Huntington's disease,critical illness insurance and life insurance

We describe briefly a model of Huntington's disease (HD), a highly penetrant, dominantly inherited, fatal neurological disorder. Although it is a single-gene disorder, mutations are variable in their effects, depending on the number of times that the CAG trinucleotide is repeated in a certain region of the HD gene. The model covers: (a) rates of onset, depending on CAG repeat length as well as age; (b) post-onset rates of mortality; and (c) the distribution of CAG repeat lengths in the population. Using these, we study the critical illness and life insurance markets. We calculate premiums based on genetic test results that disclose the CAG repeat length, or more simply on a family history of HD. These vary widely with age and policy term; some are exceptionally high, but in a large number of cases cover could be offered within normal underwriting limits. We then consider the possible costs of adverse selection, in terms of increased premiums, under various possible moratoria on the use of genetic information, including family history. These are uniformly very small, because of the rarity of HD, but do show that the costs would be much larger in relative terms if family history could not be used in underwriting. We point out some difficulties involved in applying a moratorium that recognises simply a dichotomy between ‘carriers’ and ‘non-carriers’ of any mutation in a gene when these mutations are, in fact, very variable in their effects. These complexities suggest that restrictions on the disclosure, rather than on the use, of genetic information, if it became established as a principle, could deprive insurers of information needed for risk management even if not used in underwriting.     

浅谈植物病虫害的防治要点

本文就植物病虫害防治要点进行初步探讨。     

碳纤维布在杨树桥加固改造中的应用

粘贴碳纤维结构加固技术是指采用高性能粘结剂将碳纤维布粘贴在建筑结构构件表面,使两者共同工作,提高结构构件的(抗弯、抗剪)承载能力,由此而达到对建筑物进行加固、补强的目的。本文着重介绍了杨树桥加固工程中采用碳纤维布部分的设计方法、施工工艺及施工过程中的注意要点。     

悬索桥空缆状态数值分析

本文主要介绍悬索桥空缆状态数值分析方法。主要包括:基于无应力状态分析法和悬链线理论求解悬索桥空缆线形的数值迭代方法;等高、不等高悬链线求解方法及利用matlab编制相应程序实现空缆线形数据的求解。     

贴钢法加固桥梁技术探讨

文章探讨了贴钢法加固桥梁的机理,提出了贴钢法加固桥梁的结构设计方法、施工工艺要点及验收办法。     

刚构连续梁合拢段施工方案与锁定计算

文章以武广客运专线宋家湾特大桥48m+80m+48m连续梁设计图为例,对其合拢段进行锁定设计计算,以供设计单位未提供刚构连续梁合拢段锁定设计的施工单位设计参考。     

文学与疾病题材关系简论

以疾病为题材的文学作品揭示了文学与疾病的种种联系,它们把疾病组合进个人-疾病-社会这个特殊的三角形中。从心理学角度看,对读者可起到交流和治疗作用;从接受美学角度看,可成为健康人的学习资料和生活指南。     

Cost analysis of a disease management programme for adult Medicaid clients with schizophrenia

Summary

This investigation assessed changes in direct medical costs, from the perspective of a public payer, associated with a comprehensive, field-based disease management programme for adult Medicaid clients with schizophrenia in the US State of Colorado.

A propensity score-matching algorithm was employed in this retrospective analysis owing to the inherent non-randomisation of enrollees. Of the 126 clients initially enrolled, 73 (58%) remained within the programme continuously for 6–12 months.

These participants were associated with 30% lower overall per member per month medical costs (p<0.001), although no differences were noted for overall pharmacy costs. Provision of the disease management programme was through an external vendor and cost $31,250 per month regardless of the number enrolled.

Future research should seek to assess long-term clinical, humanistic and economic outcomes in this population and to develop methods that increase programme participation.     

中小跨径双曲拱桥拱上建筑最优拆除方案研究

本文以矿山桥(东)为例,综合考虑桥梁所处地理位置和经济成本并利用有限元软件对控制截面进行计算,介绍中小跨径双曲拱桥最优拆除方案,对今后类似桥梁的拆除工程具有借鉴意见。     

沥青混凝土路面病害防治的施工管理措施

对于沥青混凝土地面而言,裂缝、水破坏、松散、泛油、推移等都是其最常见的病害现象,可以说是公路施工过程中质量方面的通病,不但影响了车辆通行的速度及安全,也对我们所有施工技术人员提出了严峻的考验和挑战,本文系统的介绍了沥青混凝土路面病害的形成原因和在施工管理过程中的如何采取相应的有效措施,希望可以供所有同仁参考。