Il est rarement possible de connaitre avec précision la mortalité à long terme associée à une condition médicale. Cependant, l’estimation de cette mortalité est primordiale dans certains domaines tels l’assurance-vie et l’expertise médicale. La méthode du Relative Risk (RR) constant, qui est la plus utilisée, comporte plusieurs failles, permettant seulement de faire des estimations grossières et conservatrices de cette mortalité. Nous avons donc comparé deux autres méthodes d’estimation de la mortalité, soit Excess Death Rate (EDR) constant et Proportional Life Expectancy (PLE). Nous avons analysé la mortalité à long terme de plusieurs maladies chroniques, entre autres le cancer et les maladies cardiovasculaires, et avons comparé ces résultats avec ceux que nous donnaient les différentes méthodes d’estimation. Nous avons ainsi pu déterminer la meilleure méthode. Nos résultats indiquent que les méthodes EDR constant et PLE sont supérieures au RR constant dans l’estimation de la mortalité. Aussi, plus l’estimation de la survie se fait à long terme, plus l’EDR constant et la PLE donnent de meilleurs résultats. Finalement, l’âge ou le type de conditions médicales analysées ne semblent pas avoir un impact déterminant lorsque l’on choisit d’utiliser l’une des trois méthodes. Les méthodes de l’EDR constant et la PLE devraient être préconisées dans l’analyse de la mortalité lors de la sélection des risques en médecine d’assurance ou lors d’évaluation de l’espérance de vie pour une expertise médicale. / Long term mortality associated to medical conditions is rarely known with accuracy. Despite this, mortality assessment is essential in certain field of activity, such as life insurance and medical expertise. Constant Relative Risk (RR) methodology is the most used method although often leading to superficial and conservative estimations. We then decided to compare two mortality estimation methods, the constant Excess Death Rate (EDR) and the Proportional Life Expectancy (PLE). We analyzed long term mortality of several chronic medical conditions, such as cancers and coronary artery diseases, and we compared those results with those from the three distinct estimation methods. Thus, we were able to determine which methodology is the most accurate. Our results show that constant EDR and PLE are superior to constant RR to better estimate the mortality. The longer the follow-up is, the better those methods are. Finally, factors like age and the kind of the medical condition seem not to have an important impact when it comes to identify the most suitable method. Constant EDR and PLE should be recommended for mortality assessment in medical insurance underwriting and for life expectancy evaluation in medical expertise.

This study investigates whether the HIV/AIDS and Life Skills Education Programme for schools was implemented in accordance with the Ministry's directives. It also seeks to establish whether the programme was effective or not by identifying and examining different implementation strategies and methodologies. Fieldwork was undertaken in the Lupane Area Development Programme where nine schools were randomly selected from sixteen primary schools. A total of nine head-teachers responded to the heads' questionnaire and fifty-eight Grade 4 to 7 teachers responded to the teachers' questionnaire. The study reveals that to a very large extent the HIV/AIDS and Life-skills Education Programme was implemented from Grades 4 to 7 in the primary schools. However, substantial improvements still need to be made in mobilising reading and financial resources. More training and the introduction of more participatory methodologies need to be stepped up for the children to realise more benefits from this life skills education programme. / Development Studies / M.A. (Development Studies)

We study skill- and income-related differences in the access to health care as drivers of longevity inequality from a theoretical life-cycle as well as from a macroeconomic perspective. To do so, we develop an overlapping generations model populated by heterogeneous agents subject to endogenous mortality. We model two groups of individuals for whom differences in skills translate into differences in income and in the ability to use medical technology effectively in curbing mortality. We derive the skill- and age-specific individual demand for health care based on the value of life, the level of medical technology and the market prices. Calibrating the model to the development of the US economy and the longevity gap between the skilled and unskilled, we study the impact of rising effectiveness of medical care in improving individual health and examine how disparities in health care utilisation and mortality emerge as a consequence. In so doing, we explore the role of skill-biased earnings growth, skill-bias in the ability to access state-of-the art health care and to use it effectively, and skill-related differences in health insurance coverage. We pay attention to the macroeconomic feedback, especially to medical price inflation. Our findings indicate that skill-bias related to the effectiveness of health care explains a large part of the increase in the longevity with earnings-related differences in the utilisation of health care taking second place. Both channels tend to be reinforced by medical progress.

