Search

This was a fifteen-month research project (Jul 2019 ��� Oct 2021) funded by the Economic and Social Research Council (Risk sharing mechanisms to mitigate the financial consequences of pandemic risk: Economic and social insurance solutions for the UK (ES/V009389/1)) and carried out by researchers at City, University of London and Birkbeck, University of London. The pandemic has been causing critical business interruption (BI) across UK businesses, resulting in unprecedently widespread and global economic losses that are too large to be absorbed by the insurance industry. Many businesses had to stop trading for months due to nationally imposed lockdowns or had to deal with reduced revenues due to reduced demand or enforced reduced capacity. Yet, many businesses could not access BI insurance ��� either they had not already purchased it, or that BI insurance that they did purchase did not cover pandemic risk. They thus had no insurance payments to cover their losses from BI. Furthermore, given the systemic nature of the risk, even when all restrictions were removed by governments, the insurance industry was no longer offering BI insurance for pandemic, so that businesses could not buy it going forward to protect them from the losses of a future possible lockdown. As the government steps in to protect businesses, the burden for taxpayers is rising exponentially. There has been little, if any, understanding of how the economic burden that systemic risks such as pandemics cause to businesses can be shared through insurance-based mechanisms. This study sought to develop an understanding of the risk-sharing mechanisms that might enable the effective sharing of pandemic BI risk between UK businesses, insurers and the government. Through action research, we focused on enabling our partners to define the problem and act upon it. We partnered with UK businesses (Confederation of British Industry ��� CBI), the insurance industry (Association of British Insurers ��� ABI) and government stakeholders (Government Actuary's Department ��� GAD) in their efforts to develop a BI risk-sharing mechanism. Bringing in our knowledge and experience on risk-sharing mechanisms from around the globe for other catastrophic disasters, we worked with them in evaluating and developing BI interruption solutions to enable the continuation of UK businesses trading. We encouraged and supported a line of communication between the UK businesses, insurers and government for supporting UK businesses against interruption from current and future pandemics. Through this research, we sought to inform policy and practice in the emergent solutions of sharing BI risk in the UK. Having a closer and more granular look at how pandemic BI risk can be dealt with from a risk transfer point of view and with a clear focus on public-private partnerships, we developed a typology informed by the various proposals in the UK on possible solutions for BI insurance. Based on our action research, we developed this typology into a strategic response framework that evaluates four strategies for responding to pandemic risk for three audience groups: the insurance industry, government decision-makers and policymakers, and UK businesses. Data description (abstract) These data were generated as part of a fifteen-month ESRC-funded action research project aiming at enabling our key partners as they endavoured to generate solutions that can be applied to sharing business interruption (BI) risk from pandemic. The project involved: (1) attending meetings as participants where, as part of our action research objective we interacted closely with our partners, the UK businesses (Confederation of British Industry ��� CBI), the insurance industry (Association of British Insurers ��� ABI) and government stakeholders (Government Actuary's Department ��� GAD); and (2) collecting documentary data that we used to inform our understanding of the problem and the emerging solutions. The documentary data comprise (1) media articles around the problem of BI risk against the pandemic both in the UK and around the world, as well as the discussed and implemented solutions; (2) reports and announcements about the problem and the implemented solutions from the insurance industry, the UK businesses and the government; and (3) the evolving impact outcome of our action research that includes a media article, a report, and a practitioner paper that inform both industry and government action.

The pandemic has an ongoing financial impact on the global economy, resulting in its uninsurability and ultimately an insurance protection gap. While solutions exist to address other protection gaps caused by large-scale disasters such as repeated flooding, earthquakes, and terrorism, pandemics differ and require novel solutions. This paper builds on Jarzabkowski et al.’s (2018) strategic response framework to large-scale, catastrophic disasters and applies it to the pandemic insurance protection gap. Set in the U.K. context, the research empirically studies various insurance solutions that are being proposed for pandemic risk and presents and evaluates four types of responses.

Additional file 1: Questionnaire for the inventory analysis of ethics curricula at medical schools in Turkey.

