Severe Financial Constraints Research Articles

Sustainable Management of Healthcare Settings’ Personnel Based on Intelligent Project-Oriented Approach for Post-War Development

The paper considers the transformation of human resource management processes in the healthcare settings of Ukraine in the context of war and the COVID-19 pandemic. It is noted that the unstable and hostile environment of a healthcare setting during times of crisis leads to the need to change the personnel selection and team formation model to increase the adaptability and resilience of human resources involved in the provision of medical care. The key features of the human resource management process in a turbulent environment are the high migration activity of personnel, which leads to the need to reallocate resources, the need to operate under severe financial constraints, and the need to consider personnel as a non-renewable resource when it is impossible to attract additional resources. To ensure the reliability of the functioning of a medical institution, the transformation of human resource management processes should be based on strategic agility and human resource management, organizational resilience as a resource-based capability, corporate sustainability, and transformation of enterprises’ resources, which can be achieved by applying methodological support for resource management in a multi-project environment. Considering a network of medical institutions as a multi-project environment will allow using the methodology of project-oriented resource management, forming adaptive teams in a multi-project environment, to ensure flexible redistribution of resources both within a single institution and within a network of institutions. It is proposed to use formal transformations to manage a medical institution’s human resources. Applying the proposed approach for managing the human resources of a medical institution is considered. The formation of a project team that satisfies the minimum requirements with the maximum value of the team’s qualification score is considered. It is shown that the use of this methodological support made it possible to choose the composition of the project team with a minimum number and a maximum value of the characteristic.

Effects of air pollution on accounting conservatism

We examine the impact of air pollution on a firm's accounting policy conservatism. We hypothesize that, in response to risks associated with increased air pollution, firms apply more conservative accounting practices and utilize more conservative estimates in their reporting. Using a sample of Chinese firms, accounting conservatism measures, and a satellite-based air pollution metric, we confirm the validity of our hypothesis. Additional analysis suggests that the impact of air pollution on accounting policy conservatism is more salient for firms in high-pollution industries, firms under severe financial constraint, firms with higher environmental risk, and firms that receive high media coverage. Further, we document that air pollution does not significantly affect a firm's return on assets, year-on-year sales growth, or Tobin's Q measure. Hence, it is management's risk perception, not objective performance concern, that is driving accounting conservatism. Finally, specifically investigating accounting conservatism, we discover that, for firms with higher pollution levels, selling general and administrative expenses, liabilities provision, accrued expenses, and asset impairment loss are significantly higher.

Performance Evaluation of Bangalore Metropolitan Transport Corporation: An Application of Data Envelopment Analysis

Maintaining and enhancing public transit services in Indian cities is important to meet rapidly-growing mass mobility needs. Indian cities rely predominantly on buses for public transportation, and issues of performance measurement and efficiency analyses for bus companies have been gaining significance due to severe operational stress and financial constraints in which these bus companies provide service to people. In public transportation, multiple parameters are involved that influence the efficiency of operation. This study measures the performance of premium bus services operated by Bangalore Metropolitan Transport Corporation (BMTC) using data envelopment analysis. This approach enabled the identification of opportunities for improvement at the bus depot and route levels. The analysis indicates that most depots are efficient, but some routes have significant opportunities for improvement.

Role of income and government responsiveness in reducing the death toll from floods in Indian states

Floods are the most commonly occurring natural disasters in India due to India’s unique geographical location and socioeconomic conditions. Frequent flooding causes enormous loss of human lives and damage crops and public utilities. Furthermore, floods adversely affect economic development and increase the government's financial burden by increasing spending on various disaster mitigation measures. Recent empirical literature based on cross-national comparisons shows that disaster fatalities and damages are monotonically decreasing in per capita income. We challenge this view on the monotonic negative relationship between income and flood damages. We examine the non-monotonic (inverted U-shaped) relationship between per capita income and flood impact in terms of deaths, people affected, and damages due to floods in 19 major Indian states from 1980 to 2011, using Poisson and Tobit estimation methods. In particular, deaths and the population affected by floods increase with a turning point of income up to 882 US$ and 578 US$, respectively, and diminishes thereafter. Our results confirm an inverted U-shaped relationship between income and fatalities and the population affected by floods. In addition to income, we argue that government responsiveness plays an essential role in mitigating the risk of floods. We employ the fixed-effect Poisson estimation method to examine the government's role in protecting people against disaster risk, focusing on regional differences in India. Deaths from floods remain non-linear and follow the inverted U-pattern with respect to government responsiveness. However, the effect of government responsiveness on flood fatalities and flood damages is statistically insignificant. Our results further suggest that high-income states experience a lower death toll from floods. The high-income (rich) states are capable of incurring a higher threshold level of income and higher natural calamity expenditure to reduce flood fatalities and protect the population affected by floods than the low-income (poor) states. The poor states have minimal resources and face severe financial constraints to reduce the death toll from floods. From the perspective of public policy, the poor states, in particular, require an increase in income, better governance, and effective disaster management policies to mitigate flood impact.

