Current Valuation Research Articles

Economic Value of Unpaid Family Caregiver Time Following Hospital Discharge and at End of Life

ContextFamily caregivers (FCGs) play a crucial role in care for people with serious illness, yet unpaid care is often overlooked in estimates of care recipient (CR) care costs. ObjectivesThis study quantifies the economic value of unpaid caregiving by FCGs between hospital discharge and end of life. MethodsTrial participants were rural FCGs of CRs receiving palliative care during hospitalization. Caregiving hours were self-reported by FCGs over six months following hospital discharge. Economic value was assigned to hours based on wage data from the United States Bureau of Labor Statistics. Time was valued using 1) home health aide wages (proxy cost), 2) median national wage by FCG sex and education level (opportunity cost), 3) opportunity cost if employed and proxy cost otherwise (combination cost). ResultsOf 282 FCGs, 94% were non-Hispanic White, 71% were female, 71% had a college degree, and 51% were in the workforce. FCGs of decedents (58%) compared to survivors reported significantly more caregiving hours per person-month (392 vs. 272), resulting in higher estimated economic value per person-month using opportunity ($12,653 vs. $8843), proxy ($5689 vs. $3955), and combined costing methods ($9490 vs. $6443) ConclusionThis study informs more complete economic evaluations of palliative care by estimating the economic value of unpaid caregiving. The high intensity of unpaid caregiving for people with serious illness, especially toward the end of life, should be considered when designing policies and interventions to support FCGs. Better methods for approximating economic value are needed to address potential inequities in current valuation approaches.

Bundesbank-Verluste: Bilanzierungspraxis und etwaige Nachschusspflicht des Bundes

Abstract The Bundesbank’s balance sheet and those of other central banks in the eurozone are currently showing high “operating“ losses due to the discrepancy between the low interest bearing securities holdings from bond purchases and the now higher interest bearing commercial bank deposits. However, the current accounting practice does not reflect the associated losses in value anywhere near the market level – even though, according to the PSPP ruling of the German Federal Constitutional Court, the sale of securities before final maturity should be the rule. Even under the current valuation practice, an equity gap cannot be ruled out in the future, which is generally seen as unproblematic for central banks. However, there are risks in the context of recapitalisation by the state. Within the eurozone, national and European requirements could make such capital injections necessary.

Trends and predictors of inflation-adjusted costs in transcatheter and surgical aortic valve replacement in a nationally representative sample

BackgroundTranscatheter aortic valve replacement has become an accepted alternative to surgical aortic valve replacement. We examined the trends and predictors in inflation-adjusted costs of transcatheter aortic valve replacement and surgical aortic valve replacement. MethodsNational Inpatient Sample identified patients who underwent aortic valve replacement for severe aortic stenosis by International Classification of Diseases, Ninth and Tenth Revisions, codes. Hospitalization costs were inflation-adjusted using the Federal Reserve’s consumer price index to reflect current valuation. Outcomes of interest were unadjusted trend in annual cost for each procedure and predictors of in-patient cost. Generalized linear models with a log link function identified predictors of adjusted costs. Interaction terms determined where cost predictors were different by operation type. ResultsBetween 2011 and 2019, the mean annual inflation-adjusted cost of surgical aortic valve replacement increased from $62,853 to $63,743, in contrast to decreasing cost of transcatheter aortic valve replacement from $64,913 to $56,042 ($1,854 per year; P = .004). Significant independent predictors of patient-level cost included operation type (transcatheter aortic valve replacement associated with $9,625 increase; P < .001), incidence of in-hospital mortality ($28,836 increase; P < .001), elective status ($2,410 decrease; P < .001), Elixhauser Index ($995 increase; P < .001), and postoperative length of stay ($2,014 per day increase; P < .001). Compared to discharges with Medicare, discharges with private insurance and Medicaid paid $736 less (P = .004) and $1,863 less (P = .01), respectively. Increasing hospital volume was a significant predictor of decreasing patient level cost (P < .001). ConclusionAnnual cost of transcatheter aortic valve replacement has decreased significantly and has been a more cost-effective modality compared to surgical aortic valve replacement since 2017. Predictors of patient-level costs allow for mindful preparation of healthcare systems for aortic valve replacement.

