bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Political Economy of Regulation
Authors: Booth P.M. 
Published: June 2011

ABSTRACTThis paper examines the political economy of regulation, reviewing market socialist, neo-classical and public interest approaches to regulation and analysing the development of financial services and insurance regulation in these frameworks. However, the paper suggests that these approaches do not capture properly many of the features of a market and the behaviour of regulators. Public choice theory is discussed, and it is concluded that there has not been significant capture of the regulatory process by interest groups. Austrian economics is proposed as a possible framework within which to analyse markets and regulators. It is concluded that there is prima facie evidence to suggest that the Austrian view of the market is realistic and that regulation in insurance markets can have unforeseen and undesirable effects. The author also concludes that, until 1970, insurance regulation did not deviate from principles which are appropriate if either a public choice or Austrian view is taken. However, the Financial Services Act 1998 and the Pensions Act 1995 do deviate from those principles.
Notes on the FT/S&P Actuaries World Indices in 1996
Authors: Brumwell J.C.H. 
Published: June 2011

ABSTRACTThis note marks 10 years of publication of the FT/S&P World Indices. Equity indices are given for 28 countries, 11 continental groups, and the whole world, covering the Developed World and an increasing number of those in Emerging Markets.
Human Genetics and Financial Services. A Discussion Meeting with Supporting Papers
Authors: Wilkie A.D. , Le Grys D.J. , Macdonald A.S. , Ross T.M. , Daykin C.D. 
Published: June 2011

The Profession held a joint seminar on ‘Human Genetics: Uncertainties and the Financial Implications Ahead’ with the Royal Society of London in September 1996. Papers submitted to that seminar included four from the profession and several from the medical, legal, social and scientific communities.This Sessional Meeting is designed to provide a forum for discussion amongst a wider actuarial audience. The topic is important to the profession, not only in relation to life insurance, but perhaps even more in relation to health insurance. The four papers by the actuarial authors are reproduced, together with a short third party summary of the whole seminar and a more detailed summary by C.D. Daykin of the actuarial, legal and social points raised in the discussions.The meeting takes the form of a panel discussion. Each of the panellists is to be invited to make introductory comments on their papers to update them where appropriate in the light of developments since September 1996 (for example the ABI statement) and will also suggest specific topics for discussion at the meeting. There is then an opportunity for members and guests to raise and debate all relevant issues.
Address by the President of the Institute of Actuaries: For Goodness Sake
Authors: Ferguson D.G.R. 
Published: June 2011

ABSTRACTThe Presidential Address argues that, by acting in the public interest, the power of actuaries to benefit individuals financially can become a competitive advantage for the profession. This theme is explored by reference to professionalism being under threat, the negative impact of professional negligence claims, the need for unity in the profession, nationally and internationally, and the consequences for our education. The future of the profession will be brighter, and can be expansionist, if actuaries are recognised and valued for serving the public interest in the wider fields, but this will require effective public relations.
Address by the President of the Faculty of Actuaries
Authors: Grace P.H. 
Published: June 2011

ABSTRACTThe first part of the Address is a review of changes over the last 30 years in the actuarial management of a life office — ranging from the introduction of the Appointed Actuary system to some of the consequences of the Financial Services Act. It draws attention to some of the differences in the regulatory treatment of life assurance companies and other competing organisations in the savings field, highlights some of the shortcomings in the European solvency regime that is currently being reviewed by the authorities, comments on developments in the area of anti-discriminatory legislation and draws attention to some possible problems arising from such legislation.The Address continues by outlining some of the issues that must be tackled if the profession is to expand into other fields, and the last part comments on developments in the day-to-day management of the United Kingdom actuarial profession and the Faculty's relationship with the Institute.
A Review of Wilkie's Stochastic Asset Model
Authors: Huber P.P. 
Published: June 2011

