Vertical relationships between health insurers and healthcare providers

The current institutional reforms in the Dutch healthcare sector may increase the extent of vertical relations (such as vertical contracts and vertical integration) between insurers and healthcare providers. Vertical relations may have both welfare increasing and welfare reducing effects. In this study, we focus on the latter, in particular on anticompetitive foreclosure. We distinguish three possible mechanisms that may lead to anticompetitive foreclosure, called respectively 'exclusivity', 'sabotage', and the 'waterbed effect'. We discuss under which conditions they come into play and which policy measures can prevent them.

Static efficiency in Dutch supermarket chain

In this study, we analyse changes in market power in the Dutch supermarket chain and discuss the effects on welfare. The supermarket chain includes consumers, supermarkets, buyer groups and food manufactures. We look at the theoretical background of market power. �Special attention has been paid to recent theories of buyer power of retailers in the vertical chain. Theory suggests that supermarkets can enhance their buyer power by, for instance, using own private brands as an outside option in bargaining with manufacturers. Using firm-level data, indicators reveal that profit margins of both supermarkets and of manufacturers have declined between 1993 and 2005. Hence, competition on these markets seems to have become tougher and mark-ups lower over time. Furthermore, we find no significant empirical indications that supermarkets were able to use their buyer power to shift profits from manufacturers to supermarkets after 1993. Finally, all else equal, in terms of welfare consumers have benefited from fiercer competition in terms of lower prices.

The role of victims’ lawyers in criminal proceedings in the Netherlands

The role of the victim in the criminal trial process has evolved considerably in recent decades. On a European level, an important driver has been the EU Directive 2012/29/EU, according to which European countries are legally bound to afford certain rights to crime victims. In the Netherlands the EU Directive has instigated several extensions of existing victims’ rights, and in the Code of Criminal Procedure a separate section has been devoted to the victim. The current study specifically addresses one of the victims’ rights, i.e. the right to be legally represented. The Dutch government has financially invested in access to and specialization of victim lawyers in order to stimulate the realization of victims’ rights, specifically for victims of severe crimes and sex offences. The goal of the current study was to investigate the added value of victim lawyers and the extent to which they contribute to fulfilment of victims’ rights in the criminal law process. A literature study was conducted to examine legislation pertaining to victims’ rights; a questionnaire study was conducted to investigate the perspective of victim lawyers (n=148); and interviews were conducted to examine the perspective of the police, Victim Support, Public Prosecuting Service, and criminal courts (n=17). The results show that victim lawyers were important to the realization of victims’ rights. They were considered most necessary with respect to the right to claim compensation and with respect to the right to get access to the case file. They were also required because victims’ rights have not yet been smoothly implemented into legal practice. In addition, victim lawyers’ presence in the courtroom was considered important as it contributed to victims experiencing that they were taken seriously. It has been concluded that the support of victim lawyers is an important contribution to victim participation in criminal procedures

Peripheral arterial disease in the elderly: The Rotterdam Study

To assess the age- and sex-specific prevalence of peripheral arterial disease (PAD) and intermittent claudication (IC) in an elderly population, we performed a population-based study in 7715 subjects (40% men, 60% women) aged 55 years and over. The presence of PAD and IC was determined by measuring the ankle-arm systolic blood pressure index (AAI) and by means of the World Health Organization/Rose questionnaire, respectively. PAD was considered present when the AAI was <0.90 in either leg. The prevalence of PAD was 19.1% (95% confidence interval, 18.1% to 20.0%): 16.9% in men and 20.5% in women. Symptoms of IC were reported by 1.6% (95% confidence interval, 1.3% to 1.9%) of the study population (2.2% in men, 1.2% in women). Of those with PAD, 6.3% reported symptoms of IC (8.7% in men, 4.9% in women), whereas in 68.9% of those with IC an AAI below 0.90 was found. Subjects with an AAI <0.90 were more likely to be smokers, to have hypertension, and to have symptomatic or asymptomatic cardiovascular disease compared with subjects with an AAI of 0.90 or higher. The authors conclude that the prevalence of PAD in the elderly is high whereas the prevalence of IC is rather low, although both prevalences clearly increase with advancing age. The vast majority of PAD patients reports no symptoms of IC

Anomaly detection in urban drainage with stereovision

This work introduces RADIUS, a framework for anomaly detection in sewer pipes using stereovision. The framework employs three-dimensional geometry reconstruction from stereo vision, followed by statistical modeling of the geometry with a generic pipe model. The framework is designed to be compatible with existing workflows for sewer pipe defect detection, as well as to provide opportunities for machine learning implementations in the future. We test the framework on 48 image sets of 26 sewer pipes in different conditions collected in the lab. Of these 48 image sets, 5 could not be properly reconstructed in three dimensions due to insufficient stereo matching. The surface fitting and anomaly detection performed well: a human-graded defect severity score had a moderate, positive Pearson correlation of 0.65 with our calculated anomaly scores, making this a promising approach to automated defect detection in urban drainage

Seeing ‘Where’ through the Ears: Effects of Learning-by-Doing and Long-Term Sensory Deprivation on Localization Based on Image-to-Sound Substitution

BACKGROUND: Sensory substitution devices for the blind translate inaccessible visual information into a format that intact sensory pathways can process. We here tested image-to-sound conversion-based localization of visual stimuli (LEDs and objects) in 13 blindfolded participants. METHODS AND FINDINGS: Subjects were assigned to different roles as a function of two variables: visual deprivation (blindfolded continuously (Bc) for 24 hours per day for 21 days; blindfolded for the tests only (Bt)) and system use (system not used (Sn); system used for tests only (St); system used continuously for 21 days (Sc)). The effect of learning-by-doing was assessed by comparing the performance of eight subjects (BtSt) who only used the mobile substitution device for the tests, to that of three subjects who, in addition, practiced with it for four hours daily in their normal life (BtSc and BcSc); two subjects who did not use the device at all (BtSn and BcSn) allowed assessment of its use in the tasks we employed. The impact of long-term sensory deprivation was investigated by blindfolding three of those participants throughout the three week-long experiment (BcSn, BcSn/c, and BcSc); the other ten subjects were only blindfolded during the tests (BtSn, BtSc, and the eight BtSt subjects). Expectedly, the two subjects who never used the substitution device, while fast in finding the targets, had chance accuracy, whereas subjects who used the device were markedly slower, but showed much better accuracy which improved significantly across our four testing sessions. The three subjects who freely used the device daily as well as during tests were faster and more accurate than those who used it during tests only; however, long-term blindfolding did not notably influence performance. CONCLUSIONS: Together, the results demonstrate that the device allowed blindfolded subjects to increasingly know where something was by listening, and indicate that practice in naturalistic conditions effectively improved "visual" localization performance

Can hysterosalpingo-foam sonography replace hysterosalpingography as first-choice tubal patency test? A randomized non-inferiority trial

Funding Information: The FOAM study was an investigator-initiated study funded by ZonMw, The Netherlands organization for Health Research and Development (project number 837001504). ZonMw funded the whole project. IQ Medical Ventures provided the ExEm-foamVR kits free of charge. The funders had no role in study design, collection, analysis and interpretation of the data. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.Peer reviewedPublisher PD

StereoDemo

Demo accompanying the article "RADIUS: Robust Anomaly Detection in Urban Drainage with Stereovision