77 Case series of juvenile scleroderma from Nigeria

BackgroundThe word scleroderma means ‘hard skin’ that develops due to excessive accumulation of collagen. It is the third most frequent rheumatic disease in paediatric rheumatology after juvenile idiopathic arthritis and systemic lupus erythematosus. When it occurs in individual <16 years, it is called juvenile scleroderma. It is a rare disease that occurs in one per million children, documented to be more common in African adults with poorer survival states compared with Caucasians.Objectives To describe the clinical and laboratory characteristics of children with juvenile scleroderma seen in our clinic, thus, increasing its awareness.MethodsRetrospective review of records of three children diagnosed with juvenile scleroderma at the paediatric Rheumatology Clinic of Lagos State University Teaching Hospital(LASUTH) between May 2018 to April 2022.Results Case 1 A 12-year-old girl presented with skin tightness of the left hand and thigh of one year, contracture of the 3rd, 4th and 5th proximal interphalangeal joints, arthritis of the left wrist, skin induration of the dorsum of the left hand involving the 4th and 5th finger and extending to the wrist and skin and induration of the anterolateral aspect of the left thigh. Her blood tests showed an erythrocyte sedimentation rate (ESR) at 20 mm/h, an ANA titre of 1:2560, a negative anti-Scl 70/anti-centromere antibodies, a normal complete blood count and serum electrolytes/urea/creatinine. A diagnosis of linear scleroderma was made, the patient had prednisolone, methotrexate and folic acid, in addition to topical emollients. She improved clinically as observed during follow up visits six weeks after initiation of treatment but later defaulted from the clinic due to unknown reason. Case 2 A 4-year-old girl presented with constitutional symptoms, swollen hands and feet, sclerodactyly, narrowing of oral aperture, ulcers at tips of the fingers, inflammatory pain of the large joints, hypopigmented macules on the face, trunk, abdomen and back and also abnormal capillaroscopy. Erythrocyte sedimentation rate was 22 mm/h with normal levels of electrolytes/urea/creatinine, thrombocytosis, ANA titre of 1:640 and negative anti-centromere and anti-U1RNP antibodies. A diagnosis of diffuse systemic sclerosis was made. She started prednisolone, methotrexate, nifedipine and omeprazole and was asked to do an ECG, an Echocardiogram, a spirometry and a chest HRCT but she couldn’t afford to do these investigations due to severe financial constraints. She was clinically stable for four months until she presented at the emergency room with sudden loss of consciousness and congestive cardiac failure. She died during resuscitation attempt. Case 3 An 11-year-old girl known patient of haematology unit with sickle cell anaemia, presented with inflammatory arthritis of the small joints of the hands, elbows and knees of nine-month duration, sclerodactyly, contractures of the PIP of the fingers, narrowing of oral aperture, generalized hypopigmented macules and abnormal nailfold capillaroscopy. Investigation showed an ANA titre of 1:640, positive anti-Scl 70 antibodies, negative anti-centromere antibodies, ESR of 130 mm/h and thrombocytosis. The echocardiogram showed a normally structured heart with severe restriction on spirometry and features of interstitial lung disease on HRCT of the chest. She started mycophenolate mofetil, prednisolone and nifedipine. She later received 2 doses of rituximab due to slow clinical improvement. She is being followed up.ConclusionMost data on scleroderma are from adult studies, we reported these three cases due to the rare occurrence of scleroderma in children, thus increasing its awareness.

Formal finance and household enterprise performance in Ghana: The gender dimension.

In this study, we empirically examine the gender dimension of the effect of formal finance on enterprise performance. While the literature suggests that formal finance, in general, improves firm performance, this effect may differ across firms headed by male and female entrepreneurs since the latter are faced with more severe social, economic, and financial constraints, which undermine their firm performance. Consequently, the effect of finance on firm performance is expected to be weaker in female-headed enterprises. So far, there is little evidence as to whether a gender gap exists regarding the effect of formal finance on firm performance, especially among small household enterprises. To fill the gap in the literature, we use the Ghana Living Standards Survey 2016/2017 and study the effect of formal credit on the productivity of male-headed and female-headed non-farm household enterprises in Ghana. Our results show that a positive effect of formal credit on labor productivity is only found in male-headed enterprises, but not in female-headed ones. We suspect that this result may be explained by women’s relatively less endowment in conditional factors, such as skills, knowledge, experiences, and capabilities.

Does mandatory disclosure of firm’s tax avoidance position affect corporate investment efficiency?

