Health plan pricing behaviour and managed competition

In the Dutch social health insurance scheme, health plans operate in a managed competition framework. Essential features of this framework are risk adjustment, open enrolment and community rating. The objective is to study how health plans determine their community rated premiums. Using a panel data set for all health plans operating in the Dutch social health insurance market over the period 1996-2004, we estimate a premium model to determine which factors explain the price setting behaviour of health plans. Our empirical results indicate that competition did not play a major role in premium setting by health plans. We find that financial stability rather than profit maximisation offers the best explanation for health plan pricing behaviour. The forecast of next year's health-care expenditure by the government and the adjusted forecast by the insurers' association play a major role in health plans' pricing decisions. The introduction of a national health insurance scheme in 2006 urged all citizens to reconsider their health plan choice. The threat of losing customers had a profound impact on health plans' pricing behaviour. In sharp contrast to the period 1996-2005, in 2006 competition seems to play a dominant role in insurers' pricing decisions. Whether this will be a temporary or a lasting phenomenon is hard to predict.

Brain processing of contagious itch in patients with atopic dermatitis

Several studies show that itch and scratching cannot only be induced by pruritogens like histamine or cowhage, but also by the presentation of certain (audio-) visual stimuli like pictures on crawling insects or videos showing other people scratching. This phenomenon is coined Contagious itch (CI). Due to the fact that CI is more profound in patients with the chronic itchy skin disease atopic dermatitis (AD), we believe that it is highly relevant to study brain processing of CI in this group. Knowledge on brain areas involved in CI in AD-patients can provide us with useful hints regarding non-invasive treatments that AD-patients could profit from when they are confronted with itch-inducing situations in daily life. Therefore, this study investigated the brain processing of CI in AD-patients. 11 AD-patients underwent fMRI scans during the presentation of an itch inducing experimental video (EV) and a non-itch inducing control video (CV). Perfusion based brain activity was measured using arterial spin labeling functional MRI. As expected, the EV compared to the CV led to an increase in itch and scratching (p \u3c 0.05). CI led to a significant increase in brain activity in the supplementary motor area, left ventral striatum and right orbitofrontal cortex (threshold: p \u3c 0.001; cluster size k \u3e 50). Moreover, itch induced by watching the EV was by trend correlated with activity in memory-related regions including the temporal cortex and the (pre-) cuneus as well as the posterior operculum, a brain region involved in itch processing (threshold: p \u3c 0.005; cluster size k \u3e 50). These findings suggest that the fronto-striatal circuit, which is associated with the desire to scratch, might be a target region for non-invasive treatments in AD patients. © 2017 Schut, Mochizuki, Grossman, Lin, Conklin, Mohamed, Gieler, Kupfer and Yosipovitch

Optical-trapping micromanipulation using 780-nm diode lasers

We have designed and implemented an optical-trapping configuration that uses near-infrared laser diodes. The highly divergent output beam of the diode laser was collimated by using only one aspheric compact disc lens. The resulting output beams are astigmatic and elliptic and have a flat, non-Gaussian intensity profile. Calculations and measurements were performed to investigate the influence of this profile on the trapping forces. The results show that use of a laser diode, collimated with a compact disc lens, provides a near-infrared light source that can be used for optical trapping. The light source is compact and relatively cheap and can be easily incorporated into an existing microscope

Institutionalising dialogue in Rwanda through innovation platforms

A platform of farmers, retailers and service providers,civil society organisations, NGOs, government officials, and researchers improves livelihoods in Rwanda. Through interaction and collaboration, these groups experiment with various technological and institutional innovations, thereby tackling local agricultural challenges. This experience illustrates the importance of institutionalising a space where knowledge can be co-created