Resources for care & security. An update on tax-free viatical settlements.
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Genetic testing is a powerful technology that enables prediction of future health status. Testing for cancer-predisposition genes provides information for both the individual and his or her family. The use of this information reaches beyond the medical sphere to the psychological, social, legal, and ethical. The important issues include informed consent, autonomy, confidentiality, justice, disclosure and non-disclosure, duty to warn, genetic discrimination, predictive genetic testing of children, preimplantation genetic diagnosis, and patenting of cancer-predisposition genes.
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Epidemiological studies should allow comparisons to be made of the prevalence of disease in populations from different countries, but the population characteristics and health problems in French horses are not well established. We have conducted a retrospective evaluation of the causes of death and vital characteristics of insured horses in France for the year 1995, with a view to comparison with published data from other countries. Files on 448 deceased horses were provided by nine insurance companies. Most of the animals were used for breeding (60%), followed by leisure (20%), eventing and racing (10% each). Physical characteristics were associated significantly with occupational categories. The overall mortality rate was 2.47%, and was due, in decreasing order, to foaling (24%), colic (21%) or locomotor (21%), cardiovascular (9%), neurological (8%), respiratory (5%) or infectious (4%) disease. Infectious disease was more frequent in younger animals (p < 0.05) and locomotor disease in racehorses (p < 0.01). Horses aged over 15 years had a lower incidence of colic (p <0.05). The cause of death was not significantly linked to breed, insurance value or season. Despite some selection bias, the study provides useful information about mortality in the French equine population.
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In a control-group field experiment using a reversal design, 30 insurance salespeople were randomly assigned to an experimental group that received self-management training. A multivariate analysis of variance and subsequent repeated-measures analyses of variance revealed that, compared with a control condition (n = 30), training in self-management skills significantly improved job performance as assessed through both objective and subjective measures. Performance improvement continued with time, and increases were sustained across a 12-month period posttraining. Subsequent training of the control group produced similar increases in self-efficacy, outcome expectancies, and job performance. Potential mediating effects of self-efficacy and outcome expectancies on the self-management-performance relationship were explored and partially supported.
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The insurance industry is likely to find it more difficult to use genetic data on disease susceptibility than some of its critics claim. But it is already contesting demands for strict controls on the way this data is used.
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