ABSTRACTThis paper reviews the United Kingdom stochastic asset model developed by Wilkie (1995b). Certain aspects of the methodology used to develop this model could be problematic. Moreover, Wilkie (1995b) did not provide a complete evaluation of his model; certain economic theories and the constancy of the model's parameter values did not appear to have been specifically considered. This paper attempts to provide a comprehensive review of Wilkie's model.
Address by the President of the Institute of Actuaries. Flourishing in a Changing Employment Landscape
Authors: Masters Nigel Barry 
Published: June 2011

ABSTRACTAgainst a background of globalisation, regulatory change and the prospect of a merger with the Faculty of Actuaries, the profession is in a state of renewal. Traditional areas of actuarial expertise are likely to see employment reductions. However, our skills in risk and finance should be in demand. To ensure this we need to maintain the relevance of our examination system, develop the appropriate research resources and CPD offerings, give members the support that they need throughout their careers whilst working with employers to produce the skilled professionals that they require.
A Review of Lifetime Risk Factors for Mortality
Authors: Kuh D. , Hardy R. , Hotopf M. , Lawlor D. A. , Maughan B. , Westendorp R. , Cooper R. , Black S. , Mishra G. D. 
Published: June 2011

ABSTRACTThis review was undertaken for the Faculty and Institute of Actuaries as part of their programme to encourage research collaborations between health researchers and actuaries in order to understand better the factors influencing mortality and longevity. The authors presented their findings in a number of linked sessions at the Edinburgh conference (Joining Forces on Mortality and Longevity) in October 2009 and contributed to this overview. The purpose is to review evidence for the impact on adult mortality of characteristics of the individual's lifetime socioeconomic or psychosocial environment or phenotype at the behavioural; multi-system (e.g. cognitive and physical function); or body system level (e.g. vascular and metabolic traits) that may be common risk factors for a number of major causes of death. This review shows there is growing evidence from large studies and systematic reviews that these individual characteristics, measured in pre-adult as well as the adult life, are associated with later mortality risk. The relative contribution of lifetime environment, genetic factors and chance, whether these contributions change with age, and the underlying social and biological pathways are still to be clarified. This review identifies areas where further life course research is warranted.
Selected Issues in Modelling Mortality by Cause and in Small Populations
Authors: Richards S. J. 
Published: June 2011

ABSTRACTActuarial practice as regards mortality analysis and projection is changing rapidly. This paper provides a short introduction to some of the limitations and risks in using trends in cause of death as a means for projecting future mortality rates. It also covers recent developments in analysing the mortality of smaller populations, including survival models and “piggyback” models.
Remote Sensing for Water Quality Monitoring & Watershed Assessment On the Lake Traverse Reservation
Authors: German David , O’Neill Mary , Sampson James , Shmagin Boris 
Published: June 2011

AbstractDuring the summer of 2010, three student interns from Sisseton Wahpeton Tribal College along with researchers from South Dakota State University engaged in a pilot project to assess the feasibility of using Landsat imagery to determine water transparency in reservation lakes in northeastern South Dakota. The students were trained to assist with data collection, image processing, and spatial and statistical analyses. Secchi depth measurements and lake algae bloom observations were made on cloud-free Landsat overpass days. Measurement locations were geo-referenced using GPS. Field observations and satellite image classification and interpretation techniques were used to create a land use map for the watershed and explore possible land-use-related causes of the variation in water transparency. The results of this project included a better understanding of the relationship between Landsat images and on site observations of water transparency at first and then land use and water quality in reservation lakes.
Real-Time Elastography: Strain Ratio Measurements Are Influenced by the Position of the Reference Area
Authors: Havre R. F. , Waage J. R. , Gilja O. H. , Ødegaard S. , Nesje L. B. 
Published: June 2011

