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Authors: Sitarrine Thongpussawal, Hui Shao, Clark Gantzer

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Terracing is a conservation practice to reduce erosion and widely used for soil and water conservation throughout the world but is relatively expensive. A modification of the Soil and Water Assessment Tool (called SWAT-Terrace or SWAT-T) explicitly aims to improve the simulation of the hydrological process of erosion from the terraces. SWAT-T simulates erosion from the terraces by separating terraces into three segments instead of evaluating the entire terrace. The objective of this work is to evaluate the terrace benefits on erosion from the Goodwater Creek Experimental Watershed (GCEW) at watershed and Hydrologic Response Unit (HRU) scales using SWAT-T. The HRU is the smallest spatial unit of the model, which lumps all similar land uses, soils, and slopes within a sub-basin. The SWAT-T model was parameterized for slope length, steepness and the empirical Universal Soil Erosion Equation support practice factor for three terrace segments. Data from 1993-2010 measured at the watershed outlet were used to evaluate the models for calibration and validation. Results of SWAT-T calibration showed good performance between measured and simulated erosion for the monthly time step, but poor performance for SWAT-T validation. This is probably because of large storms in spring 2002 that prevented planting, causing poorly simulated scheduling of actual field operations. To estimate terrace benefits on erosion, models were compared with and without terraces. Results showed that SWAT-T showed significant ~3% reduction in erosion (Pr <0.01) at the watershed scale and ~12% reduction in erosion at the HRU scale. Studies using the SWAT-T model indicated that the terraces have advantages to reduce erosion from terraced-agricultural watersheds. SWAT-T can be used in the evaluation of erosion to sustainably conserve the soil and water.

Keywords: Erosion, Modeling, Terraces, SWAT

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Authors: Ali Abu Ali, Mohammad Salhab

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Introduction: In the Middle East and North Africa (MENA) microfinance struggles to find momentum. The Lebanese economy has been struggling through the years due to domestic and external, political and social instability. Although as of 2014 there are around 23 MFIs that are mainly subsidized by the USAID, operating in the country, the Lebanese microfinance market is mostly dominated by three microfinance institutions: Al Majmoua, Vitas, and Al Quard Al Hassan Association. Methodology: A quantitative approach using a standardized questionnaire would analyse the perception of the average Lebanese towards microfinance. A questionnaire was designed and validated. Results: Almost half of the respondents earn a monthly income ranged between $100 and $600. Almost 52% of the respondents were university graduates, around 25% finished secondary and high school, and 12% hold a masters or MBA degree. Topic understanding towards microfinance differs across Lebanese areas. The highest percentage of respondents who claim that microfinance offers financial services to low income people are the residents of Beirut (35.1%), Bekaa (30.8%), and South of Lebanon (24.7%). Higher levels of topic understanding were associated with lower levels of age range. Al Quard el Hassan foundation was regarded as the most known micro financial institution operating in Lebanon. In general, Lebanese people tend to believe that microfinance can play an important role in reducing unemployment rates and poverty levels in Lebanon. When people were asked what would motivate you to get a loan from MFIs, most of the respondent (57.4%) across all the Lebanese region claimed that it was the need for money to satisfy a need such as paying back a loan, to fix something at home, or for self-consideration like buying a car. Conclusion: Our findings showed that in general Lebanese tend to have a positive perception towards microfinance. However, most Lebanese perceive microfinance as the process of just providing loans without specifying for whom it is intended. We advise that government introduces laws to regulate the microfinance market.

Keywords: microfinance, economics, finance, business, analysis, theory

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Authors: Marc Evenst Jn Jacques, Sophie Bernard

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Electrical and electronic applications, as well as rechargeable batteries, are common in any economy. They also contain a number of important and valuable metals. It is critical to investigate the impact of these new materials or volume sources on the metal market dynamics. This paper investigates the impact of responsible recycling within the European region on metal price volatility. As far as we know, no empirical studies have been conducted to assess the role of metal recycling in metal market price volatility. The goal of this paper is to test the claim that metal recycling helps to cushion price volatility. A set of circular economy indicators/variables, namely, 1) annual total trade values of recycled metals, 2) annual volume of scrap traded and 3) circular material use rate, and 4) information about recycling, are used to estimate the volatility of monthly spot prices of regular metals. A combination of the GARCH-MIDAS model for mixed frequency data sampling and a simple GARCH (1,1) model for the same frequency variables was adopted to examine the potential links between each variable and price volatility. We discovered that from 2010 to 2019, except for Nickel, scrap consumption (Millions of tons), Scrap Trade Values, and Recycled Material use rate had no significant impact on the price volatility of standard metals (Aluminum, Lead) and precious metals (Gold and Platinum). Worldwide interest in recycling has no impact on returns or volatility. Specific interest in metal recycling did have a link to the mean return equation for Aluminum, Gold and to the volatility equation for lead and Nickel.

Keywords: recycling, circular economy, price volatility, GARCH, mixed data sampling

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Authors: O. Ubani, H. I. Atagana, M. S. Thantsha

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This study was conducted to measure the reduction in polycyclic aromatic hydrocarbons (PAHs) content in oil sludge by co-composting the sludge with pig, cow, horse and poultry manures under laboratory conditions. Four kilograms of soil spiked with 800 g of oil sludge was co-composted differently with each manure in a ratio of 2:1 (w/w) spiked soil:manure and wood-chips in a ratio of 2:1 (w/v) spiked soil:wood-chips. Control was set up similar as the one above but without manure. Mixtures were incubated for 10 months at room temperature. Compost piles were turned weekly and moisture level was maintained at between 50% and 70%. Moisture level, pH, temperature, CO2 evolution and oxygen consumption were measured monthly and the ash content at the end of experimentation. Bacteria capable of utilizing PAHs were isolated, purified and characterized by molecular techniques using polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE), amplification of the 16S rDNA gene using the specific primers (16S-P1 PCR and 16S-P2 PCR) and the amplicons were sequenced. Extent of reduction of PAHs was measured using automated soxhlet extractor with dichloromethane as the extraction solvent coupled with gas chromatography/mass spectrometry (GC/MS). Temperature did not exceed 27.5O°C in all compost heaps, pH ranged from 5.5 to 7.8 and CO2 evolution was highest in poultry manure at 18.78 µg/dwt/day. Microbial growth and activities were enhanced. Bacteria identified were Bacillus, Arthrobacter and Staphylococcus species. Results from PAH measurements showed reduction between 77 and 99%. The results from the control experiments may be because it was invaded by fungi. Co-composting of spiked soils with animal manures enhanced the reduction in PAHs. Interestingly, all bacteria isolated and identified in this study were present in all treatments, including the control.

