Valuation of functions of the Wadden Area

The rationale of this position paper is to explore ways to employ valuation methods to assess the impacts of alternative policy decisions on the functions of the Wadden Area. Based on this rationale, this paper aims to bring an ecological-economic perspective on the benefits of the Wadden Area. It highlights key issues involved in the notion and application of monetary valuation methods for valuing the (ecological) functions of the area. It also pays attention to the development of policy handles on the basis of the outcome of the valuation of ecological functions. Particularly, the paper discuss Payment for Environmental Services (PES), which aims at preservation and protection by purchasing conservation. The use of a valuation instrument within a Payment for Environmental Services Scheme is new. Valuation is of course an established technique within a Cost-Benefit framework. However, Payment for Environmental Services is an innovative way of designing policy instruments in the collaboration between ecologists and economist

Making Financial Uncertainty Count: Unit‐Linked Insurance, Investment and the Individualisation of Financial Risk in British Life Insurance

While most scholarship in the sociology of insurance has focused on the making of insurance risk by investigating mechanisms of pooling and spreading, this article examines insurers’ management of financial uncertainty. Based on a large corpus of written sources and 44 semi‐structured oral history interviews, this article seeks to describe and explain a shift in how financial uncertainty is dealt with in British life insurance, away from traditional multipolar arrangements revolving around actuarial prudence and discretion, towards bipolar arrangements that rely on explicit risk quantification and the logic of risk‐based capital to “individualise” financial risk. The article identifies two factors that were key in bringing about this shift: first, the competitive dynamics that unfolded with the emergence of challenger “unit‐linked” insurers in the 1960s, and, second, changes in the professional ecology, as manifested by the changing relations between the actuarial profession and insurance supervisors

Talk the Talk and Walk the Walk? European Insurance Capital Regulation and the Financial Vocabulary of Motive

‘Financialization’ refers to a variety of processes characterized by the increased prevalence of financial actors and logics in contemporary capitalist societies. Borrowing from Mills, I suggest that financialization may fruitfully be understood as the institutionalization of a financial vocabulary of motive. Mills argues that the type of reasons we give and the type of reasons we accept as legitimate varies, dependent on the social setting. The financial vocabulary of motive requires actors to motivate their actions by analogical extension of key concepts, ideas and paradigmatic problem solutions from modern finance theory. Analysing documents and 44 oral history interviews, I study the implementation of Solvency II—a European regulatory framework for insurance capital that transforms how insurers evaluate their assets and liabilities. To prevent the immediate failure of insurers’ traditional business models, insurers had to re-articulate past practices in the language of financial risk management.1. Introduction 2. Financialization as the diffusion of a financial vocabulary of motive 3. Solvency II: Towards a European insurance industry 4. Re-articulating insurance in financial terms 5. Conclusion Footnote Acknowledgements Reference

De dokter, het leven en de dood

De dood laat niet met zich sollen. Maar daar waar de dokter uit het sprookje van het begin zich moest behelpen met een kruidendrankje en de influisteringen van zijn bijzondere oom, stel ik vast dat onze dood inmiddels behoorlijk maakbaar en redelijk bespreekbaar is geworden. Dat is de basis voor voortgaande gedachtevorming, discussie, onderzoek en verbetering van de praktijk. Er zijn bijvoorbeeld duidelijke aanwijzingen dat er nog teveel bewuste en onbewuste onbekwaamheid en onhandigheid is bij zorgverleners, en dat er nog teveel onzekerheid en onvervulde behoeften zijn bij patiënten en hun familie. Bovendien is er nog onvoldoende kennis over de omvang, aard, oorzaken en gevolgen van passende en niet-passende zorg in de laatste levensfase. En het is een cliché, maar we gaan maar één keer dood, dus het kan niet over als het niet goed is gegaan. Onderzoek heeft al veel aanknopingspunten voor verbetering opgeleverd, zowel wat betreft adequate behandeling van symptomen als wat betreft methoden voor goede besluitvorming en communicatie. Onze eigen, veelal in samenwerking lopende projecten op het gebied van palliatieve sedatie, medicatiegebruik, zorg in het ziekenhuis en de bijdrage van consultatieteams, ook wat kostenbesparingen betreft, communicatie en besluitvorming, prognostiek, en zorg in de stervensfase zullen verder bijdragen aan onze kennis op dit gebied. We sluiten daarmee graag aan bij een van de strategische doelstellingen van het Erasmus MC, ‘zichtbaar betere zorg’, niet alleen door sterftecijfers zo laag mogelijk te houden en daardoor als ziekenhuis hoog op ranglijstjes terecht te komen, maar ook door passende zorg te bieden als het overlijden onvermijdelijk is geworden. Ook door de verdere ontwikkeling van onderwijs voor geneeskundestudenten en post-academisch onderwijs voor artsen en onderzoekers wil ik daar graag mijn bijdrage aan leveren

Private Insurance, Public Welfare, and Financial Markets: Alpine and Maritime Countries in Comparative-Historical Perspective