Abstract
Purpose: Real-time elastography (RTE) is an ultrasound-based method for the visualization of relative strain distribution in soft tissues. Strain ratio is a semi-quantitative measurement of strain differences between two user-defined areas in an elastogram. The aim of this study was to evaluate the impact of the size and location of a reference area when measuring the strain ratio of focal lesions in a tissue-mimicking phantom and in normal liver tissue. We also investigated whether the strain ratio was affected by changing the scanner parameter: elasticity dynamic range (E-dyn).
Materials and Methods: Two investigators individually collected data by scanning 4 spherical inclusions with different elasticity in a phantom in which the elastic modulus was known in both the lesions and the background. Subsequently, a liver scan was performed in-vivo using the same scanning protocol. Five different setups with changes in reference area position or size were tested. All eight levels of the scanner setting Edyn were recorded for each setup and the strain ratio was measured in 3 different representative elastograms for each recording situation.
Results: The four inclusions had significantly different mean strain ratio levels (p < 0.01) when compared to the surrounding material. Changing the position of the reference area to a deeper position influenced the strain ratio measurements significantly for all phantom lesions and in the liver. Changing the size of the reference area, while keeping the center depth unchanged, did not influence the mean strain ratio levels significantly. The strain ratio was independent of the E-dyn parameter setting. The intraand interobserver reliability was high when measuring the strain ratio with a free-hand technique.
Conclusion: Strain ratio provides reproducible measurements of inclusions representing different elastic contrasts using a free-hand technique in vitro. Changes in the distance of the reference areas to the ultrasound probe, representing the stress source, seem to have a significant impact on strain ratio measurements.
Enhancement of biomixing by swimming algal cells in two-dimensional films
Authors: Kurtuldu Hüseyin , Guasto Jeffrey S. , Johnson Karl A. , Gollub J. P. 
Published: June 2011

Fluid mixing in active suspensions of microorganisms is important to ecological phenomena and presents a fascinating stochastic process. We investigate the mixing produced by swimming unicellular algal cells (
Chlamydomonas
) in quasi-two-dimensional liquid films by simultaneously tracking the motion of the cells and that of microscopic passive tracer particles advected by the fluid. The reduced spatial dimension of the system leads to long-range flows and a surprisingly strong dependence of tracer transport on the concentration of swimmers, which is explored over a wide range. The mean square displacements are well described by a stochastic Langevin model, which is used to parameterize the mixing. The effective diffusion coefficient
D
grows rapidly with the swimmer concentration Φ as
D
∼ Φ
3/2
, as a result of the increasing frequency of tracer-swimmer interactions and the long-range hydrodynamic disturbances created by the swimmers. Conditional sampling of the tracer data based on the instantaneous swimmer position shows that the rapid growth of the diffusivity enhancement with concentration must be due to particle interactions with multiple swimmers simultaneously. Finally, the anomalous probability distributions of tracer displacements become Gaussian at high concentration, but manifest strong power-law tails at low concentration, while the tracer displacements always grow diffusively in time.
Clostridium difficileInfection in a Long-Term Care Facility: Hospital-Associated Illness Compared with Long-Term Care-Associated Illness
Authors: Kim Jong Hun , Toy Diana , Muder Robert R. 
Published: June 2011

Background.Controversy exists over whetherClostridium difficileinfection (CDI) commonly occurs in long-term care facility residents who have not been recently transferred from an acute care hospital.Objective.To assess the incidence and outcome of CDI in a long-term care facility.Methods.Retrospective cohort study in a 262-bed long-term care Veterans Affairs facility in Pittsburgh, Pennsylvania, for the period January 2004 through June 2010. CDI was identified by positive stoolC. difficiletoxin assay and acute diarrhea. Patients were categorized as hospital-associated CDI (HACDI) or long-term care facility–associated CDI (LACDI) and followed for 6 months.Results.The annual rate of CDI varied between 0.11 and 0.23 per 1,000 resident-days for HACDI patients and between 0.04 and 0.28 per 1,000 resident-days for LACDI patients. We identified 162 patients, 96 patients (59.3%) with HACDI and 66 patients (40.7%) with LACDI. Median age was 74 and 77 years, respectively, for HACDI and LACDI (P= .055) patients. There were more patients with at least 1 relapse of CDI during 6 months of follow up in LACDI patients (32/66, 48.5%) than in HACDI patients (28/96, 29.2%;P= .009). Logistic regression showed that ages of at least 75 years (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.07–5.07;P= .033), more than 2 transfers to an acute care hospital (OR, 7.88; 95% CI, 1.88–32.95;P= .005), and LACDI (OR, 3.15; 95% CI, 1.41–7.05;P= .005) were associated with relapse of CDI.Conclusions.Forty percent of CDI cases were acquired within the long-term care facility, indicating a substantial degree of transmission. Optimal strategies to prevent CDI in the long-term care facility are needed.
Clinical practices, complications, and mortality in neurological patients with acute severe hypertension: The Studying the Treatment of Acute hyperTension registry
Authors: Mayer Stephan A. , Kurtz Pedro , Wyman Allison , Sung Gene Y. , Multz Alan S. , Varon Joseph , Granger Christopher B. , Kleinschmidt Kurt , Lapointe Marc , Peacock W. Frank , Katz Jason N. , Gore Joel M. , O'Neil Brian , Anderson Frederick A. 
Published: June 2011

