The Evolution of the Insurance Sector in Central and Eastern Europe and the Former Soviet Union

This paper provides a detailed profile of the development of the insurance industry between 1989-98 in the countries of Central and Eastern Europe (CEE) and the New Independent States (NIS) of the former Soviet Union. In doing so, the author utilizes various sources of data to describe the nature of the insurance market in the region. On an individual host country basis, attention is given to data on premium income with respect to both life and non-life coverage, an analysis of average annual growth rates, as well as insurance density and penetration rates by type of coverage. The paper also addresses a number of issues pertaining to the competitive environment, including the legal conditions for insurance operators, a profile of the key players, and the role of foreign insurers operating within the region. The paper concludes by identifying the three main trends of the insurance industry in the region, the associated policy implications of each, as well as the need for future research.http://deepblue.lib.umich.edu/bitstream/2027.42/39720/3/wp336.pd

The Evolution of the Insurance Sector in Central and Eastern Europe and the Former Soviet Union

This paper provides a detailed profile of the development of the insurance industry between 1989-98 in the countries of Central and Eastern Europe (CEE) and the New Independent States (NIS) of the former Soviet Union. In doing so, the author utilizes various sources of data to describe the nature of the insurance market in the region. On an individual host country basis, attention is given to data on premium income with respect to both life and non-life coverage, an analysis of average annual growth rates, as well as insurance density and penetration rates by type of coverage. The paper also addresses a number of issues pertaining to the competitive environment, including the legal conditions for insurance operators, a profile of the key players, and the role of foreign insurers operating within the region. The paper concludes by identifying the three main trends of the insurance industry in the region, the associated policy implications of each, as well as the need for future research.

The X-ray Line Emission from the Supernova Remnant W49B

The Galactic supernova remnant W49B has one of the most impressive X-ray emission line spectra obtained with the Advanced Satellite for Cosmology and Astronomy (ASCA). We use both plasma line diagnostics and broadband model fits to show that the Si and S emission lines require multiple spectral components. The spectral data do not necessarily require individual elements to be spatially stratified, as suggested by earlier work, although when ASCA line images are considered, it is possible that Fe is stratified with respect to Si and S. Most of the X-ray emitting gas is from ejecta, based on the element abundances required, but is surprisingly close to being in collisional ionization equilibrium. A high ionization age implies a high internal density in a young remnant. The fitted emission measure for W49B indicates a minimum density of 2 cm^-3, with the true density likely to be significantly higher. W49B probably had a Type Ia progenitor, based on the relative element abundances, although a low-mass Type II progenitor is still possible. We find persuasive evidence for Cr and possibly Mn emission in the ASCA spectrum--the first detection of these elements in X-rays from a cosmic source.Comment: 22 pages incl 8 postscript figures, to appear in Ap

Tracking ecological restoration : temporal and spatial patterns of bird communities on the Whangaparāoa Peninsula, New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Conservation Biology at Massey University, Albany, New Zealand

Humans have dramatically transformed New Zealand’s ecological communities, leading to declining populations or extinction of native fauna. Hunting, habitat loss, and introduced terrestrial mammals are key drivers of these losses. Forest and Bird began the Pest-Free Hibiscus Coast project in 2011 with the aim of eradicating rats, stoats and possums from the Whangaparāoa Peninsula. To evaluate the effectiveness of pest-management and monitor changes in the bird community, volunteers conducted annual November five-minute stationary bird counts across 32 locations between 2013 and 2020. I used fixed effects models to examine changes in the abundances of the 21 most common species recorded over 2,115 surveys. Using station as a random effect and controlling for the time of day, day of the month, weather, wind levels, survey methodology used and volunteer birding experience, I found 17 bird species remained stable or had significant increases in abundance between 2017 and 2020. The same can be said for 18 species between 2013 and 2020. Overall, abundance trends of common bird species throughout the survey period were comparable with community responses seen in other research from known healthy or predator-free environments. Using GIS (geospatial information systems), I also analysed species richness and the mean relative abundances of endemic, native, and introduced birds across 17 locations. The richness of endemic birds was more than double that of other comparable areas across Auckland. Principal component analysis revealed greater abundances of the four most common endemic species at locations with more natural features and less manmade features, and vice versa for the four most common introduced species. The four most common native species showed intermediate patterns. These patterns highlight the critical importance of natural habitats to support endemic and some native bird species, and reveal that sufficient natural habitat must be available to maximise the efficacy of pest-management. This thesis archives the first eight years of bird survey data collected for Hibiscus Coast Forest and Bird. My findings contribute to the growing body of scientific research focused on improving the conservation of native birds in urban environments and provides important insight into New Zealand’s predator-free 2050 goal