Contemporary capitalist societies use different institutions to manage economic risks. While different public welfare state and financial institutions (banks, capital markets) have been studied across coordinated and liberal market economies, this paper adds the private insurance sector to the study of countries’ security arrangements, following up on Michel Albert’s classical distinction between Alpine and Maritime insurance cultures. Building on extensive new insurance data collections (1880–2017) and institutional analysis, this paper corroborates the long-run historical existence of two worlds of private insurance. Maritime countries (USA, GBR, CAN) developed much bigger life and non-life insurance earlier, with no state-associated insurance enterprises and riskier investments steered towards financial markets. Alpine insurance (AUT, DEU, CHE), by contrast, was initially smaller, with strong state involvement, a significant reinsurance tradition and relatively heavy investments in mortgages and property, due to economic and financial backwardness. We argue that the larger and more “Maritime” the insurance sector, the more it made welfare states liberal and securities markets large. Insurance is thus a hidden factor for countries’ varieties of capitalism and world of welfare. The recent convergence on the Maritime model, however, implies that the riskier and risk-individualizing type of private insurance has added to privatization and securitization trends everywhere.Moderne kapitalistische Gesellschaften bedienen sich verschiedener Institutionen, um wirtschaftliche Risiken zu managen. Während wohlfahrtsstaatliche und Finanzinstitutionen (Banken, Kapitalmärkte) in koordinierten und liberalen Marktwirtschaften bereits hinreichend untersucht wurden, wird in diesem Beitrag der private Versicherungssektor in die Untersuchung der Sicherheitsarrangements der Länder einbezogen, aufbauend auf Michel Alberts klassischer Unterscheidung alpiner und maritimer Versicherungskulturen. Mit einer neuen Sammlung von Versicherungsdaten (1880–2017) und einer institutionellen Analyse bestätigt dieses Papier die langfristige historische Existenz zweier Welten privater Versicherung. Die maritimen Länder (USA, GBR, CAN) entwickelten früher viel größere und weniger staatsregulierte Lebens- und Schadensversicherungen mit risikoreicheren Investitionen, die auf die Finanzmärkte gelenkt wurden. Die alpine Versicherung (AUT, DEU, CHE) war dagegen anfangs kleiner, mit einer ausgeprägten staatlichen Beteiligung, einer bedeutenden Rückversicherungstradition und relativ hohen Investitionen in Hypotheken und Immobilien, was auf die wirtschaftliche und finanzielle Rückständigkeit zurückzuführen ist. Wir argumentieren, dass je größer und „maritimer“ der Versicherungssektor war, desto mehr hat er die Wohlfahrtsstaaten liberalisiert und die Wertpapiermärkte vergrößert. Das Versicherungswesen ist somit ein versteckter Faktor für die verschiedenen Kapitalismusformen und Wohlfahrtssysteme der Länder. Die jüngste Konvergenz hin zum maritimen Modell bedeutet jedoch, dass die risikoreichere und risikoindividualisierende Art der privaten Versicherung überall zu Privatisierungs- und Verbriefungstendenzen beigetragen hat.1 Introduction 2 Literature: Between varieties of capitalism and insurance studies 3 Alpine and Maritime insurance cultures Insurance size “Market-based” versus non-market-based portfolios Size of reinsurance Public elements in the insurance market 4 Insurance: A historical life of its own and force to reckon with in welfare and corporate finance Causes of divergence: Alpine and Maritime insurance trajectories Insurance and welfare Insurers and financial systems 5 Conclusion Appendix Reference

How could the service delivery process of dynamic arm supports be optimized?

BACKGROUND: The service delivery process of dynamic arm support (DAS) is complex. Obtaining an optimal match between user and DAS depends on a variety of interrelated factors, different professionals are involved, and the market of available solutions is evolving. OBJECTIVE: To determine how the service delivery process of DAS could be optimized. METHODS: Interviews with DAS users that retrospectively focused on the experienced service delivery process, which was compared to the general Dutch prescription guideline. Results were presented in a focus group session to seven DAS consultants, and subsequently verified by a member-check. RESULTS: Sixteen people who considered the Gowing (a DAS new on the market) as a solution and seven DAS consultants participated. Aspects that can be optimized in the current service delivery process included an improved cooperation between clients, professionals and consultants, increased knowledge of DAS in professionals, an embedded user evaluation, and timely delivery. CONCLUSIONS: It is recommended that the service delivery process is optimized by developing a DAS specific prescription framework. The issues identified in this study should be addressed in this framework. For this additional knowledge on how to optimally match persons and DAS is needed

Economische groei in Indonesië en de rol van de Nederlandse ondernemer

Na de machtsovername door generaal Soeharto in 1966 verkeerde de Indonesische economie in een slechte staat. Alle cijfers wezen erop dat de tijd rijp was voor drastische veranderingen. De regering stelde hiertoe de Repelita in. Repelita staat voor REncana PEmbangunan Lima TAhun, een vijfjarenplan voor het economische herstel van het land. Hiervan werden er vijf gepland voor de daarop volgende vijfentwintig jaa

Unravelling narcolepsy : from pathophysiology to measuring treatment effects

Narcolepsy is a disorder of the regulation of sleep and wakefulness, with as its major features excessive daytime sleepiness (EDS), cataplexy, hypnagogic hallucinations, sleep paralysis and disturbed nocturnal sleep. The first part of this thesis concernes an overview of the pathophysiology, symptoms and treatment of narcolepsy type 1. The second part elaborates some pathophysiological aspects, focussing on the autoimmune hypothesis of narcolepsy. The third part focuses on alterations of temperature regulation and on measuring treatment effects of symptomatic treatment on sustained attention, i.e. vigilance.  LUMC / Geneeskund