This thesis addresses the absence of explicit pricing formulae and the complexity of proposed models (incomplete markets framework) in the area of mortality risk management requiring the application of advanced techniques from the realm of Financial Mathematics and Actuarial Science. In fact, this is a multi-essay dissertation contributing in the direction of designing and pricing mortality-linked derivatives and offering the state of art solutions to manage longevity risk. The first essay investigates the valuation of Catastrophic Mortality Bonds and, in particular, the case of the Swiss Re Mortality Bond 2003 as a primary example of this class of assets. This bond was the first Catastrophic Mortality Bond to be launched in the market and encapsulates the behaviour of a well-defined mortality index to generate payoffs for bondholders. Pricing this type of bond is a challenging task and no closed form solution exists in the literature. In my approach, we adapt the payoff of such a bond in terms of the payoff of an Asian put option and present a new methodology to derive model-independent bounds for catastrophic mortality bonds by exploiting the theory of comonotonicity. While managing catastrophic mortality risk is an upheaval task for insurers and re-insurers, the insurance industry is facing an even bigger challenge - the challenge of coping up with increased life expectancy. The recent years have witnessed unprecedented changes in mortality rate. As a result academicians and practitioners have started treating mortality in a stochastic manner. Moreover, the assumption of independence between mortality and interest rate has now been replaced by the observation that there is indeed a correlation between the two rates. Therefore, my second essay studies valuation of Guaranteed Annuity Options (GAOs) under the most generalized modeling framework where both interest rate and mortality risk are stochastic and correlated. Pricing these types of options in the correlated environment is an arduous task and a closed form solution is non-existent. In my approach, I employ the use of doubly stochastic stopping times to incorporate the randomness about the time of death and employ a suitable change of measure to facilitate the valuation of survival benefit, there by adapting the payoff of the GAO in terms of the payoff of a basket call option. I then derive general price bounds for GAOs by employing the theory of comonotonicity and the Rogers-Shi (Rogers and Shi, 1995) approach. Moreover, I suggest some `model-robust' tight bounds based on the moment generating function (m.g.f.) and characteristic function (c.f.) under the affine set up. The strength of these bounds is their computational speed which makes them indispensable for annuity providers who rely heavily on Monte Carlo simulations to calculate the fair market value of Guaranteed Annuity Options. In fact, sans Monte Carlo, the academic literature does not offer any solution for the pricing of the GAOs. I illustrate the performance of the bounds for a variety of affine processes governing the evolution of mortality and the interest rate by comparing them with the benchmark Monte Carlo estimates. Through my work, I have been able to express the payoffs of two well known modern mortality products in terms of payoffs of financial derivatives, there by filling the gaps in the literature and offering state of art techniques for pricing of these sophisticated instruments.

從1906到1999年間，台灣地區男性出生時平均餘命增加了43.55歲，女性增加了47.63歲，雖然台灣地區平均餘命不斷地在增加，地區間死亡風險的差異情形則未有所改善。本研究以生命表方式計算台灣地區縣市級、鄉鎮級平均餘命，尤以鄉鎮級為研究重心，配合統計地圖的使用以瞭解小地區間死亡風險的差異情形。 在縣市層級方面，男性與女性出生時平均餘命皆以七大都市較高，西部其他地區次之，東部地區的花蓮縣、台東縣最低。各縣市出生時平均餘命的差異，正指出各縣市之間的死亡風險差異甚大，特別是東部地區明顯地比西部地區更處於不利的狀態。 在鄉鎮層級方面，男性與女性各生命階段平均餘命皆呈現出西部地區高、東部地區低的明顯差異，而且平均餘命數值越低的地區其兩性平均餘命的差距也越大，此種現象尤以男性平均餘命越低的地區越為明顯。在空間模式上，男、女平均餘命最高的地區皆以大都市為中心向外擴散至其鄰近地區，平均餘命最低的地區則廣散在山地鄉之間。總的來說，中央山脈兩側的鄉鎮不僅死亡風險較其他地區高、兩性的死亡風險差異大，山地鄉之間的死亡風險結構更是呈現高度的異質性。 關鍵字：鄉鎮市區、死亡風險、平均餘命、性別差異、統計地圖、空間模式。 / Over the twentieth century (1906-1999), the life expectancy at birth in Taiwan has increased 43.55 and 47.63 years for males and females respectively. Undoubtedly, such a dramatic increase in life expectancy is resulted from the improvement of living quality in Taiwan over the past century. Nevertheless, after detailed examination of historical data, it shows that the areal variation in life expectancy over the life cycle is significant and has never diminished. This study, by applying the life table methods and statistical maps, attempts to analyze the areal variation in risks of death at small areas in Taiwan. The data sources for achieving this purpose come from the vital statistics and death-registration- profiles. The research findings show that life expectancies for both males and females are highest in the most-developed urban counties. On the contrary, the life expectancies are lower in rural counties. The gaps in life expectancies at birth between Taipei City and Taitung county reach 11 years and 7 years for males and females respectively. The spatial pattern of variation in life expectancy at the township-level is consistent with the research findings at the county-level. In general, the life expectancies for townships within the central metropolitan area are highest, and then gradually decrease for townships distant from the metropolis center. The life expectancies for both males and females are lowest in the rural-mountain townships. The gap in life expectancies between males and females is also larger in these rural-mountain areas. Finally, the life expectancies for the aboriginal townships are lowest in Taiwan. However, the age profiles for risks of death are heterogeneous in these aboriginal townships. Keywords: life expectancy, life table, statistical maps, spatial pattern