P19 The role of policy and key stakeholder decision-making in the propagation, and deceleration, of resistance evolution

Abstract Background Antimicrobials have an intangible value on reducing global health burden of infection, yet current valuation methods do not holistically capture the enablement of healthcare as a result of antimicrobials. A lack of incentive and subsequent investment into the novel antimicrobial pipeline demonstrates the urgent need for collaboration amongst those influencing the decision-making process, namely key stakeholders such as governmental bodies, industry and academia. Studies into resistance evolution focus almost entirely on proximate causes, such as the number of antibiotics used in clinical settings, or the understanding of evolutionary pathways to resistance under controlled laboratory conditions. Comparatively, the association between resistance evolution and policy decisions from governments, industry and regulatory bodies is poorly understood. Objectives The primary aim was to evaluate the multifactorial associations between β-lactam development and evolution of β-lactam resistance to inform the current and future antibiotic development pipeline. Methods To undertake this narrative report, we focussed on β-lactam antibiotics, given their clear development timeline and continuous molecular refinement to meet arising clinical and microbiological needs. As such, the evolution of resistance to β-lactams poses a significant threat to mortality, quality of life, and societal function. This report consists of six historical case studies, all of which have significantly influenced the antimicrobial resistance landscape since Fleming’s discovery of penicillin in 1928. We include lesser-known events in our narrative, such as the establishment of the National Research and Development Corporation (NRDC), which propelled the mass commercialization of penicillin, and the subsequent emergence of penicillinases. Pivotal events such as the emergence of ESBL and MBLs into clinical settings also provide insight into the historical decision-making process by key stakeholders such as governmental bodies, industry and academia. Literature reviews were conducted with a focus on the initial introduction of a particular β-lactam into the clinic and when resistance arose. Key stakeholder activities and policy decisions made during these time periods influenced the formation of case studies. Results The case studies are as follows: (i) the influence of the NRDC in accelerated antimicrobial development; (ii) the introduction of the β-lactamase inhibitor—the influence of short-term clinical and financial benefit on prescribing behaviour; (iii) the ‘golden era’ of antibiotics—cephalosporin development and the consequences of short-term market forces; (iv) knowledge of MBL resistance prior to introduction of carbapenems in clinical settings; (v) consequences of controlled manufacturing for the global supply of piperacillin/tazobactam; and (vi) early surveillance studies and the beginning of the antimicrobial stewardship agenda. Conclusions In each case study we provide insight into how key stakeholders can improve practices by learning from past experiences, to inform the future stewardship agenda. We built a case for the need to incorporate evolutionary microbiology into policy and industrial decision-making in order to improve the mitigation of antimicrobial resistance.

Determinants of peer review engagement and quality in scientific journals: insights for academic research and the sustainability of the peer-review system

ABSTRACT Research productivity is a common topic in the literature, but peer reviewing for journals has received less attention, although it is a key activity of academic research. We help to fill this knowledge gap by assessing the determinants of peer review engagement and quality in scientific journals. We do so by analysing the combined information from a survey of academics working in different parts of the world and various fields of science, along with their publication and peer review information gathered from Scopus and Publons/Web of Science. We find that age, gender, and some dimensions of academics’ strategic research agendas are important predictors of peer review engagement. We also find that academic inbreeding along the educational path has a negative association with the quality of peer-review activities. However, we find no statistically significant results concerning academic inbreeding related to the professional trajectory and peer review engagement and quality. Equally importantly, our results suggest that although the activities of publishing and peer reviewing are closely associated, peer review tends to be ancillary to publishing, rather than the other way around. Furthermore, the greater the perceived availability of resources, including research funding throughout an academic’s career, the greater the focus is on publishing and the less the focus is on peer reviewing. These findings are discussed in relation to the current valuation of publication versus peer reviewing in terms of scientific and academic career recognition.

