Security is something that people tend to care about. But is it also something that they should care about? To explore this question, this dissertation first develops a new conceptual framework of... Show moreSecurity is something that people tend to care about. But is it also something that they should care about? To explore this question, this dissertation first develops a new conceptual framework of security. Next, it analyses how security relates to some key values for liberal democratic societies. The first of these is well-being. It is argued that there are important ways in which security can contribute to somebody’s well-being – but there are also ways in which security may hamper a person’s flourishing. The second value is freedom. It is shown that in public decision-making freedom and security may come at each other’s cost – yet there are also ways in which the two can work to each other’s benefit. The third value is equality. It is demonstrated that in order for a society to meet the demands of equality it must provide its members with a particular set of securities – while at the same time the pursuit of equality puts another set of securities out of reach. Ultimately, this dissertation finds no reason for considering security to be good for its own sake, but it argues that security can be good for the sake of well-being, freedom, and equality. Show less
Webers, C.; Grimm, S.; Tubergen, A. van; Gaalen, F. van; Heijde, D. van der; Joore, M.; Boonen, A. 2023
ObjectiveTo demonstrate the value of diagnosing axSpA, by comparing health and costs associated with available diagnostic algorithms and perfect diagnosis.MethodsUsing data from SPACE and other... Show moreObjectiveTo demonstrate the value of diagnosing axSpA, by comparing health and costs associated with available diagnostic algorithms and perfect diagnosis.MethodsUsing data from SPACE and other cohorts, a model was developed to estimate health (quality-adjusted life-years, QALYs) and costs (healthcare consumption and work productivity losses) of different diagnostic algorithms for axSpA amongst patients with low back pain referred to a rheumatologist, over a 60-year horizon. The model combined a decision-tree (diagnosis) with a state-transition model (treatment). The three algorithms (Berlin [BER, highest specificity], Modification 1 [M1; less strict inflammatory back pain (IBP) criterion] and Modification 2 [M2; IBP not mandatory as entry criterion, highest sensitivity]) were compared. Changes in sensitivity/specificity were explored and the value of perfect diagnosis was investigated.ResultsFor each correctly diagnosed axSpA patient, up to 4.7 QALYs and €60,000 could be gained/saved, considering a societal perspective. Algorithm M2 resulted in more health and lower costs per patient (24.23 QALYs; €157,469), compared to BER (23.96 QALYs; €159,423) and M1 (24.15 QALYs; €158,417). Hypothetical improvements in M2 sensitivity resulted in slightly more value compared to improvements in specificity. Perfect diagnosis can cost €7,500 per patient and still provide enough value.ConclusionCorrect diagnosis of axSpA results in substantial health and cost benefits for patients and society. Not requiring IBP as mandatory for diagnosis of axSpA (algorithm M2) provides more value and would be preferable. A considerably more expensive diagnostic algorithm with better accuracy than M2 would still be considered good value for money. Show less
This article examines court cases brought by clients against private health insurance companies and against Brazil’s public health system. When clients take private health insurers to court, they... Show moreThis article examines court cases brought by clients against private health insurance companies and against Brazil’s public health system. When clients take private health insurers to court, they successfully claim that the insurer violated their dignity, which entitles them to a moral damage payment. Similar cases against the state did not include moral damage claims. In relation to public healthcare, it is somehow not possible to equate dignity with economic value. One might conclude that the dignity of consumers in the market is worth more than that of citizens vis-à-vis the state. Instead, I argue for a more subtle approach by concentrating on the ethics of incommensurability. What legal and ethical considerations lead to such a fundamental incommensurability between personhood and economic value? How do the actors involved in court proceedings (claimants, prosecutors, judges, and insurers) perceive the differences between cases against insurance companies and against public health authorities? What can we make of the differences between the legal and everyday understandings of dignity and morality? Show less
Imprint of Action investigates the sociocultural impact of archaeology through public activities. These activities provide an ideal setting for research, as they represent a structured point of... Show moreImprint of Action investigates the sociocultural impact of archaeology through public activities. These activities provide an ideal setting for research, as they represent a structured point of encounter between the public and archaeological heritage; in analysing them, aspects of people’s connections to the past are revealed. As such this research forms an integral part of the NEARCH project (2013-2018). As a basis for analysis, survey data from three large-scale case studies – ‘DOMunder’ (Netherlands), ‘You(R ) Archaeology’ (Cross-Europe), and ‘Invisible Monuments’ (Greece) was used. The analysis and interpretation of the case studies is based on a newly created methodological framework which finds its roots in the broader culture and arts sector. Results shows that activities encourage participation and interaction, which engenders sociocultural impacts on participants, most notably in knowledge increase, skill development, social relations, and happiness. Imprint of Action is the first large-scale study focussing entirely on sociocultural impact in archaeology and, as such, is explorative in nature; it provides unique insights into the workings of interaction and participation in archaeological events, and openly shares qualitative and quantitative research data with the expanding field. Show less
The starting point for this study is that for a large part of their existence, the paintings belonging to this genre have primarily been seen as export articles without intrinsic artistic value.... Show moreThe starting point for this study is that for a large part of their existence, the paintings belonging to this genre have primarily been seen as export articles without intrinsic artistic value. This fact, and the fact that they cannot be unequivocally classified, explains why this genre has, for a long time, not received the attention it deserves. The label ‘exportware’, though, does not exclude that these paintings can also be approached as ‘art’. They have an historic, an artistic, and a material value, which, as a result of their representative and social functions, over time formed an artistic phenomenon in its own right, and a shared cultural visual repertoire with its own (Eurasian) character. In order to draw conclusions about the appreciation of the extensive and historically valuable eighteenth- and nineteenth-century Chinese export paintings in Dutch public collections, this multidisciplinary research follows the entire trajectory of this specific transcultural painting genre in sixteen museums, from the production two centuries ago to the current position. At work in this trajectory are mechanisms between people, institutions and the paintings, which increase or, indeed, diminish the appreciation of this time- and place-specific art. Show less