Objective:
To determine the demographic and clinical features, hospital complications, and predictors of 90-day mortality in neurologic patients with acute severe hypertension.

Design:
Studying the Treatment of Acute hyperTension (STAT) was a multicenter (n = 25) observational registry of adult critical care patients with severe hypertension treated with intravenous therapy.

Setting:
Emergency department or intensive care unit.

Patients:
A qualifying blood pressure measurement >180 mm Hg systolic or >110 mm Hg diastolic (>140/90 mm Hg for subarachnoid hemorrhage) was required for inclusion in the STAT registry. Patients with a primary neurologic admission diagnosis were included in the present analysis.

Interventions:
All patients were treated with at least one parenteral (bolus or continuous infusion) antihypertensive agent.

Measurements and Main Results:
Of 1,566 patients included in the STAT registry, 432 (28%) had a primary neurologic diagnosis. The most common diagnoses were subarachnoid hemorrhage (38%), intracerebral hemorrhage (31%), and acute ischemic stroke (18%). The most common initial drug was labetalol (48%), followed by nicardipine (15%), hydralazine (15%), and sodium nitroprusside (13%). Mortality at 90 days was substantially higher in neurologic than in non-neurologic patients (24% vs. 6%, p < .0001). Median initial blood pressure was 183/95 mm Hg and did not differ between survivors and nonsurvivors. In a multivariable analysis, neurologic patients who died experienced lower minimal blood pressure values (median 103/45 vs. 118/55 mm Hg, p < .0001) and were less likely to experience recurrent hypertension requiring intravenous treatment (29% vs. 51%, p = .0001) than those who survived. Mortality was also associated with an increased frequency of neurologic deterioration (32% vs. 10%, p < .0001).

Conclusion:
Neurologic emergencies account for approximately 30% of hospitalized patients with severe acute hypertension, and the majority of those who die. Mortality in hypertensive neurologic patients is associated with lower minimum blood pressure values, less rebound hypertension, and a higher frequency of neurologic deterioration. Excessive blood pressure reduction may contribute to poor outcome after severe brain injury.
Levosimendan reduces heart failure after cardiac surgery: A prospective, randomized, placebo-controlled trial*
Authors: Lahtinen Pasi , Pitkänen Otto , Pölönen Pekka , Turpeinen Anu , Kiviniemi Vesa , Uusaro Ari 
Published: June 2011

Objective:
To investigate whether levosimendan diminishes the incidence of heart failure after cardiac surgery.

Design:
Prospective, randomized, placebo-controlled clinical study.

Setting:
Cardiac surgery operating room and postanesthesia care unit in a university hospital.

Patients:
Two hundred patients assigned to undergo heart valve or combined heart valve and coronary artery bypass grafting surgery.

Interventions:
Patients were randomized to receive a 24-hr infusion of placebo or levosimendan administered as a 24 μg/kg bolus over 30-mins and thereafter at a dose of 0.2 μg/kg/min.