Valuation Techniques and Financial Statement Disclosures for Non-Bearer Plant Sustainability Performance in Indonesia

This study presents early evidence of the current valuation techniques and financial statement disclosure of non-bearer plants by companies on the Indonesia Stock Exchange. The emphasis is on measurement and valuation techniques amended in 2018-2019—the compliance in financial statement disclosure items provided by the companies. The valuation technique of a biological asset is quite challenging because this process includes measurements due to changes in market price and biological transformation. The study was conducted through a review of financial statements, primarily focusing on their disclosure. The study compared the change recorded in the initial years after amendments in accounting policy (2018 and 2019). The result showed that companies applied no uniform techniques to the valuation of biological assets. Therefore, it significantly affected their disclosure mainly due to the scarcity of technical guidance concerning biological assets. This study was limited to observing disclosure information and its accounting treatment by companies listed in Indonesian Stock Exchange under Agriculture and related industries. This study is useful to academics, accounting standard setters, and regulatory bodies. The paper is useful as feedback to accounting standard setters regarding implementing Financial Accounting Standard No.69: Agriculture in Indonesia. The findings aim to provide insights to regulatory bodies regarding financial information provided by companies in the logging sector. Keywords: measurement, valuation technique, financial statement disclosure, non-bearer plant, compliance, Indonesia

Employee Satisfaction, Labor Market Flexibility, and Stock Returns Around the World

Studying 30 countries, we find that the link between employee satisfaction and stock returns is significantly increasing in a country’s labor market flexibility. This result is consistent with employee satisfaction having greater recruitment, retention, and motivation benefits where firms face fewer hiring and firing constraints and employees have greater ability to respond to satisfaction. Labor market flexibility also increases the link between employee satisfaction and current valuation ratios, future profitability, and future earnings surprises, inconsistent with omitted risk factors and identifying channels through which employee satisfaction may affect stock returns. The findings have implications for the differential profitability of socially responsible investing strategies around the world—in particular, the importance of considering institutional factors when forming such strategies. This paper was accepted by Lin William Cong, finance. Funding: This work was supported by Deloitte Institute of Innovation and Entrepreneurship. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2023.4889 .

Asset Valuation Model for Highway Rigid Pavements Applicable in Public–Private Partnerships Projects

Recently, in Chile, infrastructure asset value has been incorporated into highway concession contracts. However, the current valuation model used for rigid pavements is not adapted to the standards and conditions of such projects. This study develops a valuation model for rigid pavements of interurban highway concessions and evaluates it in a case study. The proposed model captures the loss in asset value associated with the performance degradation over time, considering a typical Jointed Plain Concrete Pavement (JCPC) configuration. The value is calculated using performance indicators that represent the structural capacity and level of service provided to road users. The model represents a significant improvement compared to current asset valuation models used in highway concessions. It enables the public agency to objectively evaluate the preservation of asset value carried out by the private partner during the concession. Additionally, it could also be used as a tool to establish payments between infrastructure stakeholders. Some of the concepts applied could also be relevant for other highway assets existing in Public–Private Partnership (PPP) projects.

A Comparative Study of Immediate Annuities and Ordinary Annuities in establishing the Phantom of Zero Liability Under the Trusteeship Pension Valuation Structure

Background: The liabilities of a pension scheme define the financial value to be paid at a definite period in the future. The underlying goal of pension plans is to provide retirees with sufficient stream of income to enable them to live a decent financially independent life post-employment period. The regulatory framework for occupational pension schemes necessitates the services of trustees as administrators who assume legal administrative responsibilities on the scheme and saddled to oversee actuarial valuations of the scheme's liabilities at definite points in time. Objectives: The objective of this paper is (i) to empirically examine the drivers of pension liability and how they are evaluated by the trustee’s model. (ii) Specifically, the study intends to use input parameters of the trustee model to establish the conditions for which the value of liability is zero under trusteeship annuity factor. Methods: This study applies trustees’ valuation model, the present values together with infinitesimal calculus. Salary data as well as demographic data were obtained from an agricultural production services company located in Jos-South, Nigeria. Results: Computational evidence from our results proves that the total service liability under the conditions of the current model is vanishingly zero. However, when the annuity factor is replaced by life table annuity, the service liability does not vanish. Conclusion: The total service liability obtained as zero therefore initiates inquiry as to whether this current valuation framework causes potential uncertainties for the pension trustees who are responsibly saddled with both administration and core decision-making responsibilities of the system.