Keywords: bioremediation, co-composting, oil refinery sludge, PAHs, bacteria spp, animal manures, molecular techniques

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Authors: M. T. Islam, S. H. Shakif, R. Hasan, S. H. Kobi

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Investigation of rainfall trends is crucial considering climate change, food security, and the economy of a particular region. This research aims to study seasonal and annual precipitation trends and their abrupt changes over time in the south-central climatic zone of Bangladesh using monthly time series data of 50 years (1970-2019). A trend-free pre-whitening method has been employed to make necessary adjustments for autocorrelations in the rainfall data. Trends in rainfall and their intensity have been observed using the non-parametric Mann-Kendall test and Theil-Sen estimator. Significant changes and fluctuation points in the data series have been detected using the sequential Mann-Kendall test at the 95% confidence limit. The study findings show that most of the rainfall stations in the study area have a decreasing precipitation pattern throughout all seasons. The maximum decline in the rainfall intensity has been found for the Tangail station (-8.24 mm/year) during monsoon. Madaripur and Chandpur stations have shown slight positive trends in post-monsoon rainfall. In terms of annual precipitation, a negative rainfall pattern has been identified in each station, with a maximum decrement (-) of 14.48 mm/year at Chandpur. However, all the trends are statistically non-significant within the 95% confidence interval, and their monotonic association with time ranges from very weak to weak. From the sequential Mann-Kendall test, the year of changing points for annual and seasonal downward precipitation trends occur mostly after the 90s for Dhaka and Barishal stations. For Chandpur, the fluctuation points arrive after the mid-70s in most cases.

Keywords: trend analysis, Mann-Kendall test, Theil-Sen estimator, sequential Mann-Kendall test, rainfall trend

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Authors: Adedolapo Ayoade, John the Beloved Dada

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This study identified the phytoplankton assemblage of the Dandaru Lake (that received effluents from a zoological garden and hospital) as bioindicators of water quality. Physicochemical parameters including Dissolved Oxygen (DO), biochemical oxygen demand, nitrate, phosphate and heavy metals were also determined. Samples of water and plankton were collected once monthly from April to September, 2015 at five stations (I – V). The mean physicochemical parameters were within the limits of National Environmental Standards and Regulations Enforcement Agency (NESREA) and USEPA except Lead, 0.02 ± 0.08 mg/ L; Manganese, 0.46 ± 1.00 mg/ L and Zinc, 0.05 ± 0.17 mg/ L. Means of DO, alkalinity, and phosphate were significantly different between the stations at p < 0.05. While highest mean DO (6.88 ± 1.34 mg/L) was recorded in station I with less anthropogenic activities, highest phosphate concentration (0.28 ± 0.28 mg/L) occurred in station II, the entry point of wastewater from hospital and zoological garden. The 147 phytoplankton species found in the lake belonged to six classes: Chlorophyceae (50), Euglenophyceae (40), Bacillariophyceae (37), Cyanophyceae (17), Xanthophyceae and Chrysophyceae (3). The order of abundance for phytoplankton was Euglenophyceae (49.77%) > Bacillariophyceae (18.00%) > Cyanophyceae (17.39%) > Chlorophyceae (13.7%) > Xanthophyceae (1.06%) > Chrysophyceae (0.02%). The stations impacted with effluents were dominated by members of Euglenophyceae (Station III, 77.09%; IV, 50.55%) and Cyanophyceae (Station II, 27.7%; V, 32.57%). While station I was dominated by diatoms (57.98%). The species richness recorded was 0.32 – 4.49. Evenness index was highest in station I and least in station III. Generally, pollution tolerant species (Microcystis, Oscillatoria, Scenedesmus, Anabaena, and Euglena) showed greater density in areas impacted by human activities. The phytoplankton assemblage and comparatively low biotic diversity in Dandaru Lake could be attributed to perturbations in the water column that exerted selective effects on the biological assemblage.

Keywords: manmade lake, Nigeria, phytoplankton, water quality

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Authors: Asteria Nsamba

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Social networking applications and tools have become compelling platforms for generating and sharing knowledge across the world. Social networking applications and tools refer to a variety of social media platforms which include Facebook, Twitter WhatsApp, blogs and Wikis. The most popular of these platforms are Facebook, with 2.41 billion active users on a monthly basis, followed by WhatsApp with 1.6 billion users and Twitter with 330 million users. These communication platforms have not only impacted social lives but have also impacted students’ learning, across different delivery modes in higher education: distance, conventional and blended learning modes. With this amount of interest in these platforms, knowledge sharing has gained importance within the context in which it is required. In open distance learning (ODL) contexts, social networking platforms can offer students and teachers the platform on which to create and share knowledge, and form learning collaborations. Thus, they can serve as support mechanisms to increase interactions and reduce isolation and loneliness inherent in ODL. Despite this potential and opportunity, research indicates that many ODL teachers are not inclined to using social media tools in learning. Although it is unclear why these tools are uncommon in these environments, concerns raised in the literature have indicated that many teachers have not mastered the art of teaching with technology. Using technological, pedagogical content knowledge (TPCK) and product quality theory, and Bloom’s Taxonomy as lenses, this paper is aimed at; firstly, assessing the quality of three social media applications: Facebook, Twitter and WhatsApp, in order to determine the extent to which they are suitable platforms for teaching and learning, in terms of content generation, information sharing and learning collaborations. Secondly, the paper demonstrates the application of teaching, learning and assessment using Bloom’s Taxonomy.

Keywords: distance education, quality, social networking tools, TPACK

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Authors: Arragaw Alemayehu, Woldeamlak Bewket

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The aim of this study was to understand the influence of current climate variability on crop production in the central highlands of Ethiopia. We used monthly rainfall and temperature data from 132 points each representing a pixel of 10×10 km. The data are reconstructions based on station records and meteorological satellite observations. Production data of the five major crops in the area were collected from the Central Statistical Agency for the period 2004-2013 and for the main cropping season, locally known as Meher. The production data are at the Enumeration Area (EA ) level and hence the best available dataset on crop production. The results show statistically significant decreasing trends in March–May (Belg) rainfall in the area. However, June – September (Kiremt) rainfall showed increasing trends in Efratana Gidim and Menz Gera Meder which the latter is statistically significant. Annual rainfall also showed positive trends in the area except Basona Werana where significant negative trends were observed. On the other hand, maximum and minimum temperatures showed warming trends in the study area. Correlation results have shown that crop production and area of cultivation have positive correlation with rainfall, and negative with temperature. When the trends in crop production are investigated, most crops showed negative trends and below average production was observed. Regression results have shown that rainfall was the most important determinant of crop production in the area. It is concluded that current climate variability has a significant influence on crop production in the area and any unfavorable change in the local climate in the future will have serious implications for household level food security. Efforts to adapt to the ongoing climate change should begin from tackling the current climate variability and take a climate risk management approach.