'The best thing since sliced bread' : patient experiences of teleoncology in western NSW

Objective: This study explored experiences of rural cancer patients who were receiving treatments by remote video-assisted chemotherapy (RVAC) or participating in clinical trials remotely. Setting: Participants lived in Coonabarabran or Dubbo in western NSW. Participants: Seven cancer patients undergoing treatment for breast, bladder or colon cancer, renal cell carcinoma or lymphoma. Design: Appreciative inquiry informed this qualitative study. Semi-structured interviews were conducted between July 2018 and January 2019 and thematically analysed. Results: The patient experience of teleoncology was overwhelmingly positive. Patients explained the value of relationships that developed with the local and virtual care team. Patients felt they received better care if they saw the same oncologist for the duration of their treatment and felt RVAC had accommodated this. Teleoncology allowed patients to remain independent because they were able to maintain their usual support mechanisms including family, friends and health care team. Patients described the reduced physical and emotional travel burden in addition to reduction in travel time and cost. Conclusions: These findings highlight the acceptability of teleoncology for rural patients as chemotherapy can be added to the health care and social and emotional supports, which exist in their hometown. Expansion of teleoncology should be codesigned with local communities with a focus on establishing care teams with consistent staffing to build trust between the treating team and the patient. These relationships improve the patient experience and enhance patient independence, which is a desirable attribute of cancer survivorship. Recruitment to clinical trials using teleoncology is acceptable and should be factored into trial development

Contending cultures of counterterrorism: transatlantic divergence or convergence?

Terrorist attacks on the United States, Spain and the United Kingdom have underlined the differing responses of Europe and the United States to the 'new terrorism'. This article analyses these responses through the prism of historically determined strategic cultures. For the last four years the United States has directed the full resources of a 'national security' approach towards this threat and has emphasized unilateralism. Europe, based on its own past experience of terrorism, has adopted a regulatory approach pursued through multilateralism. These divergences in transatlantic approaches, with potentially major implications for the future of the relationship, have appeared to be mitigated by a revised American strategy of counterterrorism that has emerged during 2005. However, this article contends that while strategic doctrines may change, the more immutable nature of strategic culture will make convergence difficult. This problem will be compounded by the fact that neither Europe nor America have yet addressed the deeper connections between terrorism and the process of globalization

The prevalence of bronchiectasis in patients with alpha-1 antitrypsin deficiency: initial report of EARCO

Alpha-1 antitrypsin deficiency; Emphysema; PrevalenceDeficiència d'alfa-1 antitripsina; Emfisema; PrevalençaDeficiencia de alfa-1 antitripsina; Enfisema; PrevalenciaBackground Although bronchiectasis has been recognised as a feature of some patients with Alpha1-Antitrypsin deficiency the prevalence and characteristics are not widely known. We wished to determine the prevalence of bronchiectasis and patient characteristics. The first cohort of patients recruited to the EARCO (European Alpha1 Research Collaboration) International Registry data base by the end of 2021 was analysed for radiological evidence of both emphysema and bronchiectasis as well as baseline demographic features. Results Of the first 505 patients with the PiZZ genotype entered into the data base 418 (82.8%) had a reported CT scan. There were 77 (18.4%) with a normal scan and 38 (9.1%) with bronchiectasis alone. These 2 groups were predominantly female never smokers and had lung function in the normal range. The remaining 303 (72.5%) ZZ patients all had emphysema on the scan and 113 (27%) had additional evidence of bronchiectasis. Conclusions The data indicates the bronchiectasis alone is a feature of 9.1% of patients with the PiZZ genotype of Alpha1-antitrypsin deficiency but although emphysema is the dominant lung pathology bronchiectasis is also present in 27% of emphysema cases and may require a different treatment strategy.The International EARCO registry is funded by unrestricted grants of Grifols, CSL Behring, Kamada, pH Pharma and Takeda to the European Respiratory Society (ERS)

Design for Noticing with the Biodiversity Logbooks

This paper introduces the use of design to improve noticing skills in order to address environmental issues at a variety of physical and temporal scales. We illustrate the application of ‘design for noticing’ through Biodiversity Logbooks – a pilot project intended to reduce ‘plant blindness’ amongst primary school children. Plant blindness is the inability to recognise, appreciate and value plants and it has far reaching social, environmental and economic implications. In this project, we designed pedagogical tools and processes to foster the skills of noticing plants in their environments, and connecting the small-scale of their individual features to large-scale systems. Biodiversity Logbooks was designed in collaboration with primary school staff. We present initial lessons learnt from our work to support the delivery of specialist content and to create activities that can be embedded in the curriculum for the long term