Bu tez ile, Türkiye biyoetik çevrelerine anlatısallık kuramı ve anlatısal etik yaklaşımınıntanıtılması ve tıp etiği eğitiminin, ?ölüm ve ölümcül hastaya yaklaşım? konusunda planlananbölümünün verilmesinde anlatısal yöntemlerin etkililiğini sorgulamak hedeflenmiştir.Çalışmanın ilk bölümünde kapsamlı ve derleyici bir kuramsal inceleme yapılmıştır. İkincibölümde ise, ilgili eğitim ile öngörülen bilgi, beceri ve tutumların oluşturulmasında anlatısalyöntemlerin, öteki yöntemlerle etkililik açısından karşılaştırıldığı bir araştırmanın raporusunulmuştur. Burada amaç, belirli bir bağlamda da olsa anlatısal yöntemlerin tıp etiğieğitimdeki yerine dair somut ve genellebilir veriler elde etmektir. Bunun yanı sıra, ikincil biramaç olarak, ?ölüm ve ölümcül hastaya yaklaşım? konusunda ele alınan eğitimyöntemlerinin hangi açılardan başarılı ya da başarısız olduğunu saptanmaya çalışılmıştırAraştırma çerçevesinde, ?ölüm ve ölümcül hastaya yaklaşım? konusunda tıp fakültesi lisansdüzeyi öğrencilerinden oluşan küçük gruplara farklı yöntemler ile etik eğitimi verilmiştir.Çalışmaya 2007 yılı bahar döneminde, Ankara Üniversitesi Tıp Fakültesi'ndeki eğitimlerinedevam eden 3., 4., 5. ve 6. sınıf öğrencileri dahil edilmişlerdir. Başvuran gönüllü öğrenciler,rasgelleme yöntemi ile eğitim verilecek üç gruba ayrılmışlardır. Buna göre, birinci grup ?roloynama?yöntemi ile, ikinci grup ?seminer oturumları? yöntemi ile, üçüncü grup ise?anlatısal yöntemler? ile seçilen konuda hazırlanmış bir tıp etiği eğitimi programınakatılmışlardır. Dördüncü gruba ise, sadece bu grup için gönüllü olmak isteyen öğrencilerkatılmışlardır. Bu son gruba herhangi bir eğitim verilmemiş, gruptaki öğrenciler kendiolağan tıp eğitimlerine müdahalesiz bir şekilde devam etmişlerdir (kontrol grubu).Uygulamanın öncesinde ve sonrasında, her gruptaki öğrencilerden, aldıkları eğitim ilekazandırılması öngörülen tutum değişiklerini ölçmeye yönelik hazırlanan ?tutum ölçeği?nidoldurmaları istenmiştir (ön test ve son test).Eğitimden sonra, hem süreç boyunca her bir grubun kendi içinde ne yönde değiştiği, hem degrupların birbirlerine göre farklılaşıp farklılaşmadığı, son test puanlarının hesaplanmasıylaortaya konulmuştur. Buna göre, rol oynama ve anlatısal yöntemlerinin her ikisi de, ölçekkapsamında birer alt-ölçek olan dört boyut (?ölümcül hastalar ve yakınları ile iletişim?,?bakım sorumluluğunu devretme?, ?ölümcül hastadan kaçınma? ve ?öz-yeterlilik algısı?)açısından eğitimle hedeflenen tutumun (daha az kaçınıcı tutum) kazandırılmasında etkilidir.Seminer yöntemi ise bu boyutlardan sadece ikisi (?bakım sorumluluğunu devretme? ve?ölümcül hastadan kaçınma?) açısından istenen yönde tutum değişikliği yaratabilmiştir.Diğer iki boyut (?ölümcül hastalar ve yakınları ile iletişim? ve ?öz-yeterlilik algısı?)açısından grubun son test puanları göz önüne alındığında Seminer Grubu'nun hedeflenentutum değişikliğini gerçekleştiremediği söylenebilir. Rol oynama ve anlatısal yöntemleri,açık ki, hedeflenen tutum değişikliğine ulaşmakta seminer yöntemine göre daha etkilidir.Bu sonuçlar her bir yöntemin etkililiği açısından tartışılmıştır. Anlatısal yöntemlerin, biruygulamalı etik biçimi olan tıp etiği eğitiminde kayda değer bir etkiliğe sahip olduğukanıtlanmıştır. The purpose of this thesis study is to introduce narrative theory and narrative ethics approachto Turkish bioethics scholars and to question the efficacy of narrative methods in giving astructured part of ?approach to death and dying? ethics education. In the first section acomprehensive theoretical review was presented. In the second section a research study wasreported in which narrative methods were compared to other methods in terms of efficacy ineducating and teaching the skills and attitudes to students. The objective of the research was,whether in some certain context, to obtain specific and generalizable data about the role ofnarrative methods in medical ethics education. In addition to that, the secondary objective isto determine in which aspects the applied methods succeeded or failed regarding the topic of?approach to death and dying?.Within the framework of this research, small groups of medical students were given ethicseducation on the topic of ?approach to death and dying?, however for each of them adifferent method was applied. Students from 3rd, 4th, 5th and 6th grades of Ankara University,School of Medicine were included in the study. These students, who applied voluntarily,were divided randomly into three groups. The first group attended an education programusing the ?role play? method, the second group was educated by the ?seminar? method andthe third group was exposed to ?narrative? methods. Students who specifically volunteeredwere included in the fourth group, where they were not given any education and theycontinued their usual medical education without any intervention (control group). Before andafter the application of the education program, students from each group were asked to fill inthe ?attitude scale? which was prepared to measure the changes in the attitude, foreseenas theoutcome of the educational intervention (pre-test and post-test).After the educational phase, both whether the groups had showed any difference in theirattitudes and if so, in which direction each single group had changed were determined bycalculating their post-test points. According to these results, both role play group (Group 1)and narrative group (Group 3) showed a significantly ?less thanatophobic? attitude in all fourmeasured dimensions: 1) communication with dying patients and their relatives, 2) turningover the responsibility of care, 3) avoiding contact with the dying patient, 4) self-competencyperception. This means that role play and narrative methods are fully/most effective.However, the seminar method evoked a change in attitude only in two dimensions: turningover the responsibility of care and avoiding contact with the dying. It is obvious that roleplay method and narrative methods are more effective than seminar method in striving forthe change of attitude towards a less thanatophobic approach to death and dying.These results were discussed in detail from the point of view of efficacy of eachmethod/group and the reasons lying beneath them. In addition to that, this research studydemonstrates/proves that narrative methods have significant efficacy in medical ethicseducation. 291

Enerji üretimi amacıyla oluşturulan enerji santrallarının coğrafi olarak denize yakın bölgelerde geliştirildiği durumlarda; santralın kondansör ünitesinin soğutulması amacıyla kullanılacak soğutma suyunun alınacağı kaynak, en yakındaki deniz olacaktır. Bu durumda, soğutma suyu alma sistemleri hem deniz içi hem kıyı yapıları olarak birlikte düşünülerek planlanır. Bu çalışmanın birinci bölümünde, soğutma suyu sistemlerinin genel bir tanımı, amacı ve bir soğutma suyu sisteminde en genel şekliyle bulunması gerekli kısımlar belirtilmiştir. İkinci bölümde, soğutma amacıyla denizden alınacak suyun projelendirilmesi sırasında gereken başlangıç kriterleri olan su sıcaklığı ve su debisi kriterleri anlatılmıştır. Ayrıca sistem tasarımında dikkate alınması gerekli işletme koşulları, çevresel etkiler, deniz kıyısı ve deniz tabanı üzerindeki etkiler, deniz suyu sıcaklığı üzerindeki olası etkiler, kimyasal değerlendirmeler, deprem faktörü ve diğer sınırlamalar incelenmiştir. Üçüncü bölümde, deniz meteorolojisi ve iklimsel veriler, sismik ve geoteknik veriler, genel inşaat verileri, sisteme etkiyen yük verileri, zemin parametreleri ve boru iç hidroliği hesapları gibi proje tasarım verileri açıklanmıştır. Çalışmanın dördüncü bölümü boyunca daha önce işletmeye geçirilmiş deneyimlerden olan Kemerköy Termik Santralı için geliştirilen soğutma suyu alma sistemi alternatifleri ayrı ayrı ve karşılaştırılmalı olarak incelenmiştir. Beşinci bölümde, Türkiyede uygulanmış soğutma suyu deneyimleri ışığı altında su alma ağızlarının tasarım parametreleri ve işlemleri, su alma ağzı elemanları (kısımları) ve montaj işlemleri detaylı olarak genelleştirilmiştir. Altıncı bölümde, sistemin diğer bir etabı olan deniz kıyısı yapıları, uygulanan deneyimlere paralel olarak ayrı ayrı ve her birine ait tasarım verileri ve kriterleri değerlendirilmiştir. Yedinci bölümde, soğutma suyu alma sistemlerinin inşaat aşamaları adım adım ve detaylı olarak anlatılmıştır. Sekizinci bölümde, soğutma suyu sistemi su alma ve su boşaltım yapılarının kıyı dinamiği üzerindeki etkileri, doğal kıyı hareketi hesapları ve sistem metodolojisi incelenmiş ve sonuçları değerlendirilmiştir. Dokuzuncu bölümde, deniz içi yaşamının sistem üzerine etkileri ele alınmıştır. Onuncu bölümde, deniz suyundaki dalga ve akıntı etkileriyle gelişen kum ve yosun hareketleri Kemerköy Termik Santralı çalışma raporları hesap örnekleriyle desteklenerek incelenmiştir. Son bölümde ise bu çalışma boyunca tüm bölümlerde anlatılanlardan elde edilen sonuçlar özet olarak verilmiştir. In our country, the increasing demand for energy with parallel to the rapid augmentation in population, the migration to the big cities and the progressive industrialization has resulted in some changes in production-consumption policies. Due to this demand for energy, the government