Keywords: central highlands, climate variability, crop production, Ethiopia, regression, trend

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Authors: Abdulraaof H. Alqaili, Hamad A. Alsoliman

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Through progress in pavement design developments, a pavement design method was developed, which is titled the Mechanistic Empirical Pavement Design Guide (MEPDG). Nowadays, the evolution in roads network and highways is observed in Saudi Arabia as a result of increasing in traffic volume. Therefore, the MEPDG currently is implemented for flexible pavement design by the Saudi Ministry of Transportation. Implementation of MEPDG for local pavement design requires the calibration of distress models under the local conditions (traffic, climate, and materials). This paper aims to prepare data for calibration of MEPDG in Central Saudi Arabia. Thus, the first goal is data collection for the design of flexible pavement from the local conditions of the Riyadh region. Since, the modifying of collected data to input data is needed; the main goal of this paper is the analysis of collected data. The data analysis in this paper includes processing each: Trucks Classification, Traffic Growth Factor, Annual Average Daily Truck Traffic (AADTT), Monthly Adjustment Factors (MAFi), Vehicle Class Distribution (VCD), Truck Hourly Distribution Factors, Axle Load Distribution Factors (ALDF), Number of axle types (single, tandem, and tridem) per truck class, cloud cover percent, and road sections selected for the local calibration. Detailed descriptions of input parameters are explained in this paper, which leads to providing of an approach for successful implementation of MEPDG. Local calibration of MEPDG to the conditions of Riyadh region can be performed based on the findings in this paper.

Keywords: mechanistic-empirical pavement design guide (MEPDG), traffic characteristics, materials properties, climate, Riyadh

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Authors: Nyimas Annissa Mutiara Andini

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Every year, children develop hydrocephalus during the first year of life. If it is not treated, hydrocephalus can lead to brain damage, a loss in mental and physical abilities, and even death. To be treated, first, we have to do a proper diagnosis using some examinations especially to detect hydrocephalus earlier. One of the examination that could be done is using a head circumference measurement. Increased head circumference is a first and main sign of hydrocephalus, especially in infant (0-1 year age). Head circumference is a measurement of a child's head largest area. In this measurement, we want to get the distance from above the eyebrows and ears and around the back of the head using a measurement tape. If the head circumference of an infant is larger than normal, this infant might potentially suffer hydrocephalus. If early diagnosis and timely treatment of hydrocephalus could be done most children can recover successfully. There are some problems with early detection of hydrocephalus using regular tape for head circumference measurement. One of the problem is the infant’s comfort. We need to make the infant feel comfort along the head circumference measurement to get a proper result of the examination. For that, we can use a helpful stuff, like a hat. This paper is aimed to describe the possibility of using a head circumference measuring instrument for early detection of hydrocephalus in an infant with a mike hat, coloured-tape-in-hat. In the first life, infants’ head size is about 35 centimeters. First three months after that infants will gain 2 centimeters each month. The second three months, infant’s head circumference will increase 1 cm each month. And for the six months later, the rate is 0.5 cm per month, and end up with an average of 47 centimeters. This formula is compared to the WHO’s head circumference growth chart. The shape of this tape-in-hat is alike an upper arm measurement. This tape-in-hat diameter is about 47 centimeters. It contains twelve different colours range by age. If it is out of the normal colour, the infant potentially suffers hydrocephalus. This examination should be done monthly. If in two times of measurement there still in the same range abnormal of head circumference, or a rapid growth of the head circumference size, the infant should be referred to a pediatrician. There are the pink hat for girls and blue hat for boys. Based on this paper, we know that this measurement can be used to help early detection of hydrocephalus in an infant.

Keywords: head circumference, hydrocephalus, infant, mike hat

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Authors: Dibakar Sahoo, Sridevi Gummadi

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The focus of the study is to empirically analyse the climatic impacts on foodgrain yield and its variability across seasons and altitudes in Odisha, one of the most vulnerable states in India. The study uses Just-Pope Stochastic Production function by using two-step Feasible Generalized Least Square (FGLS): mean equation estimation and variance equation estimation. The study uses the panel data on foodgrain yield, rainfall and temperature for 13 districts during the period 1984-2013. The study considers four seasons: winter (December-February), summer (March-May), Rainy (June-September) and autumn (October-November). The districts under consideration have been categorized under three altitude regions such as low (< 70 masl), middle (153-305 masl) and high (>305 masl) altitudes. The results show that an increase in the standard deviations of monthly rainfall during rainy and autumn seasons have an adversely significant impact on the mean yield of foodgrains in Odisha. The summer temperature has beneficial effects by significantly increasing mean yield as the summer season is associated with harvesting stage of Rabi crops. The changing pattern of temperature has increasing effect on the yield variability of foodgrains during the summer season, whereas it has a decreasing effect on yield variability of foodgrains during the Rainy season. Moreover, the positive expected signs of trend variable in both mean and variance equation suggests that foodgrain yield and its variability increases with time. On the other hand, a change in mean levels of rainfall and temperature during different seasons has heterogeneous impacts either harmful or beneficial depending on the altitudes. These findings imply that adaptation strategies should be tailor-made to minimize the adverse impacts of climate change and variability for sustainable development across seasons and altitudes in Odisha agriculture.

Keywords: altitude, adaptation strategies, climate change, foodgrain

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Authors: Felicity Aphiwe Mkhongi, Walter Musakwa

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Smallholder crop production is a defining factor in achieving food security, particularly at the household level. However, the number of abandoned arable fields is increasing in communal areas of South Africa. While substantial efforts have been devoted to addressing food insecurity in the country, ownership of arable land has not been supplemented with sustainable food production for households. This paper analyses household food security in the context of deagrarianization in two villages, Ambros (Eastern Cape) and Maramanzhi (Limpopo). Semi-structured questionnaires were administered to acquire both qualitative and quantitative data from 106 heads of households. The IBM SPSS Statistics 28.0 computer program was applied to complete data analysis. From the findings of the study, it was evident that compared to arable fields, a greater proportion of households own home-gardens with an average size of 2100m in Ambros and 3400m in Maramanzhi village. The majority of arable fields were abandoned, particularly in Ambros village. Household food access challenges were measured using the Household Food Insecurity Access Scale (HFIAS). This food security indicator revealed that the majority of households were mildly food insecure owing to food shortages emanating from insufficient monthly income and waning household crop production. Food was rated as a very important reason for engaging in cultivation in both villages of the study, but deagrarianization has eroded opportunities for increasing household crop production. Among other possible solutions, this study recommends that the government invest more in agriculture to allow for sustainable strategies that revive abandoned arable land, such as arable fields in communal areas of South Africa, as this could increase food production for households.

