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Super P-Force


By E. Copper. University of Wisconsin-La Crosse. 2018.

ACTUARIAL SCIENCE AND FINANCIAL MARKETS Actuaries use a variety of complex mathematical models to esti- mate future loss and legal defense costs based on past experience discount super p-force 160mg without a prescription, estimates of future trends in claims severity and frequency discount 160 mg super p-force with mastercard, and the anticipated composition of the risk pool. These models must reflect the impact of past and prospective changes in the economic (e. Because there is a long time gap from the collection of premiums to the closing of the average claim file, these models must also reflect the value of invest- ment income. Part of the fiduciary responsibility of any insurance company is to responsibly invest premium until the money is needed 6 Gorney and Anderson to pay future losses and expenses. The investment income collected during that period can be used to subsidize the actual cost of premi- ums. For this reason, insurance rates are sensitive to the state of the investment markets, primarily interest rates. As interest rates rise or fall, the amount of money available to subsidize policyholder charges varies. In low- interest rate environments, premiums must more closely match costs. In higher return settings, insurers may be able to sell insurance for less than cost and still remain solvent. CLAIMS MADE VS OCCURRENCE COVERAGE Before the insurance crises of the 1970s, malpractice insurance was sold on an occurrence basis. Any claim arising from an event occurring in the policy period would be covered, regardless of when the claim was reported or when in the future it needed to be paid. This type of policy makes it difficult for insurance companies to predict the ultimate cost of losses, because today’s premiums must cover future losses regardless of when they are reported. The mass litigation surrounding asbestos and toxic waste that is occurring presently, many decades after the insurance was priced and sold and sometimes even prior to the identification of the potential risk, illustrates the difficulty with sustain- ing the occurrence form of insurance. For this reason, since the late 1970s, the majority of medical malpractice insurance policies for physicians is sold on a claims made basis. This form requires that a covered event must occur and the claim must be made (reported) during the policy period. Claims made coverage can be extended back by adding nose coverage, in which the insurer agrees to cover claims made during the policy period based on events that occurred prior to the inception date of the policy. When a physician retires or chooses to move to a different insurance carrier, he or she may obtain tail cover- age. This provides insurance for a covered event occurring during the policy period, even if the claim is not reported until later.

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Digestive System © The McGraw−Hill Anatomy quality 160 mg super p-force, Sixth Edition Body Companies discount super p-force 160mg line, 2001 Chapter 18 Digestive System 655 Simple Intestinal villus columnar (lined with simple epithelium columnar epithelium) Lacteal Intestinal Capillary Lamina propria villus network Goblet cells Muscularis mucosa Intestinal crypt Duodenal glands Lymph vessel FIGURE 18. The terms brush border and microvilli are Venule Waldrop often used interchangeably in describing the small intestine. The intestinal villi are covered with columnar epithelial cells, among which are interspersed the mucus-secreting goblet FIGURE 18. Absorbed monosaccharides and amino acids enter the blood capillaries; absorbed fatty acids and cholesterols enter the lacteals. Intestinal villi are considered the functional units of the digestive system because absorption through these structures is how digested molecules enter the blood or lymph. Epithelial cells at the tips of the intestinal villi are continu- ously shed and are replaced by cells that are pushed up from the bases of the intestinal villi. The epithelium at the base of the in- testinal villi invaginates downward at various points to form nar- row pouches that open through pores into the intestinal lumen. These structures are called the intestinal crypts (crypts of Lieberkühn) (see fig. Mechanical Activities of the Small Intestine Contractions of the longitudinal and circular muscles of the small intestine produce three distinct types of movement: rhyth- mic segmentation, pendular movements, and peristalsis. Digestive System © The McGraw−Hill Anatomy, Sixth Edition Body Companies, 2001 656 Unit 6 Maintenance of the Body Rhythmic segmentations are local contractions of the cir- orly on the right side to a point just below the liver; it then cular muscular layer. They occur at the rate of about 12 to 16 per crosses to the left, descends into the pelvis, and terminates at the minute in regions containing chyme. A specialized portion of the mesentery, the mesocolon, churn the chyme with digestive juices and bring it into contact supports the transverse portion of the large intestine along the with the mucosa. During these contractions, the vigorous motion posterior abdominal wall. The large intestine has little or no digestive function, but Pendular movements primarily occur in the longitudinal it does absorb water and electrolytes from the remaining chyme. In this motion, a constrictive wave moves along a In addition, the large intestine functions to form, store, and segment of the small intestine and then reverses and moves in expel feces from the body. Pen- dular movements also mix the chyme but do not seem to have a particular frequency. These wavelike contractions are usually weak and relatively short, oc- The large intestine is structurally divided into the cecum, colon, curring at a frequency of about 15 to 18 per minute. The cecum quires 3 to 10 hours to travel the length of the small intestine. The ileocecal valve is a fold of mucous membrane at the junction of the small intestine and large intestine that prohibits The sounds of digestive peristalsis can be easily heard the backflow of chyme.

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