Tackling the wicked challenge of climate change risks to property: are Australian valuers prepared?

PurposeThis research investigated Australian property valuers' identification and consideration of physical climate change risks in valuation practice.Design/methodology/approachThirty Australian valuer members of the Australian Property Institute from a variety of specialisations were interviewed. The semi-structured interviews explored climate change risks and the extent of risk investigation and consideration in valuation practice. The analysis utilised the Moser and Luers (2008) climate risk preparedness framework as a lens to evaluate current valuation practice in Australia.FindingsThe analysis reflects that while physical risks are easily identified and engaged with by valuers, correspondingly, there is a lack of understanding of and engagement with, climate change risks. This supports the need for better information sources and guidance to inform valuers of climate change risks and the development of specific mechanisms for the consideration of such risks to be included in valuation processes, practices and reports.Research limitations/implicationsThe research was limited by its sample size and qualitative approach. Therefore, the research is not a representative opinion of the Australian profession; however, the analysis provides the perspective of a range of valuers from across Australia with different valuation specialisations.Practical implicationsThis research has established that valuers have the potential to be prepared to address climate change in their professional capacity, as described by Moser and Luers (2008). However, they are constrained by information communication, access and detail and subsequent market awareness of information on climate change risk exposure on properties. There is a need for further support, guidance, information and tools, as well as awareness-raising, to enable valuers to accurately identify and reflect all risks affecting a property in the process of valuation.Originality/valueThis research provides the first investigation into the consideration of climate change in valuation practice. Property stakeholders—owners, investors, financiers and occupiers—are escalating their climate change risk analysis and reporting for property portfolios and organisations. This research suggests that valuers also need to be aware of the changing dynamics of market reporting and decision-making related to climate change risks to ensure appropriate reflection in valuation practice.

How can Circular Strategies be Implemented in Real Estate Valuation AN EXPLORATORY RESEARCH

The construction sector, as one of the world's greatest waste generators, is responsible for a cascade of events such as global warming, climate change, and natural resource depletion. Raw materials are continuously extracted from nature, and the rate at which they can refill is insufficient to meet demand. This system suffers significant losses across the value chain (Ellen MacArthur Foundation, 2013). On the contrary, the circular economy concept proposes a circular model of 'reuse-refurbish-recycle' that focuses on reducing waste and optimising resource value retention. The strategy is ideal to adopt in a high-growth, high-waste sector like the built environment. This research was taken up because a significant gap is seen within valuation practices. The current valuation methods, although efficient, collect data and provide property valuations based on previous studies. For example, when using a comparative method of property valuation, we compare one asset with a neighbouring one, that has similar features. This process incorporates the older values already provided to this old building, without accounting for innovations such as re-usability or adaptability of the components How different would the sector be if we incorporated the value of circular interventions to the original value determined, rather than looking back at older valuation standards? Will there be a significant difference, and, more importantly, would it impact the way real estate investors viewed circularity? In conducting the research, The primary hypothesis of this study was that there is a link between circularity and valuation and that this link can be incorporated within present valuation procedures. The thesis research explains how the connections can be made, as well as specific actual instances for each. The number of possible scenarios is endless.