Keywords: cultivation, deagrarianization, food security, rural households, smallholder farmers

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Authors: Namekong Fokeng Armand

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Background: Zoonoses are nowadays a serious public health problem in both developing and developed countries. They contribute to increase the economic burden. In case of emergence, rural populations are the most affected, hence the need to investigate risk practices in rural households of Penka-Michel (West Cameroon). Methods: This cross-sectional study was conducted from October to November 2021 among 200 heads of households living in the Penka-Michel health district (West Cameroon). It was done using a pre-tested and validated questionnaire, allowing to obtain socio-demographic, economic data, and data on zoonotic risk practices. Results: The participants [women (56%), men (44%)] worked mainly in the informal private sector (53%) and practiced agriculture secondarily (90%). Their highest level of education, for the most part, was a secondary school (50%); the average household size was 06 persons with a monthly income > 36270 FCFA (72%). 74% of household heads thought that animals can transmit diseases, and 17% had heard about zoonotic diseases through the media (65%). Rats caught in households (60%) were consumed there (74%), as was bush meat (61%) or dog meat (18%). For family food (90%), animals were slaughtered within the household (97%), rarely preceded by a veterinary inspection (6%). 87% of households practiced traditional rites with animal blood, 65% shared the same habitat as their animals, 41% did not systematically wash their hands after handling animals. More than 50% of households owned one or more dogs, usually strays (41%) and 48% of which were vaccinated (rabies). Many households had at least one: poultry (98%); pig (50%); dog (57%), cat (52%). 25% of households slaughtered sick animals for consumption, and 27% ate dead animals. Conclusion: This study identified numerous zoonotic risk practices in households in the Penka-Michel health district (West Cameroon). Concerted, multisectoral communication / awareness-raising actions are needed to break with these practices.

Keywords: zoonoses, risky practices, rural households, penka-michel, cameroon

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Authors: Thabiso Sthembiso Msomi

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SMEs are the main engine of growth in most developing economies. One of the main factors that hinder the development of SME is access to finance. In this study, we explored the factors that hinder the growth and survival of SMEs in South Africa. The capital structure theory formed the theoretical underpinning for the study. The quantitative research design was adopted and data was collected from retail, construction, manufacturing and agriculture sectors of SMEs within the KwaZulu-Natal province of South Africa. The modified version of the Cochran formula was used to determine the sample size as 321 SMEs and analysed using the five-point Likert scale. The purposive sampling technique was used to select owners of SME. Statistical Package for the Social Sciences (SPSS) was used for the data analysis through Exploratory Factor Analysis (EFA) to determine the factor structures of items employed to measure each of the constructs in this study. Then, the Cronbach’s alpha test was conducted to determine the reliability of each construct. Kaiser-Meyer-Olkin (KMO) was used to determine the adequacy of the sample size. Linear regression was done to determine the effect of the independent variables on the dependent variable. The findings suggest that the main constraints facing South African SMEs were the lack of experienced management. Furthermore, the SMEs would fail to raise customer awareness of their products and services, which in turn affects their market access and monthly turnover. The study recommends that SMEs keep up-to-date records of business transactions to enable the business to keep track of its operations. The study recommends that South African banks adopt an SME accounting and bookkeeping program. The finding of this study benefits policymakers in both the private and public sectors.

Keywords: small businesses, access to finances, COVID-19, SMEs survival

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Authors: Ilma Robo, Saimir Heta, Nedja Hysi, Vera Ostreni

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Introduction: Marginal gingivitis is a disease with considerable frequency among patients who present routinely for periodontal control and treatment. In fact, this disease may not have alarming symptoms in patients and may go unnoticed by themselves when personal hygiene conditions are optimal. The aim of this study was to collect retrograde data on the prevalence of marginal gingiva in the respective group of patients, evaluated according to specific periodontal diagnostic tools. Materials and methods: The study was conducted in two patient groups. The first group was with 34 patients, during December 2019-January 2020, and the second group was with 64 patients during 2010-2018 (each year in the mentioned monthly period). Bacterial plaque index, hemorrhage index, amount of gingival fluid, presence of xerostomia and candidiasis were recorded in patients. Results: Analysis of the collected data showed that susceptibility to marginal gingivitis shows higher values according to retrograde data, compared to cross-sectional ones. Susceptibility to candidiasis and the occurrence of xerostomia, even in the combination of both pathologies, as risk factors for the occurrence of marginal gingivitis, show higher values ​​according to retrograde data. The female are presented with a reduced bacterial plaque index than the males, but more importantly, this index in the females is also associated with a reduced index of gingival hemorrhage, in contrast to the males. Conclusions: Cross-sectional data show that the prevalence of marginal gingivitis is more reduced, compared to retrograde data, based on the hemorrhage index and the bacterial plaque index together. Changes in production in the amount of gingival fluid show a higher prevalence of marginal gingivitis in cross-sectional data than in retrograde data; this is based on the sophistication of the way data are recorded, which evolves over time and also based on professional sensitivity to this phenomenon.

Keywords: marginal gingivitis, cross-sectional, retrograde, prevalence

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Authors: Pei-Chun Chen, Chi-Ting Tseng, Lih-Chi Chen, Kai-Hsiang Yang

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Introduction: The pharmacist is responsible for encouraging adverse drug reaction (ADR) reporting. In a local center in Northern Taiwan, promotion and rewarding of ADR reporting have continued for over six years but failed to bring significant changes. This study aims to find a solution to increase ADR reporting. Research question or hypothesis: We hypothesized that under-reporting is due to the inconvenience of the reporting system. Reports were made conventionally through printed sheets. We proposed that reports made per month will increase if they were computerized. Study design: An ADR reporting platform was established in April 2015, before which was defined as the first stage of this study (January-March, 2015) and after which the second stage. The third stage commenced in November, 2015, after adding a reporting module to physicians prescription system. ADRs could be reported simultaneously when documenting drug allergies. Methods: ADR report rates during the three stages of the study were compared. Effects of the information platform on reporting were also analyzed. Results: During the first stage, the number of ADR reports averaged 6 per month. In the second stage, the number of reports per month averaged 1.86. Introducing the information platform had little effect on the monthly number of ADR reports. The average number of reports each month during the third stage of the study was 11±3.06, with 70.43% made electronically. Reports per month increased significantly after installing the reporting module in November, 2015 (P<0.001, t-test). In the first two stages, 29.03% of ADR reports were made by physicians, as compared to 70.42% of cases in the third stage of the study. Increased physician reporting possibly account for these differences. Conclusion: Adding a reporting module to the prescription system significantly increased ADR reporting. Improved accessibility is likely the cause. The addition of similar modules to computer systems of other healthcare professions may be considered to encourage spontaneous ADR reporting.

