about a product within a limited time frame. The Cox s proportional hazards (PH) model is often utilized for reliability prediction. My master thesis research focuses on designing accelerated life testing experiments for reliability estimation. We consider multiple step-stress ALT plans with censoring. The optimal stress levels and times of changing the stress levels are investigated. We discuss the optimal designs under three optimality criteria. They are D-, A- and Q-optimal designs. We note that the classical designs are optimal only if the model assumed is correct. Due to the nature of prediction made from ALT experimental data, attained under the stress levels higher than the normal condition, extrapolation is encountered. In such case, the assumed model cannot be tested. Therefore, for possible imprecision in the assumed PH model, the method of construction for robust designs is also explored.

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Insurance Policy issued by the Columbus Insurance Company of Columbus, Ohio to William Woodruff of St. Davids, Ontario on a detached brick building situated on Lot no. 6 on St. Paul Street, St. Catharines. This is fire policy no. 113, book 1, folio 112, April 11, 1884.

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Certificate for 8 shares of capital stock in Insurance Investments Limited to Hamilton K. Woodruff, Aug. 12, 1929.

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Certificate for 5 4/5 shares of capital stock in Insurance Investments Limited to Hamilton K. Woodruff, Jan. 15, 1930.

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Cogswell, Maria, includes: Application for loan on Real Estate, Feb. 20, 1882; Insurance Policy no. 2199780 from the Royal Insurance Company of Liverpool, March 17, 1887 and Mortgage Loan Envelope for mortgage no. 1535 from March 1, 1882 – March 1, 1887.

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Printed blank from Frank Pearce and Co. Shipping and Insurance Agents regarding the bill of landing for the porcelain cask, Oct. 26, 1876.

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Insurance policy (tourists’ policy) to insure Annie L. Woodruff for 1 year. This is accompanied by an envelope, Oct. 21, 1921.