Understanding Startup Valuation and its Impact on Startup Ecosystem

Abstract Startups play a substantial role in the economic growth of a nation, by introducing new technologies, ground-breaking innovation, creating jobs, etc. A couple of decades back, it was extremely difficult to start a business, but today new businesses pop up every day, all around the world. Recognizing the importance of a startup, governments across the globe are doing their best to provide an atmosphere where startups can bloom. Despite its importance and all the support, the startup failure rate is at 90%; about 10% of startups fail in the first year and 70% fail in two to five years. The startup boom saw the emergence of alternative sources of funding like Venture Capitalist, Angel Investors, etc. These investors (Venture Capitalist, Angel Investors, etc.) played a crucial role in startup success by providing easy access to funds which is a critical and scarce resource for any founder. Traditionally business success is linked with sustainable profitability but in the startup world most used method to define success is valuation. Based on CB Insights research, as of January 2022, there are more than 900 unicorns (startup with a valuation of over $1 billion) around the world and of these unicorns less than 10% are profitable. It’s difficult to explain/comprehend how startups’ which are neither profitable nor foresee profitability in near future are valued higher than traditional business with stable profitability. Current valuation methods have impacted the startup ecosystem. Today, founders start their business with exit in mind, the focus of founders is on growth/scale rather than profitability. There is a school of thought that believes that such valuations will soon result in the bursting of the startup bubble just like the dotcom bubble seen in late 1990s. The focus of this paper is to investigate the techniques used by investors for startup valuation and how these techniques are impacting the startup ecosystem and its founders. The paper looks at all stages of the investment cycle, from seed to IPO or takeover and understands the process of valuation at each stage and how it impacts all stakeholders in the ecosystem.

Accounting and audit of electronic transactions in metaverses

Introduction. The latest stage in the development of the Internet is the active use of VR and AR technologies, which in the context of virtualization of information processes leads to the spread of meta-environments. The functioning of metaverses, which are integrated information environments of virtual communications, is associated with the emergence and circulation of intangible objects, which requires the improvement of their accounting and auditing. The fundamental basis of financial and economic activities in the metaverses are electronic transactions, so it is important to improve their accounting and control in the management of enterprises. The main aim is to research the prospects for improving the accounting and auditing of electronic transactions, which provide for the formation of contractual relationships, their implementation and payment using cryptocurrencies in the metaverses.Methods.In the process of the article purpose realization the system, innovative, institutional approaches and methods of economic and mathematical modeling, bibliographic and comparative analysis are used.Results. The influence of the peculiarities of financial and economic activity in metaverses on the method of accounting is investigated. Recognition of NFT as an accounting object using variable methods of their estimation in metaverses is determined: initial value according to past identification of cost components, fair value through current valuation, market value according to market value and prospective value.The necessity of using audit control methods to ensure the trust of participants in electronic transactions in meta-environments, as well as to confirm the accuracy of their reporting and other accounting information. A method of identifying electronic transactions has been developed, which has the following features: trade scams; legalization of money obtained illegally; use by attackers. The method of auditing the enterprises activities in the metaverses has been improved: introduction of accounting outsourcing in the field of financial accounting of electronic transactions; separation of information flows, which relate only to virtual financial and economic operations in metaverses; research of the internal control service of enterprises, assessment of current experience and training of staff to work with specific virtual accounting objects; formation of financial statements reflecting intangible assets related to the functioning of meta-environments.Perspectives. It is determined that further research is needed to improve the taxonomy of standard financial reporting to fully and accurately reflect the new accounting objects of the metaverses.

The Interplay of Macro-Prudential Regulation and Microeconomic Financial Regulation in the European Union in 2011–2014

Though macro-prudential policy is usually aimed at mitigating financial instability, in the European Union it mainly consisted of a discretionary use of old policy tools, such as micro prudential measures, which might have worsened an ongoing financial crisis. Two episodes will be examined: the 2011 special recapitalization of banks and the 2014 Asset Quality Review and stress tests. The metric for the EBA 2011 recapitalization was the ratio of capital to risk-weighted assets. In this exercise, unlike Basel II and III prescriptions, all government bonds had to be accounted for at their current valuation. This feature has not yet been included in any piece of EU legislation and was therefore highly discretionary. Given the falling prices of some European countries’ government bonds, peripheral countries’ banks were in need of more capital. Therefore, they may have reduced credit, especially to SME, or worsened credit conditions. The 2014 stress tests examined the solvency of banks with the same metric and parameters taken from a macroeconomic scenario that was a remake of the 2007–2008 financial crisis. This contrasted with the macroeconomic reality of the time in which a restrictive fiscal policy was affecting firms’ cash flows and hitting, in particular, peripheral countries.