Keywords: adverse drug reactions, adverse drug reaction reporting systems, regional hospital, prescription system

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Authors: Haritha Saranga

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Service quality has become an important driver of competition in manufacturing industries of late, as many products are being sold in conjunction with service offerings. With increase in computational power and data capture capabilities, it has become possible to analyze and estimate various aspects of service quality at the granular level and determine their impact on business performance. In the current study context, dealer level, model-wise warranty data from one of the top two-wheeler manufacturers in India is used to estimate service quality of individual dealers and its impact on warranty related costs and sales performance. We collected primary data on warranty costs, number of complaints, monthly sales, type of quality upgrades, etc. from the two-wheeler automaker. In addition, we gathered secondary data on various regions in India, such as petrol and diesel prices, geographic and climatic conditions of various regions where the dealers are located, to control for customer usage patterns. We analyze this primary and secondary data with the help of a variety of analytics tools such as Auto-Regressive Integrated Moving Average (ARIMA), Seasonal ARIMA and ARIMAX. Study results, after controlling for a variety of factors, such as size, age, region of the dealership, and customer usage pattern, show that service quality does influence sales of the products in a significant manner. A more nuanced analysis reveals the dynamics between product quality and service quality, and how their interaction affects sales performance in the Indian two-wheeler industry context. We also provide various managerial insights using descriptive analytics and build a model that can provide sales projections using a variety of forecasting techniques.

Keywords: service quality, product quality, automobile industry, business analytics, auto-regressive integrated moving average

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Authors: Ayalkibet Mekonnen, Adane Abebe

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In hydrological cycle there are many water-related human interventions that modify the natural systems. Rainwater harvesting is one such intervention that involves harnessing of water in the upstream. Water harvesting used in upstream prevents water runoff on downstream mainly disturbance on biodiversity and ecosystems. The main objectives of the study are to assess the effects of water harvesting technologies on downstream water availability in the Woreda. To address the above problem, SWAT model, cost-benefit ratio and optimal control approach was used to analyse the hydrological and socioeconomic impact and tradeoffs on water availability of the community, respectively. The downstream impacts of increasing water consumption in the upstream rain-fed areas of the Bilate and Shala Catchment are simulated using the semi-distributed SWAT model. The two land use scenarios tested at sub basin levels (1) conventional land use represents the current land use practice (Agri-CON) and (2) in-field rainwater harvesting (IRWH), improving soil water availability through rainwater harvesting land use scenario. The simulated water balance results showed that the highest peak mean monthly direct flow obtained from Agri-CON land use (127.1 m3/ha), followed by Agri-IRWH land use (11.5 mm) and LULC 2005 (90.1 m3/ha). The Agri-IRWH scenario reduced direct flow by 10% compared to Agri-CON and more groundwater flow contributed by Agri-IRWH (190 m3/ha) than Agri-CON (125 m3/ha). The overall result suggests that the water yield of the Woreda may not be negatively affected by the Agri-IRWH land use scenario. The technology in the Woreda benefited positively having an average benefit cost ratio of 4.2. Water harvesting for domestic use was not optimal that the value of the water per demand harvested was less than the amount of water needed. Storage tanks, series of check dams, gravel filled dams are an alternative solutions for water harvesting.

Keywords: water harvesting, SWAT model, land use scenario, Agri-CON, Agri-IRWH, trade off, benefit cost ratio

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Authors: Mbuso Siwela

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Background: The Sub-Saharan Africa region has the greatest number of people eligible to receive antiretroviral treatment (ART). Multi-month Drug dispensing (MMD) of antiretroviral treatment (ART) aims to reduce patient-related barriers to access long-term treatment and improve health system efficiency. In Eswatini, however, few children and adolescents are on MMD. Young Heroes is implementing an HIV program that aims to avert new HIV infections in children and youth and improve treatment outcomes for children and adolescents living with HIV (C/ALHIV: 0-19 Years) and OVC caregivers with HIV prevention and impact mitigation interventions that prevent new HIV infections and reduce vulnerability. Aim of the study: The study aimed to ascertain factors that are associated with the assignment of the MMD model on C/ALHIVs. Methodology: The project provides treatment adherence support through well-trained community cadres (Home Visitors - HVs) at both community and health facility levels. During door-to-door visits, HVs track all C/ALHIV enrolled in the project monthly and refer any who might have stopped or interrupted treatment. C/ALHIV with unsuppressed viral load is supported through case conferencing and teen clubs. A quantitative cross-sectional analysis was conducted using STATA for children and adolescents living with HIV enrolled in the project. Bivariate analysis was conducted, and the Logistic Regression model was used to ascertain the effects of duration on ART on the choice of MMD model. Results: Data for 544 C/ALHIV (0-19 Years) was analyzed in STATA. Results show a strong association between (duration on ART, Age, being in teen club) and enrolment in an MMD model. Duration on ART is a major predictor for the choice of MMD model at (95% CI: 0.0012905 – 0.0039812; P = <0.0001). C/ALHIV who have been on ART for less than a year are less likely to be on MMD. C/ALHIVs who are 1 or more years on ART are more likely to be in 3 months dispensing, while those who are 5 years or more are most likely to be in 6 months model.

Keywords: C/ALHIV, OVC, HIV, treatment

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Authors: Leandi Steenkamp

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The sectional title industry has been a part of the property landscape in South Africa for almost half a century, and plays a significant role in addressing the housing problem in the country. Stakeholders such as owners and investors in sectional title property are in most cases not directly involved in the management thereof, and place reliance on the audited annual financial statements of bodies corporate for decision-making purposes. Although the industry seems to be highly regulated, the legislation regarding accounting and auditing of sectional title is vague and ambiguous. Furthermore, there are no industry-specific auditing and accounting standards to guide accounting and auditing practitioners in performing their work and industry financial benchmarks are not readily available. In addition, financial pressure on sectional title schemes is often very high due to the fact that some owners exercise unrealistic pressure to keep monthly levies as low as possible. All these factors have an impact on the business risk as well as audit risk of bodies corporate. Very little academic research has been undertaken on the sectional title industry in South Africa from an accounting and auditing perspective. The aim of this paper is threefold: Firstly, to discuss the findings of a literature review on uncertainties, ambiguity and confusing aspects in current legislation regarding the audit of a sectional title property that may cause or increase audit and business risk. Secondly, empirical findings of risk-related aspects from the results of interviews with three groups of body corporate role-players will be discussed. The role-players were body corporate trustee chairpersons, body corporate managing agents and accounting and auditing practitioners of bodies corporate. Specific reference will be made to business risk and audit risk. Thirdly, practical recommendations will be made on possibilities of closing the audit expectation gap, and further research opportunities in this regard will be discussed.