allowed private sector to establish their own energy production complexes. In the area of building new power plants, the efforts of the private sector began to grow up as well as those of the government. The initiation of fielding seawater intake systems for cooling purposes in our country coincides with the establishments of new power plants. The condenser unit which is a part of power plant warms up through its operation state, and this causes a significant decrease in productivity, various malfunctions and serious operation problems. Avoiding those problems mentioned above requires a cooling system for the condenser unit. In a case that a power plant is settled geographically close to sea, cooling of the condenser unit by means of a system producing the conditioned seawater becomes the most relevant solution both technically and economically. In this study, the extraction and the conveying of sea water for cooling purposes of the power plants those are built near coastal environments and water collection and conditioning installations were examined in a general scope. During the preperation of this study, the study reports and experiences of the cooling water systems for Kemerköy Thermal Power Plant were basically utilized additionally to severe applications and experimentations. While exploiting those references, it was tried to support this study with a broad theoretical knowledge extracted from different resources. In the first chapter, the need for sea water intake systems for cooling purposes and the cases causing that requirement were discussed. It was emphasized that two major criterias for cooling water system of a plant are cooling water quantity and the temperature. The specialized study teams required during the initial design phases of the system and the alternate intake system were briefly mentioned as well. Additionally, the major parts of a sea water intake system and almost every subordinate components of them were identified in detail. The objectives of this study were also explained in this chapter. A seawater intake system for cooling purposes consists of : 1 -Intake head and pipeline, 2-Conditioning system for the condenser and the condenser unit itself, 3-Discharge line of the heated water. These three major parts are composed of following subordinate components those are case-dependent in sequence: 1 -Intake head, 2-Offshore intake pipeline, 3-Water conveyor channels, 4-Water collection reservoirs, 5-Conditioning systems (screens, precipitation pools, inlet and outlet lids, etc.)6-Pumphouses, 7-Water conveyor channels and pipelines to the condenser, 8-Condenser, 9-Outfall pipes 10-Used water collecting weir box, 1 1 -Outfall channells(culverts), 12-Outfall tank, 13 -Discharge pipes. In the second chapter, two major criterias briefly mentioned in the first chapter were explained in a more detailed manner. The former is the temperature in that cooling water should be to cool the condenser within the required limits. The latter is the cooling water quantity. The water extraction in a required level of temperature depends on the proper determination of the sea depth that is to be reached in accordance with the geographical aspects and the climatic conditions of that environment. Because the water temperatures reached within the same level of depth can vary due to different geographical aspects and different climatic conditions. On the other hand, the temperature falls in a high rate as the depth between top and bottom levels of sea rises. Place where this fall is observed is called as `thermocline`. Thermocline layers have different characteristics with respect to the geographical conditions, seasons, sea water currents. It is possible to group thermoclines in three categories: `permanent thermocline` in an extreme depth where an intake head is not considered to be placed; `seasonal thermocline `existing seasonally -that is- in general beginning in spring and ending in fall; and `daily thermocline` that occurs only in daytime. The effects of the depth reached on the design and construction steps such as assembly and selection of pipes are also discussed in this chapter. Cooling water quantity is calculated as an outcome of the technical requirements of the condenser unit. Another initial criteria for determination of pipe diameter, type and material, pipe assembly techniques and dimensioning of the installations where water will be stored and conditioned onshore is the acquisition of the water that can meet the required water quantity within a desired level of temperature. At the end of