A l'image de la population du continent européen, la population française vieillit. Ainsi, dans le sillage d'une transition démographique qui a duré plus de deux siècles et qui s'est combinée, ces dernières années, avec une baisse importante et continue de la mortalité aux grands âges, l'espérance de vie des Français a connu un fabuleux essor. Cette progression régulière a fini par accroître, au fil des ans, la proportion des personnes âgées et, par conséquent, leurs besoins en soins. C'est à l'hôpital en tant que pierre angulaire du système de santé français que revient la tâche la plus ardue de la satisfaction de ces besoins. De plus, parallèlement à l'augmentation continue de la demande en soins gériatriques, le contexte économique trouble qui caractérise les finances publiques, depuis plusieurs années, a amené les autorités à introduire plusieurs réformes du financement des établissements de santé, ce qui n'est pas sans effet sur la qualité des prises en charge des patients âgés. Caractériser au point de vue démographique, social et économique le vieillissement de la population française, comprendre ses effets sur la sphère individuelle et collective et analyser sa prise en charge par le système hospitalier, notamment par les unités de soins de suite et de réadaptation, sont les principaux axes de cette thèse. / Following the trend of European continent population, French population is aging. Thus in the wake of a demographic transition that lasted more than two centuries with an important and continuous decline of mortality these years in the aged population, the life expectancy of the French population has experienced a fabulous boon. This regular progression of life expectancy ended up by increasing over the years the proportion of older persons and therefore their care needs. The Hospital as the cornerstone of the French health system has the more arduous task to care for the needs of aged population. Parallel to the continuous increase in demands for geriatric care, the difficult economic situation which characterizes the French public finances has led the authorities to introduce several reforms of heath institutions and facilities which are not without consequences for the quality of health services provided to the elderly patients. This thesis deals with the demographic, social and economic aspects of the aging French population by analyzing their effects in individual and collective spheres. It seeks to understand the challenges of support systems such as hospitals and care units of rehabilitation.

Thin film coatings of ZnO, TiO2, CeOX and BiOX have been deposited on soda lime silica glass through spray pyrolysis. The effects on the optical properties of the coated glass, as well as the possible impacts on the life expectancy and energy efficiency of PV-modules have been studied. ZnO and TiO2 coatings both reduced the transmission of UV radiation of wavelengths destructive to PV-modules. Therefore, both have the potential to increase the life expectancy of PV-modules if used on cover glass. The ZnO thin film also showed an increase in photoluminescence at 377 nm when radiated with UV radiation of 325 nm while TiO2 reduced the photoluminescence. ZnO coatings on the cover glass have the potential to increase the efficiency of PV-modules in addition to UV protection. No CeOX or BiOX films were found to be deposited with the method used. The ZnO and TiO2 coated samples showed a decrease in transmission of light, due to increased reflection and possibly scattering. This needs to be addressed if these kinds of coatings are going to be beneficial for Si PV-modules.