Characteristics of alpha-1 antitrypsin deficiency related lung disease exacerbations using a daily symptom diary and urinary biomarkers

Background: Pulmonary exacerbations in alpha-1 antitrypsin deficiency (AATD) related lung disease are a significant contributor to disease burden, as with usual COPD. Separating the early stages of an exacerbation from the day-to-day variation in stable COPD is central to the concerns of both clinicians and patients and has been identified as a research priority by NIHR.Clinical tools that distinguish baseline symptoms from those of an exacerbation could allow early and appropriate treatment of AECOPD to reduce the impact and potentially may slow disease progression thereby improving survival and quality of life. Candidate tools include symptom diaries and biomarkers of infection and acute inflammation. Urinary biomarkers of AECOPD have yet to be explored in AATD related COPD. Methods: 55 patients with AATD related lung disease with a history of 2 or more AECOPD in the preceding year were prospectively followed for 18 months. Each patient recorded symptom scores daily via an electronic symptom diary (eDiary) based on Bronkotest. Urinary biomarkers for AAT, NE, CRP, TIMP1 and desmosine were measured weekly using a home urinary lateral flow device. During self-reported AECOPD patients were asked to perform urine analysis on the first 7 consecutive days.Results: Type I Anthonisen exacerbations and episodes occurring in autumn/winter lasted longer than Type II/III exacerbations and spring/summer episodes respectively. Median urinary CRP concentration across all study participants increased during Type I AECOPD. eDiary adherence was 68% over a median of 17.8 months (IQR 15.7 to 18.5).Conclusions: Use of an eDiary and urinary biomarkers to detect and characterise AECOPD remotely in AATD related lung disease is feasible over a prolonged period and paves the way for precision detection of exacerbations. <br/

Influence of inflammatory polyarthritis on quantitative heel ultrasound measurements.

BACKGROUND: There are few data concerning the impact of inflammatory polyarthritis (IP) on quantitative heel ultrasound (QUS) measurements. The aims of this analysis were i) to determine the influence of IP on QUS measurements at the heel and, ii) among those with IP to determine the influence of disease related factors on these measurements. METHODS: Men and women aged 16 years and over with recent onset IP were recruited to the Norfolk Arthritis Register (NOAR). Individuals with an onset of joint symptoms between 1989 and 1999 were included in this analysis. At the baseline visit subjects underwent a standardised interview and clinical examination with blood taken for rheumatoid factor. A population-based prospective study of chronic disease (EPIC-Norfolk) independently recruited men and women aged 40 to 79 years from the same geographic area between 1993 and 1997. At a follow up assessment between 1998 and 2000 subjects in EPIC-Norfolk were invited to have quantitative ultrasound measurements of the heel (CUBA-Clinical) performed. We compared speed of sound (SOS) and broadband ultrasound attenuation (BUA), in those subjects recruited to NOAR who had ultrasound measurements performed (as part of EPIC-Norfolk) subsequent to the onset of joint symptoms with a group of age and sex matched non-IP controls who had participated in EPIC-Norfolk. Fixed effect linear regression was used to explore the influence of IP on the heel ultrasound parameters (SOS and BUA) so the association could be quantified as the mean difference in BUA and SOS between cases and controls. In those with IP, linear regression was used to examine the association between these parameters and disease related factors. RESULTS: 139 men and women with IP and 278 controls (mean age 63.2 years) were studied. Among those with IP, mean BUA was 76.3 dB/MHz and SOS 1621.8 m/s. SOS was lower among those with IP than the controls (difference = -10.0; 95% confidence interval (CI) -17.4, -2.6) though BUA was similar (difference = -1.2; 95% CI -4.5, +2.1). The difference in SOS persisted after adjusting for body mass index and steroid use. Among those with IP, disease activity as determined by the number of swollen joints at baseline, was associated with a lower SOS. In addition SOS was lower in the subgroup that satisfied the 1987 ACR criteria. By contrast, disease duration, steroid use and HAQ score were not associated with either BUA or SOS. CONCLUSIONS: In this general population derived cohort of individuals with inflammatory polyarthritis there is evidence from ultrasound of a potentially adverse effect on the skeleton. The effect appears more marked in those with active disease.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are