Keywords: assurance, audit, audit risk, body corporate, corporate governance, sectional title

Procedia PDF Downloads 261

Authors: Bumjo Kim, Hyun Jin Kim, Joon Ha Kim

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The separate sewer system is that collects the wastewater as a sewer pipe and rainfall as a stormwater pipe separately, and then sewage is treated in the wastewater treatment plant, the stormwater is discharged to rivers or lakes through stormwater drainage pipes. Unfortunately, even for separate sewer systems, it is not possible to prevent Rainfall Driven Inflow/Infiltration(RDII) completely to the sewer pipe. Even if the sewerage line is renovated, there is an ineluctable RDII due to the combined sewer system in the house or the difficulty of sewage maintenance in private areas. The basic statistical analysis was performed using environmental data including rainfall, sewage, water qualities and groundwater level in the strict of Gwangju in ​South Korea. During rainfall in the target area, RDII showed an increased rate of 13.4 ~ 53.0% compared to that of a clear day and showed a rapid hydrograph response of 0.3 ~ 3.0 hr. As a result of water quality analysis, BOD5 concentration decreased by 17.3 % and salinity concentration decreased by 8.8 % at the representative spot in the project area compared to the sunny day during rainfall. In contrast to the seasonal fluctuation range of 0.38 m ~ 0.55 m in groundwater in Gwangju area and 0.58 m ~ 0.78 m in monthly fluctuation range, while the difference between groundwater level and the depth of sewer pipe laying was 2.70 m on average, which is larger than the range of fluctuation. Comprehensively, it can be concluded that the increasing of flowrate at sewer line is due to not infiltration water caused by groundwater level rise, construction failure, cracking due to joint failure or conduit deterioration, rainfall was directly inflowed into the sewer line rapidly. Acknowledgements: This work was supported by the 'Climate Technology Development and Application' research project (#K07731) through a grant provided by GIST in 2017.

Keywords: ground water, rainfall, rainfall driven inflow/infiltration, separate sewer system

Procedia PDF Downloads 150

Authors: Y. Jin, N. Zhang, X. Luo, W. Zhang

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China with annual increasing 0.5-0.6 billion squares city residence has brought in enormous energy consumption by HVAC facilities and other appliances. In this regard, governments and researchers are encouraging renewable energy like solar energy, geothermal energy using in houses. However, high cost of equipment and low energy conversion result in a very low acceptable to residents. So what’s the equilibrium point of eco-feedback to reach economic benefit and thermal comfort? That is the main question should be answered. In this paper, the objective is an on-site solar PV and heater house, which has been evaluated as a low energy building. Since HVAC system is considered as main energy consumption equipment, the residence with 24-hour monitoring system set to measure temperature, wind velocity and energy in-out value with no HVAC system for one month of summer and winter. Thermal comfort time period will be analyzed and confirmed; then the air-conditioner will be started within thermal discomfort time for the following one summer and winter month. The same data will be recorded to calculate the average energy consumption monthly for a purpose of whole day thermal comfort. Finally, two analysis work will be done: 1) Original building thermal simulation by computer at design stage with actual measured temperature after construction will be contrastive analyzed; 2) The cost of renewable energy facilities and power consumption converted to cost efficient rate to assess the feasibility of renewable energy input for residence. The results of the experiment showed that a certain deviation exists between actual measured data and simulated one for human thermal comfort, especially in summer period. Moreover, the cost-effectiveness is high for a house in targeting city Guilin now with at least 11 years of cost-covering. The conclusion proves that an eco-feedback of a low energy residence is never only consideration of its energy net value, but also the cost efficiency that is the critical factor to push renewable energy acceptable by the public.

Keywords: cost efficiency, eco-feedback, low energy residence, thermal comfort

Procedia PDF Downloads 251

Authors: Antonio Marco Miotti, Antonella Ruffatto, Giampaola Basso, Antonio Madia, Giulia Zavatta, Emanuela Salvatico, Emanuela Zilli

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A National Action Plan to fight antimicrobial resistance was launched in Italy in 2017. In order to reduce inappropriate exposure to antibiotics and infections from multi-drug resistant bacteria, it is essential to set up a structured system of surveillance and monitoring of the implementation of National Action Plan standards, including antimicrobial consumption, with a special focus on quinolones, third generation cephalosporins and carbapenems. A quantitative estimate of antibiotic consumption (defined daily dose - DDD - consumption per 100 days of hospitalization) has been provided by the Pharmaceutical Service to the Hospital of Cittadella, ULSS 6 Euganea – Health Trust (District of Padua) for the years 2019 (before the pandemic), 2020 and 2021 for all classes of antibiotics. Multidisciplinary meetings have been organized monthly by the local Antimicrobial Stewardship Group. Between 2019 and 2021, an increase in the consumption of carbapenems in the Intensive Care Unit (from 12.2 to 18.2 DDD, + 49.2%) and a decrease in Medical wards (from 5.3 to 2.6 DDD, - 50.9%) was reported; a decrease in the consumption of quinolones in Intensive Care Unit (from 17.2 to 10.8 DDD, - 37.2%), Medical wards (from 10.5 to 6.6 DDD, - 37.1%) and Surgical wards (from 10.2 to 9.3 DDD, - 8.8%) was highlighted; an increase in the consumption of third generation cephalosporins in Medical wards (from 18.1 to 22.6 DDD, + 24,1%) was reported. Finally, after an increase in the consumption of macrolides between 2020 and 2019, in 2021, a decrease was reported in the Intensive Care Unit (DDD: 8.0 in 2019, 18.0 in 2020, 6.4 in 2021) and Medical wards (DDD: 9.0 in 2019, 13.7 in 2020, 10.9 in 2021). Constant monitoring of antimicrobial consumption and timely identifying of warning situations that may need a specific intervention are the cornerstone of Antimicrobial Stewardship programs, together with analysing data on bacterial resistance rates and infections from multi-drug resistant bacteria.

