Risk Estimation and Value-of-Information Analysis for Three Proposed Genetic Screening Programs for Chronic Beryllium Disease Prevention

Genetic differences (polymorphisms) among members of a population are thought to influence susceptibility to various environmental exposures. In practice, however, this information is rarely incorporated into quantitative risk assessment and risk management. We describe an analytic framework for predicting the risk reduction and value-of-information (VOI) resulting from specific risk management applications of genetic biomarkers, and we apply the framework to the example of occupational chronic beryllium disease (CBD), an immune-mediated pulmonary granulomatous disease. One described Human Leukocyte Antigen gene variant, HLA-DP beta 1*0201, contains a substitution of glutamate for lysine at position 69 that appears to have high sensitivity (approximately 94%) but low specificity (approximately 70%) with respect to CBD among individuals occupationally exposed to respirable beryllium. The expected postintervention CBD prevalence rates for using the genetic variant (1) as a required job placement screen, (2) as a medical screen for semiannual in place of annual lymphocyte proliferation testing, or (3) as a voluntary job placement screen are 0.08%, 0.8%, and 0.6%, respectively, in a hypothetical cohort with 1% baseline CBD prevalence. VOI analysis is used to examine the reduction in total social cost, calculated as the net value of disease reduction and financial expenditures, expected for proposed CBD intervention programs based on the genetic susceptibility test. For the example cohort, the expected net VOI per beryllium worker for genetically based testing and intervention is $13,000, $1,800, and $5,100, respectively, based on a health valuation of $1.45 million per CBD case avoided. VOI results for alternative CBD evaluations are also presented. Despite large parameter uncertainty, probabilistic analysis predicts generally positive utility for each of the three evaluated programs when avoidance of a CBD case is valued at $1 million or higher. Although the utility of a proposed risk management program may be evaluated solely in terms of risk reduction and financial costs, decisions about genetic testing and program implementation must also consider serious social, legal, and ethical factors.     

中国企业年金缴费率的模拟分析

企业年金在多支柱养老保险体系中发挥着越来越重要的作用.以个人账户为研究对象,为我国企业年金建立了精算平衡模型.文章在精算平衡模型的基础上,运用模拟的方法,对企业年金的缴费率进行了测算分析.并根据模拟的结果,对2004年5月1日开始实施的<企业年金试行办法>中缴费率的规定进行了讨论,为企业年金的发展和政策制定提供了建议.     

大学毕业生择业价值观的现状及比较分析

对国内七所大学1513名大学毕业生进行了择业价值观的问卷调查，对大学毕业生择业价值观现状进行了探讨和分析。结果表明，发展因素和保健因素是大学毕业生择业时考虑的最重要的两个因素，大学毕业生择业价值取向在性别、生源地域、家庭经济状况、学科类型、学习成绩等因素上有不同程度的差别，有些方面差异非常显著。调查结果与同类研究结果比较说明，不同地区的大学毕业生择业价值观存在一定差异。     

The Cost of Compensating Asbestos Victims Under the Occupational Disease Compensation Act of 1983

The potentially huge financial liability due to asbestos product suits and the resulting filings for reorganization in bankruptcy by Manville, UNR Industries, Inc., and Amatex, has become a major public policy concern. In response to the problem several bills have been introduced in the Congress to provide compensation for asbestos (and other occupational disease) victims. This paper estimates the cost of compensating asbestos victims under the provisions of the "Occupational Disease Compensation Act of 1983," introduced by Congressman George Miller. Utilizing fatality projections from studies by Enterline, Selikoff, and Walker, and assumptions regarding likely claims filing and success rates, duration and degree of disability, and medical expenses, first year costs for this legislation are estimated to range from a low of $131 million to a high of $ billion. Present value cost estimates at a 2% real discount rate range from $3 billion to $56 billion. The paper also estimates the impact of possible modifications to the compensation provisions of the legislation. Reducing medical payments by the amount received from medicare would lower costs by 3-4%. Providing survivors with a 3-year lump sum benefit rather than a 5-year lump sum payment would save 20-25% as would offsetting the 5-year lump sum by expected social security old age and disability benefits. Combining all of these changes would reduce costs by almost 50%.     

职业道德建设与我国卫生体制改革

本文根据<公民道德建设实施纲要>关于职业道德的基本要求,结合卫生行业实际,提出了卫生行业各部门工作人员应遵循的具体职业道德要求,并就如何通过卫生体制改革促进卫生职业道德建设提出了自己的见解.     

关于高校师德建设的几点思考

论述了高校师德建设在当前中国社会主义现代化建设中的重要意义 ,指出当前高校师德建设所存在的问题 ,并且提出了加强高校师德建设的相应对策 ,认为高校师德建设应以思想建设为主 ,并辅以强有力的制度建设     

对中国劳动安全卫生保护问题的反思

近些年来,中国连续发生了一系列的重大劳动安全生产卫生事故,中国劳动安全卫生法律制度及执行过程中曝露出不少问题。要合理解决这些问题,应当正确实现政府角色定位、完善职业灾害补偿制度;兴起"零"灾害运动;尽快制定和完善相关立法等。     

Constructing poverty in anti-welfare Singapore

In recent years, attention on the issue of poverty in Singapore has been increasingly placed in the spotlight. This study examines the various types of attitudes among Singaporeans and how they are formed, relating them to the broader institutional context of Singapore. A mixed method design is employed where clusters or groups of attitudes are derived through the use of cluster analysis. Subsequently, discourses of poverty and welfare attitudes are construed through qualitative interviews with the aid of Foucauldian Discourse Analysis. Quantitative findings point to three clusters of attitudes: ‘Conservatives’, ‘Liberals’, and ‘Sui Generis’. Qualitative findings, however, show that ‘Sui Generis’ ultimately align themselves closer to either ‘Conservatives’ or ‘Liberals’ in their discourses of welfare. In fact, respondents in all three clusters reproduce state discourses, albeit in varying ways. In essence, this study explicates poverty and welfare attitudes as a product of social identities premised on subjective notions that are shaped by state discourses of meritocracy, self-reliance and anti-welfarism. It is thus argued that current socio-political constructions of poverty ensue a paucity of major welfare reform in the near future of Singapore.     

An expanded typology of conflict at work: Task,relationship and non-task organizational conflict as social stressors

This study investigated the roles of three types of conflict at work – task, relationship and non-task organizational – in predicting employee strain. These conflict types refer to disputes over issues that are, respectively, work-task specific, driven by emotionally charged interpersonal animosity or rooted in more broad organizationally relevant issues. Findings from a sample of 260 working adults from various organizations in the United States supported the notion that the three types of conflict function as social stressors and are related to a variety of psychological, behavioural and physical strains. They extend previous research based primarily on relationship conflict. Non-task organizational conflict emerged as a key predictor across strain criteria, thus highlighting the importance of including a more complete conceptualization of the conflict construct in social stress research. The results for task conflict are at variance with findings that it can be beneficial, and suggest that its negative relationship with well-being may be due to its co-occurrence with the other forms of conflict. These findings provide support for an expanded typology of conflict.     

概述我国古代先贤对职业病的认识及其防治

以我国古代典籍所载的史料为依据 ,汇集了先贤们对职业病的认识及其相应采取的行之有效的防治之法 ,说明在职业病领域 ,我国传统医学亦取得了一定的历史性成果。这必将为我们今天发掘职业病防治的精粹 ,开拓中医药防治职业病的新局面提供有益的启迪