Measurements and Main Results:
Heart failure was defined as cardiac index <2.0 L/min/m2 or failure to wean from cardiopulmonary bypass necessitating inotrope administration for at least 2 hrs postoperatively. Heart failure was less frequent in the levosimendan compared to the placebo group: 15 patients (15%) in the levosimendan and 59 patients (58%) in the placebo group experienced heart failure postoperatively (risk ratio 0.26; 95% confidence interval 0.16–0.43; p < .001). Accordingly, a rescue inotrope (adrenaline) was needed less frequently in the levosimendan compared to the placebo group (risk ratio 0.11; 95% confidence interval 0.01–0.89), p = .005. Intra-aortic balloon pump was utilized in one patient (1%) in the levosimendan and in nine patients (9%) in the placebo group (risk ratio 0.11; 95% confidence interval 0.01–0.87), p = .018. The hospital and the 6-month mortality were comparable between groups. There were no significant differences in major organ failures postoperatively. Eighty-three patients were hypotensive and needed noradrenaline in the levosimendan compared to 52 patients in the placebo group, p < .001. The cardiac enzymes (creatine kinase MB isoenzyme mass) indicating myocardial damage were lower in the levosimendan group on the first postoperative day, p = .011.

Conclusions:
In the present study, levosimendan infusion reduced the incidence of heart failure in cardiac surgery patients but was associated with arterial hypotension and increased requirement of vasopressor agents postoperatively. Improved mortality or morbidity was not demonstrated.
Hypoglycemia at admission is associated with inhospital mortality in Ugandan patients with severe sepsis*
Authors: Ssekitoleko Richard , Jacob Shevin T. , Banura Patrick , Pinkerton Relana , Meya David B. , Reynolds Steven J. , Kenya-Mugisha Nathan , Mayanja-Kizza Harriet , Muhindo Rose , Bhagani Sanjay , Scheld W. Michael , Moore Christopher C. 
Published: June 2011

Objective:
Dysglycemia during sepsis is associated with poor outcomes in resource-rich settings. In resource-limited settings, hypoglycemia is often diagnosed clinically without the benefit of laboratory support. We studied the utility of point-of-care glucose monitoring to predict mortality in severely septic patients in Uganda.

Design:
Prospective observational study.

Setting:
One national and two regional referral hospitals in Uganda.

Patients:
We enrolled 532 patients with sepsis at three hospitals in Uganda. The analysis included 418 patients from the three sites with inhospital mortality data, a documented admission blood glucose concentration, and evidence of organ dysfunction at admission (systolic blood pressure ≤100 mm Hg, lactate >4 mmol/L, platelet number <100,000/μL, or altered mental status).

Interventions:
None.

Measurements and Main Results:
We evaluated the association between admission point-of-care blood glucose concentration and inhospital mortality. We also assessed the accuracy of altered mental status as a predictor of hypoglycemia. Euglycemia occurred in 33.5% (140 of 418) of patients, whereas 16.3% (68 of 418) of patients were hypoglycemic and 50.2% (210 of 418) were hyperglycemic. Univariate Cox regression analyses comparing in-hospital mortality among hypoglycemic (35.3% [24 of 68], hazard ratio 2.0, 95% confidence interval 1.2–3.6, p = .013) and hyperglycemic (29.5% [62 of 210], hazard ratio 1.5, 95% confidence interval 0.96–2.4, p = .08) patients to euglycemic (19.3% [27 of 140]) patients showed statistically significantly higher rates of inhospital mortality for patients with hypoglycemia. Hypoglycemia (adjusted hazard ratio 1.9, 95% confidence interval 1.1–3.3, p = .03) remained significantly and independently associated with inhospital mortality in the multivariate model. The sensitivity and specificity of altered mental status for hypoglycemia were 25% and 86%, respectively.

Conclusion:
Hypoglycemia is an independent risk factor for inhospital mortality in patients with severe sepsis and cannot be adequately assessed by clinical examination. Correction of hypoglycemia may improve outcomes of critically ill patients in resource-limited settings.