Changing tenant covenant perceptions and flexibility in the lease model in UK city centres

ABSTRACT The retailing industry in the UK is experiencing unprecedented structural change. The impact on retailers has often dominated headlines, along with the impacts on local services and economies, but with little attention given to the implications for property owners and practitioners. Exploring and understanding the responsiveness of landlords, and their behaviours, is essential to understanding the adaptiveness of a retailing system. This study employs semi-structured interviews to examine the short- and long-term changes in the retail market and the actions of landlords in response. The findings span the period prior to and during the first year of the Covid-19 pandemic in 2020, and reveal that fundamental changes have occurred to establish tenant covenant norms and the traditional retail leasing model. The paper explores these changes, including a shift in tenant risk, reposition of the leasing model in favour of tenants, generally, and greater application of turnover rents. The pressing challenge for current valuation practitioners, therefore, is to incorporate these fundamental changes within the market into the pricing of retail assets. Significant progress in this area to date, as explored in the paper, has been limited although greater application of discounted cashflow techniques is set to be encouraged by the RICS.

INTEGRATED REPORTING ADOPTION: SUSTAINABLE CORPORATE STRATEGY IN ACHIEVING SDG 2030

The environmental crisis has initiated companies to implement sustainability accounting as a business sustainability strategy. One indicator of this implementation based on POJK No 51/2017 is the availability of integrated reports (financial reports and sustainability reports) that can be accessed by the public. This paper aims to explain the essence of implementing sustainability strategy through adopting integrated reporting schemes in the company. Therefore, the company does not only implement it to the extent of fulfilling the demands of the government, but for the benefit of the company in the long term. The author uses a quantitative and qualitative analysis approach with the variable earnings per share and the growth of the company's stock price in the sector of financial services institutions and public companies. Furthermore, the author also analyses the fundamental weakness of the integrated reporting systematics which makes it difficult to compare between companies. This paper offers a universal measurement standard that can be used by external and internal parties of the company in assessing how far the company is implementing its sustainability strategy through creating integrated reports. This standard will prove the company's ability to maintain its business continuity in the long term and affect its current valuation. However, it cannot be denied that the sustainability strategy launched by the Indonesian government still has several weaknesses. Therefore, this paper also answer the challenges of the role of accountants in Indonesia in implement sustainability accounting, especially in adopting integrated reporting scheme.

Groundhog Day: research without old data and old references.

The use of older data and references is becoming increasingly disfavored for publication. A myopic focus on newer research risks losing sight of important research questions already addressed by now-invisible older studies. This creates a 'Groundhog Day' effect as illustrated by the 1993 movie of this name in which the protagonist has to relive the same day (Groundhog Day) over and over and over within a world with no memory of it. This article examines the consequences of the recent preference for newer data and references in current publication practices and is intended to stimulate new consideration of the utility of selected older data and references for the advancement of scientific knowledge. Examples from the literature are used to exemplify the value of older data and older references. To illustrate the recency of references published in original medical research articles in a selected sample of recent academic medical journals, original research articles were examined in recent issues in selected psychiatry, medicine, and surgery journals. The literature examined reflected this article's initial assertion that journals are emphasizing the publication of research with newer data and more recent references. The current valuation of newer data above older data fails to appreciate the fact that new data eventually become old, and that old data were once new. The bias demonstrated in arbitrary policies pertaining to older data and older references can be addressed by instituting comparable treatment of older and newer data and references.

Consumer Medicine's Origins and Harms.