Keywords: carbapenems, quinolones, antimicrobial, stewardship

Procedia PDF Downloads 147

Authors: M. B. Mshelia, J. K Balogun, J. Auta, N. O. Bankole

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The current status and abundance of the genus Citharinus was carried out in Jebba Lake, Niger State, Nigeria from January to December, 2011. The aim was to determine the extent of exploitation of the genus Citharinus in Jebba Lake so as to advice the government of Nigeria on how to overcome difficulties in terms of the sustainability of the said fish in the Lake. Descriptive statistics were used to analyze the data obtained. A total of 2,389 of the genus Citharinus were caught during the sampling period. Only two species of the genus Citharinus were caught with 1,220 in number and 430.68kg total weight of Citharinus citharus and 1,169 in number and 418.56kg total weight of Citharinus latus). The current total yield estimated for the genus Citharinus in Jebba Lake in the six (6) sampling sites was calculated and pooled together to be 849.24kg. A day’s catch was calculated to be 35.38kg. The monthly and annual yields of the genus Citharinus were calculated to 1061.55 equivalents to 1 ton and 12 metric tonnes respectively. For the fecundity, June, July and August were discovered as the spawning period for the genus Citharinus and out of total experimental gillnet catch of 2, 389, only 244 (10.21%)of Citharinus citharus and 231 (9.67%) of Citharinus latus were in sexually mature stage. Out of these numbers, 113 (46.31%) were males and 121 (53.69%) were females of Citharinus citharus and 112 (48.48) were males and 119 (51.52) were females of Citharinus latus. The youngest mature males in either of the two had a standard length of 31.5 with a weight of 800.5gWhilethe youngest spawning females were having the standard length of 29.5 cm with a weight of 1,3oo.5g.It was also discovered that females started maturing earlier than the males at the standard length for females and males to be 18.0cm and 19.5cm respectively. Their fecundity ranged from 15,000 to 16, 500 eggs. The sex ratio of 1172 that were males and 1217 that were females was 1 male to 1.0383 females which was equivalent to 1:1 sex ratio of male to female. It was concluded that Jebba Lake had suffered seriously over exploitation of the genus Citharinus and proper management have to be enforced on the lake otherwise the threat of fish being extent may arise.

Keywords: Jebba Lake, Niger State, Nigeria, Citharinus citharus, Citharinus latus, fecundity, sex ratio

Procedia PDF Downloads 258

Authors: Grazia Disciglio, Annalisa Tarantino, Emanuele Tarantino

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The production system of Foggia province (Apulia, Southern Italy) is characterized by the presence of numerous agro-food industries whose activities include the processing of vegetables products that release large quantities of wastewater. The reuse in agriculture of these wastewaters offers the opportunity to reduce the costs of their disposal and minimizing their environmental impact. In addition, in this area, which suffers from water shortage, the use of agro-industrial wastewater is essential in the very intensive irrigation cropping systems. The present investigation was carried out in years 2009 and 2010 to monitor the physico-chemical and microbiological characteristics of the industrial wastewater (IWW) from the secondary treatment plant of the 'Industrial Area of Foggia'. The treatment plant released on average about 567,000 m3y-1 of IWW, which distribution was not uniform over the year. The monthly values were about 250,000 m3 from November to June and about 90,000 m3 from July to October. The obtained results revealed that IWW was characterized by low values of Total Suspended Solids (TSS), Biological Oxygen Demand (BOD), Chemical Oxygen Demand (COD), Electrical Conductivity (EC) and Sodium Absorption Rate (SAR). An occasional presence of heavy metal and high concentration of total phosphorus, total nitrogen, ammoniacal nitrogen and microbial organisms (Escherichia coli and Salmonella) were observed. Due to the presence of this pathogenic microorganisms and sometimes of heavy metals, which may raise sanitary and environmental problems in order to the possible irrigation reuse of this IWW, a tertiary treatment of wastewater based on filtration and disinfection in line are recommended. Researches on the reuse of treated IWW on crops (olive, artichoke, industrial tomatoes, fennel, lettuce etc.) did not show significant differences among the irrigated plots for most of the soil and yield characteristics.

Keywords: agroindustrial wastewater, irrigation, microbiological characteristic, physico-chemical characteristics

Procedia PDF Downloads 307

Authors: Hossein Khara, Mahmoud Sayyadborani, Mohammad Sayyadborani

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In the present study, we examined the effects of different dietary levels of ascorbic acid (vitamin C) and α-tocopherol (vitamin E) and their combinations on growth, survival and some haematological and immunological parameters of Caspian brown trout, Salmo trutta caspius juveniles. 15 experimental treatments and one control group with three replicates were considered for experiment. The experimental treatments were fish fed by experimental diets containing different levels of Vit C and E as follow: T1: Vit E (20 mg.kg diet -1) + Vit C (100 mg.kg diet -1), T2: Vit E (30 mg.kg diet -1) + Vit C (100 mg.kg diet -1), T3: Vit E (40 mg.kg diet -1) + Vit C (100 mg.kg diet -1), T4: Vit E (20 mg.kg diet -1) + Vit C (200 mg.kg diet -1), T5: Vit E (30 mg.kg diet -1) + Vit C (200 mg.kg diet -1), T6: Vit E (40 mg.kg diet -1) + Vit C (200 mg.kg diet -1), T7: Vit E (20 mg.kg diet -1) + Vit C (300 mg.kg diet -1), T8: Vit E (30 mg.kg diet -1) + Vit C (300 mg.kg diet -1), T9: Vit E (40 mg.kg diet -1) + Vit C (300 mg.kg diet -1), T10: Vit C (100 mg.kg diet -1), T11: Vit C (200 mg.kg diet -1), T12: Vit C (300 mg.kg diet -1), T13: Vit E (20 mg.kg diet -1), T14: Vit E (30 mg.kg diet -1) T15: Vit E (40 mg.kg diet -1). Also a non-vitamin supplemented was considered as control group. Growth parameters were measured monthly and serum parameters assayed at the end of the experiment. According to our results, Vit C and E improved survival and growth parameters including specific growth rate (SGR), weight gain percent (WG%) and biomass. The highest values of these parameters obtained in T8, T9 and T8 respectively. The lowest FCR obtained in T8. The haematological parameters including red blood cells (RBCs), white blood cells (WBCs), haematocrit (Hct) and haemoglobin (Hb) were higher in vitamin treated groups than control group with highest values in T8. In T13, WBC values were higher compared to other experimental groups. The immunological parameters including lysozyme activity, Immunoglobulin (IgM) and total immunoglobulin (TIg) were significantly higher in vitamin supplemented groups than in control group. In this regard the highest values of these parameters were found in T12. The lowest values of TIg and lysozyme activity were observed in control group and fish fed by only vitamin E i.e. T13, T14 and T15. In conclusion, our results show that Vit C and E in combination or only can improve growth, survival, haematological and immunological indices of Caspian brown trout.