this chapter, the general design principles were examined in such a following order: - Operation conditions, - Minimization of environmental impacts, - Safety measures against earthquake, - Optimization in operation and maintenance, - Minimization of construction costs. In the third chapter, the project design data including meteomarine and climatic conditions (air and seawater temperature, seawater currents, wind affects sea tidal characteristics), seismic and geotechnical data, general construction data (design life, design standards, environmental data, traffic loads), load definitions, soil parameters, pipe hydraulics calculation data (Darcy-Weisbach, Colebrook-White and Manning Strickler equations) was examined. -XH-Chapter four was prepared entirely in the light of study reports dated 1990 construction experimentations about the cooling water system of Kemerköy Thermal Power Plant. In this chapter, three different seawater intake systems developed for that plant were seperately explained and then a comparative outcome assessment was included. The first one of those three alternatives includes channel shaped dikes extending offshore and protective structure in front of them. The second one consists of offshore pipeline and water intake structure. The third one is the system based on the principles of conveying seawater to shore through pipes carried by a wharf structure and seawater withdrawal via a syphon system with vacuum pumps. Throughout the part related those three different solutions above, they were compared in respect of thermal recirculation, seismic resistance, impact on the sea shore and the sea bottom, visual impact, limitations to the navigations, optimization of operation and maintenance, construction costs and construction flexibility. Chapter 4 also includes the detailed drawings of those alternatives which are developed for Kemerköy Thermal Power Plant by T.E.A.Ş. In Chapter five, as a common component of all the alternative solutions presented in the former chapter, intake heads were examined solely. All design parameters and structural design procedurs were explained in detail. Additionally, all the components of intake heads (including intake head body, intake head cap, flexible joint and remainder) were described in relation to its shapes, materials and functions as well as the assembly techniques. The intake head should be designed to provide the safety against three major load described as follows: 1 -Hydrodynamics loads, 2-Seismic loads, 3-Lifting force loads. During the design process of intake head, the soil stability analysis should be performed to provide the results given below: -Bearing capacity, -Sliding stability, -Overturning stability, -Soil settlements. As the consequent phase of offshore intake heads, the onshore structures were discussed in the chapter six. They are composed of an open channel linking the offshore structures to the pumphouse, water collecting reservoirs, pumphouses, and the delivery and outfall pipelines. Onshore structures are projected on the basis of three major load impacts -those are permanent, enviromental and operational loads. While proceeding the design phases of onshore structure, stability checks against the potential floating possibilities caused by underground water, determination of soil safety coefficients and the soil settlement checks should be performed. Then a sectional determination of the onshore structure should be implemented under those following load impacts: -xiii-1 -Self weight of structure, 2-Soil weight and lateral pressure, 3 -Outer hydrostatic pressure, 4-Horizontal and vertical traffic loads, 5-Internal water hydraulic pressure, 6-Corresponding thermal impacts. In the Chapter seven, the assembly techniques of intake heads and construction phases of offshore pipeline were explained in general. During the construction phase of offshore pipelines, pipe spannings should be as long as possible. So this will enhance not only the resistance of the pipes against earthquake but also the speed of piping. Laying process of the intake pipes assembled in the longest span as much as possible is performed using launching ramps with appropriate trolleys and they are pulled over the sea by boats. Once the dredging and soil improvement along the offshore pipeline, pipes should be launched in the sea. By means of this procedure, pipeline settlements and the risque of soil liquefaction could be avoided. During the soil improvement and dredging process, (by using the vibration technique), the trench bottom is levelled with a layer of graded