Consumer medicine consists of medical interventions pursued for non-health-related goals with the locus of the goals residing solely with the patient. Currently, contraceptives, abortion, cosmetic procedures, and physician-assisted suicide (PAS)/euthanasia fall in this category. Consumer medicine originates from the fusion of expressive individualism with its sole focus on the subjective psychological well-being intersecting with an expansion of health now including well-being combined with an exaltation of autonomy. Expressive individualism is inward-focused and entirely subjective reducing the human to a psychologic self while instrumentalizing the biological and social dimensions and neglecting the spiritual dimension. Expressive individualism is currently manifested through economic activity (career and consumption) and particularly sexual expression. This contrasts with the holistic biopsychosocial-spiritual model of health with its deep inter-relationships and prioritization of the spiritual. Consumer medicine has damaged the profession of medicine. Physicians now have conflicting roles of healer versus body engineer, and conflicting obligations to do no harm while performing medical harms unrelated to objective health. There is now division within medicine and increasing external state regulations both seriously harming its professional status. The traditional teleologically driven ethical framework that is objectively disease-focused is now confused with a subjective list of non-health-related values as goals for medical interventions leading to an incoherent ethical framework. Biologic solutions best address biological problems and do not effectively address psychological, social, or even spiritual problems but rather make them worse. Medicine now reinforces and is complicit with expressive individualism and its attendant shallow and narrow understanding of what it means to be human with the current valuation of sexual expression and economic activity. Medical harms and social costs have resulted while challenging the value of those who are disabled, elderly, or marginalized. This shallow view has likely fueled the current existential crisis contributing to the marked increase in PAS/euthanasia in the West. Summary: Consumer medicine currently includes contraceptives, abortion, cosmetic procedures, and physician-assisted suicide (PAS)/euthanasia. These medical interventions are pursued for subjective non-health-related goals as opposed to the traditional goal of treating sick patients for their objective health. Consumer medicine's origins lie in the intersection of expressive individualism, the exaltation of patient autonomy combined with health's redefinition as subjective well-being. This has resulted in harms to the profession of medicine, ethical incoherence, and medical injury. Consumer medicine promotes a truncated understanding of the human at odds with the biopsychosocial-spiritual model and human flourishing. This has likely contributed to the rise of PAS/euthanasia.

Forms and Functions of the Social Emotions

In engineering, form follows function. It is therefore difficult to understand an engineered object if one does not examine it in light of its function. Just as understanding the structure of a lock requires understanding the desire to secure valuables, understanding structures engineered by natural selection, including emotion systems, requires hypotheses about adaptive function. Social emotions reliably solved adaptive problems of human sociality. A central function of these emotions appears to be the recalibration of social evaluations in the minds of self and others. For example, the anger system functions to incentivize another individual to value your welfare more highly when you deem the current valuation insufficient; gratitude functions to consolidate a cooperative relationship with another individual when there are indications that the other values your welfare; shame functions to minimize the spread of discrediting information about yourself and the threat of being devalued by others; and pride functions to capitalize on opportunities to become more highly valued by others. Using the lens of social valuation, researchers are now mapping these and other social emotions at a rapid pace, finding striking regularities across industrial and small-scale societies and throughout history.

Valuation Constellations

The focus on situated practices in current valuation studies becomes an obstacle when situations are too narrowly defined, when moments of valuation are treated as isolated events and especially when the interconnectedness of moments across situations and social fields is neglected. In order to overcome these limitations, we propose the concept of valuation constellations (Meier et al. 2016). Based on the literature on valuation the concept distinguishes positions and their relations, rules, and infrastructures. We present these three components of constellations and demonstrate the potential of the concept regarding three analytical puzzles of valuation analysis: historical change of valuation processes, the definition and solution of valuation problems, and the legitimacy of valuations. Each of the puzzles is illustrated with an empirical case, i.e. dating platforms and apps, higher education, and amateur reviewing. Going beyond situationalism, the valuation constellations perspective is key to understanding interconnected valuation processes.