This study investigates whether the HIV/AIDS and Life Skills Education Programme for schools was implemented in accordance with the Ministry's directives. It also seeks to establish whether the programme was effective or not by identifying and examining different implementation strategies and methodologies. Fieldwork was undertaken in the Lupane Area Development Programme where nine schools were randomly selected from sixteen primary schools. A total of nine head-teachers responded to the heads' questionnaire and fifty-eight Grade 4 to 7 teachers responded to the teachers' questionnaire. The study reveals that to a very large extent the HIV/AIDS and Life-skills Education Programme was implemented from Grades 4 to 7 in the primary schools. However, substantial improvements still need to be made in mobilising reading and financial resources. More training and the introduction of more participatory methodologies need to be stepped up for the children to realise more benefits from this life skills education programme. / Development Studies / M.A. (Development Studies)

Escrito pelo ficcionista e ensaísta italiano Italo Calvino, e publicado pela Einaudi em 1979, Se um viajante numa noite de inverno é uma das mais significativas obras metaficcionais da literatura ocidental, na medida em que seu autor desvela os mecanismos da narração, desencadeando uma reflexão sobre a prática da escritura e da leitura, bem como sobre as relações entre o escritor, o texto e o leitor dentro da própria obra literária. Assim, esta dissertação busca demonstrar como o romance Se um viajante numa noite de inverno opera sobre o horizonte de expectativas do Leitor – o protagonista do romance, tomando como referenciais teóricos a Hermenêutica filosófica, as Estéticas da recepção e do efeito, bem como as concepções provenientes dos estudos de região e regionalidade. São observados, nesse sentido, conceitos e categorias intrinsecamente associados ao horizonte de expectativas do Leitor, tais como experiência hermenêutica, experiência estética, lugares vazios, região e regionalidade. / Submitted by Ana Guimarães Pereira (agpereir@ucs.br) on 2014-12-05T12:41:21Z No. of bitstreams: 1 Dissertacao Bruno Brizotto.pdf: 1308074 bytes, checksum: 6071d7adf66dcb4a6da00c3634e378f4 (MD5) / Made available in DSpace on 2014-12-05T12:41:21Z (GMT). No. of bitstreams: 1 Dissertacao Bruno Brizotto.pdf: 1308074 bytes, checksum: 6071d7adf66dcb4a6da00c3634e378f4 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, CAPES, Brasil. / Written by the Italian novelist and essayist Italo Calvino, and published by Einaudi in 1979, If on a winter’s night a traveler is one of the most significant metafictional works of Western literature, to the extent that the author reveals the mechanisms of narration, triggering a reflection about the practice of writing and reading, as well as about the relationship between the writer, the text and the reader in the literary work itself. Thus, this dissertation aims to demonstrate how the novel If on a winter’s night a traveler operates on the horizon of expectations of the Reader – the protagonist of the novel, taking as theoretical references the Philosophical hermeneutics, the Aesthetics of reception and effect, as well as the conceptions derived from the studies of region and regionality. It is observed, in this sense, concepts and categories intrinsically associated with the horizon of expectations of the Reader, such as hermeneutic experience, aesthetic experience, empty spaces, region, and regionality.

Escrito pelo ficcionista e ensaísta italiano Italo Calvino, e publicado pela Einaudi em 1979, Se um viajante numa noite de inverno é uma das mais significativas obras metaficcionais da literatura ocidental, na medida em que seu autor desvela os mecanismos da narração, desencadeando uma reflexão sobre a prática da escritura e da leitura, bem como sobre as relações entre o escritor, o texto e o leitor dentro da própria obra literária. Assim, esta dissertação busca demonstrar como o romance Se um viajante numa noite de inverno opera sobre o horizonte de expectativas do Leitor – o protagonista do romance, tomando como referenciais teóricos a Hermenêutica filosófica, as Estéticas da recepção e do efeito, bem como as concepções provenientes dos estudos de região e regionalidade. São observados, nesse sentido, conceitos e categorias intrinsecamente associados ao horizonte de expectativas do Leitor, tais como experiência hermenêutica, experiência estética, lugares vazios, região e regionalidade. / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, CAPES, Brasil. / Written by the Italian novelist and essayist Italo Calvino, and published by Einaudi in 1979, If on a winter’s night a traveler is one of the most significant metafictional works of Western literature, to the extent that the author reveals the mechanisms of narration, triggering a reflection about the practice of writing and reading, as well as about the relationship between the writer, the text and the reader in the literary work itself. Thus, this dissertation aims to demonstrate how the novel If on a winter’s night a traveler operates on the horizon of expectations of the Reader – the protagonist of the novel, taking as theoretical references the Philosophical hermeneutics, the Aesthetics of reception and effect, as well as the conceptions derived from the studies of region and regionality. It is observed, in this sense, concepts and categories intrinsically associated with the horizon of expectations of the Reader, such as hermeneutic experience, aesthetic experience, empty spaces, region, and regionality.