materials up to the actual foundation level of the intake head. Also in this chapter, the friction impacts that the pipes will be exposed to during the launching process were identified as follows: -Friction of the pipe on the sea bottom, -Friction of the trolleys on the launching ramp, -Friction of the pulling cable on the sea bottom. By the time of pipe assembly, each intake pipe connects to the intake head and to the concrete culvert through connecting pipes and expansion joints. On the other hand, during the launching pipe process, intake heads and intake pipes are closed with the blind flange which prevent marine fouling. Another subject included in this chapter, is to provide temporary cathodic protection against corrosion impact caused by seawater and to backfill the pipeline. In the Chapter eight, shore dynamics were touched on within its general concepts. While examining the shore dynamics, there can be spoken of two general approaches-those are: the determination of impacts of the offshore structures on onshore and sea bottom morphology, and the examination of the impacts of the shore dynamics on the pipelines and shore structures during all operation life. As the natural evolution of shore is being examined, the aspects of wave actions and sea currents are determined by the help of specifis mathematical modellings those are calculated within the local effective winds. Consequently, shore material actions and the shore evolution estimations are provided in accordance with the wave and current data obtained. The place where the shore material motions are most frequently observed is called as `surf zone `. At the same time the `surf zone` is the place where the waves are broken and lose the large amount of their enrgy due to the sea bottom frictions and turbulence, the other local characteristics such as wind, currents, flood, tide are influencial on the shore dynamics as well. -xiv-The subject of Chapter nine is the protection against the sea life that means all the creatures including fish, shell-fish, vegetations living in the sea. The existence of them in the water-cooling system may cause some undesired malfunctions and extra ordinary operation costs, however, those unusual conditions can be prevented by means of some protective systems. Combat against the sea creatures can be performed using two different methodologies. Thermal method, is based on use of the hot water provided in the condenser unit for demolishing them. The second one called as `chemical method` can be summarized as the use of chlorination and oxygen reducer chemical agents for the same purpose. Thermal method is performed by conveying the hot water obtained in the condenser unit to the areas where the sea creatures lives on during the discharging operation. On the other hand, chlorination technique is applied on the zones such as intake heads, both ends of the pipelines, water collection weir boxes, pumphouses and all along the discharge lines. However, as chloration is applied, it is to be noticed that the chlorized solution should be within the limited values for preventing environmental contamination. In the Chapter ten, the subject was specified as sand and seaweed motions carried within the seawater. This subject was examined under three main title as follows: 1-The sand movements caused by sea bottom currents and wave impacts occurred in the depth of intake location. 2-Sand circulation inthrough the cooling water pipelines and water- conveying lines. 3-Seaweed movements based on the distribution of wave energy in the sea., The sand granule movements in the sea bottom depends on material, shape, immersed specific gravity and resistance coefficient. Other factors affecting the sand movements are the local meteomarinal, geographical and oceanographical characteristics. In the analysis of this movement, the minimum initiative velocity priorly should be identified. However, the sea weed are mostly related to the wave energy. The velocity of the water particules possessing kinetic energy which is one of the wave energy components is an influencial matter for the seaweed movements. As reaching to the deeper in depth, the value of wave energy lows with the rate of square times of the depth value. For this reason, the sea weed movements are rather appeared in the upper sea levels. In the last Chapter, a final evaluation of all the topics mentioned about throughout the study was made within a clear understanding. As a conclusion of this evaluation, seawater intake stuctures for cooling water systems has been summarized in a brief manner. 139