Keywords: vitamins E, vitamins C, growth, survival, haematological parameters, immunological parameters

Procedia PDF Downloads 338

Authors: Hatice Torcu Koc, Zeliha Erdogan

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This study presented the investigation of the population structure of Upeneus moluccensis in order to provide further knowledge and to compare the data with the studies before and thus help in the management of the population in the İskenderun Bay. For this purpose, a total of 370 golden-banded goatfish were caught by a commercial vessel monthly at a depth of 50-60 m. from İskenderun Bay in the years 2016-2018. Von Bertalanffy growth equation,length-weight relationships, sex ratio, age, condition, and gonado and hepato-somatic index values of U.peneus moluccensis specimens were determined. For this, the lengths and weights were measured using a dial caliper of 0.05 mm and a sensitive balance. Total lengths were 7.2–17.5 cm in females and 7.0–17.9 cm in males, while total weight ranges for females and males were 3.91-64.26 g and 3.69-60.95 g., respectively. Length-weight relationship for all individuals was calculated as W=0.004*L³ ³⁸, R²=0.85. Growth parameter was determined as L∞= 20.75 cm, k=0.33, t₀= - 0.56. The age readings were done by using the Bhattacharya method. The population was composed of 3 ages (1-3). The sex ratio was found as 1:1.42, corresponding to 41.4% males and 58.6% females, in favor of females (p<0.05). Values of the average condition and hepatosomatic index were found to be shown a similar pattern for males (1.088, 1.104) and females (1.124, 1.177), respectively. According to GSI values, the spawning period started in March and increased to April, May, and September. It was estimated that total (Z) mortality, natural (M) mortality, and fishing (F) mortality rates were estimated as Z=0.94 year-¹, M=0.033 year-¹, and F=0.63 year-¹, respectively. As the exploitation rate was estimated to be E=0.67, it can be shown that the golden-banded goatfish stock was influenced by overfishing. The findings of this study are very important to point out the population of U. moluccensis, which penetrated into the eastern Mediterranean Sea of Türkiye due to global heating and the construction of the Suez Canal and to be basic data for the next fisheries investigations.

Keywords: biology, U. moluccensis, invasive, lessepsian, İskenderun Bay

Procedia PDF Downloads 66

Authors: Irfan Turetgen

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Closed-circuit cooling towers are cooling units that operate according to the indirect cooling principle. Unlike the open-loop cooling tower, the filler material includes a closed-loop water-operated heat exchanger. The main purpose of this heat exchanger is to prevent the cooled process water from contacting with the external environment. In order to ensure that the hot water is cooled, the water is cooled by the air flow and the circulation water of the tower as it passes through the pipe. They are now more commonly used than open loop cooling towers that provide cooling with plastic filling material. As with all surfaces in contact with water, there is a biofilm formation on the outer surface of the pipe. Although biofilm has been studied very well on plastic surfaces in open loop cooling towers, studies on biofilm layer formed on the heat exchangers of the closed circuit tower have not been found. In the recent study, natural biofilm formation was observed on the heat exchangers of the closed loop tower for 6 months. At the same time, nano-silica coating, which is known to reduce the formation of the biofilm layer, a comparison was made between the two different surfaces in terms of biofilm formation potential. Test surfaces were placed into biofilm reactor along with the untreated control coupons up to 6-months period for biofilm maturation. Natural bacterial communities were monitored to analyze the impact to mimic the real-life conditions. Surfaces were monthly analyzed in situ for their microbial load using epifluorescence microscopy. Wettability is known to play a key role in biofilm formation on surfaces, because characteristics of surface properties affect the bacterial adhesion. Results showed that surface-conditioning with nano-silica significantly reduce (up to 90%) biofilm formation. Easy coating process is a facile and low-cost method to prepare hydrophobic surface without any kinds of expensive compounds or methods.

Keywords: biofilms, cooling towers, fill material, nano silica

Procedia PDF Downloads 126

Authors: Camila Plaza, Stefan Felder

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In October 2014, the TARMED reform was implemented in Switzerland. In an effort to even out the financial standing of general practitioners (including pediatricians) relative to that of specialists in the outpatient sector, the reform tackled two aspects: on the one hand, GPs would be able to bill an additional 9 CHF per patient, once per consult per day. This is referred to as the surcharge position. As a second measure, it reduced the fees for certain technical services targeted to specialists (e.g., imaging, surgical technical procedures, etc.). Given the fee-for-service reimbursement system in Switzerland, we predict that physicians reacted to the economic incentives of the reform by increasing the consults per patient and decreasing the average amount of time per consult. Within this framework, our treatment group is formed by GPs and our control group by those specialists who were not affected by the reform. Using monthly insurance claims panel data aggregated at the physician praxis level (provided by SASIS AG), for the period of January 2013-December 2015, we run difference in difference panel data models with physician and time fixed effects in order to test for the causal effects of the reform. We account for seasonality, and control for physician characteristics such as age, gender, specialty, and physician experience. Furthermore, we run the models on subgroups of physicians within our sample so as to account for heterogeneity and treatment intensities. Preliminary results support our hypothesis. We find evidence of an increase in consults per patients and a decrease in time per consult. Robustness checks do not significantly alter the results for our outcome variable of consults per patient. However, we do find a smaller effect of the reform for time per consult. Thus, the results of this paper could provide policymakers a better understanding of physician behavior and their sensitivity to financial incentives of reforms (both past and future) under the current reimbursement system.

Keywords: difference in differences, financial incentives, health reform, physician behavior

Procedia PDF Downloads 121

Authors: Nkwenti Mbelli Njah

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This research was motivated by a project requested by AXA on the topic of pensions payable under the workers compensation (WC) line of business. There are two types of pensions: the compulsorily recoverable and the not compulsorily recoverable. A pension is compulsorily recoverable for a victim when there is less than 30% of disability and the pension amount per year is less than six times the minimal national salary. The law defines that the mathematical provisions for compulsory recoverable pensions must be calculated by applying the following bases: mortality table TD88/90 and rate of interest 5.25% (maybe with rate of management). To manage pensions which are not compulsorily recoverable is a more complex task because technical bases are not defined by law and much more complex computations are required. In particular, companies have to predict the amount of payments discounted reflecting the mortality effect for all pensioners (this task is monitored monthly in AXA). The purpose of this research was thus to develop a stochastic model for the future mortality of the worker’s compensation pensioners of both the Portuguese market workers and AXA portfolio. Not only is past mortality modeled, also projections about future mortality are made for the general population of Portugal as well as for the two portfolios mentioned earlier. The global model was split in two parts: a stochastic model for population mortality which allows for forecasts, combined with a point estimate from a portfolio mortality model obtained through three different relational models (Cox Proportional, Brass Linear and Workgroup PLT). The one-year death probabilities for ages 0-110 for the period 2013-2113 are obtained for the general population and the portfolios. These probabilities are used to compute different life table functions as well as the not compulsorily recoverable reserves for each of the models required for the pensioners, their spouses and children under 21. The results obtained are compared with the not compulsory recoverable reserves computed using the static mortality table (TD 73/77) that is currently being used by AXA, to see the impact on this reserve if AXA adopted the dynamic tables.

Keywords: compulsorily recoverable, life table functions, relational models, worker’s compensation pensioners

Procedia PDF Downloads 161