This paper examines the effect of a firm’s tax avoidance position disclosure on corporate investment efficiency by utilising an exogenous shock to corporate tax reporting that mandates firms to disclose uncertain tax positions in their financial statements under Financial Interpretation No. 48 (FIN 48). We find that, after FIN 48, firms claiming uncertain tax benefits (i.e. affected firms) experience a significant decrease in investment efficiency relative to firms that do not have uncertain tax positions (i.e. non-affected firms). Our finding suggests that, despite promoting transparency, FIN 48 imposes an unfavourable information revelation effect that reduces investment efficiency for affected firms. In terms of the mechanism, we provide evidence that affected firms experience a larger increase (drop) in cost of capital (external financing) following FIN 48 and rule out an alternative explanation that the decreased investment efficiency may arise from internal liquidity constraints. In cross-sectional analyses, we find the adverse effect to be more pronounced for firms with higher disclosure quality, higher tax uncertainty, and more severe financial constraints. These findings provide insight into the debate on why firms sometimes forgo tax avoidance opportunities by pointing out a potential cost of tax avoidance.

Does green credit policy mitigate financialization? Evidence from Chinese heavily polluting enterprises.

Green credit policy is an important tool to use financial credit resources to stimulate heavily polluting enterprises to change their production methods. This paper constructs a difference-in-differences model based on the quasi-natural experiment of the green credit policy promulgated in 2007 to explore the impact of environmental regulation on the financialization of heavily polluting enterprises and its mechanism. The empirical results show that the green credit policy significantly inhibits the financialization of heavily polluting enterprises, especially for speculative financial assets. This inhibitory effect is more significant in non-state-owned enterprises, enterprises with severe financing constraints, highly competitive industries, and the eastern region. Furthermore, we find that the green credit policy inhibits the financialization of heavily polluting firms by promoting green innovation, mitigating agency problem, and improving media supervision. At the same time, the 2012 Green Credit Guidelines still have an inhibitory effect on the financialization of heavily polluting enterprises from 2009 to 2019, reflecting that China's green credit policy system has a continuous guiding role in the rational allocation of financial assets of heavily polluting enterprises.

Does a country's environmental policy affect the value of small and medium sized enterprises liquidity in the energy sector?

AbstractCash management is important for energy SMEs, which, differently from large firms, face severe financial constraints and need to seize growth opportunities to ensure their survival. This paper, analyzing a large sample of European energy SMEs, finds a positive effect of holding a buffer of cash on firm performance. It shows that a stock of cash allows energy firms to prevent negative contingencies and/or achieve valuable growth patterns and investments. Moreover, considering that the energy industry is involved in environmental sustainability policies promoted by national governments, we find that complying with environmental regulations reduces the value of cash. Countries that pay more attention to environmental issues provide energy SMEs with growth opportunities and financial support, reducing the need to hold a stock of cash. A key implication is that, in a context with high environmental concern, energy SMEs have more financial flexibility to guarantee their growth with positive externalities for the energy sector.

Does Signing Auditor’s Reputational Promotion Ease the Financing Constraints of Audited Firms?

Based on the senior certified public accountants selected by the Chinese Institute of Certified Public Accountants and data drawn from China's A-share listed companies from 2014 to 2019, this study studies the influence mechanism of signing auditors' personal reputational promotion on corporate financing constraints. The results show that the improved reputation of signing auditors will help ease the financing constraints faced by companies. Moreover, compared with that of signing auditors from Big Four accounting firms, the improved reputation of signing auditors from non-Big Four firms has a more significant effect on alleviating the financing constraints of enterprises. In addition, private enterprises and small and medium-sized enterprises face more severe financing constraints than state-owned enterprises and large enterprises, and the reputational promotion of signing auditors can better alleviate the financing constraints of the former two types of enterprises. The research conclusions provide theoretical and data-driven support for constructing audit reputation mechanisms in China and improving the financing capabilities of enterprises.

Research assessment in a National Health Service organisation: a process for learning and accountability

This paper describes the only known research assessment exercise to be undertaken by a health board. There is a growing imperative to evidence the impact of national health services, but no formal mechanism exists to quality-rate research or assess its effect on practice. This study describes how one healthcare organisation adapted a research impact framework along with impact dimensions and impact indicators to better identify research outcomes and account for research funding. We know that research findings rarely impact on practice in a linear manner, that their effects are difficult to measure, and that they need adaptation within practice and professional contexts before use. We found that while links to practice and professional settings within our health board were strong, researchers tended not to plan for specific outcomes or impacts at project conception. Hence, although influence on practice and policy did occur, this seemed to be the result of extempore processes. This is despite an increasing emphasis in the health service on accountability in an era of severe financial constraint. Most of our successful research outcomes arose when researchers engaged in active dissemination with different audiences including end users and opinion/senior leaders. The findings of this research assessment are helping us to better consider dissemination and knowledge translation strategies at the outset of projects. Being able to evidence specific research outcomes to senior managers and board members is enabling us to continue our modest investment in health services research.

Institutional investors’ site visits and corporate employment decision-making

This study examines the effect of institutional investors’ site visits on corporate employment decision-making. Using a unique dataset of corporate site visits (CSVs) to the listed firms in China, we find that CSVs are associated with less labor investment inefficiency. The effect is more pronounced in firms with lower information quality, worse corporate governance, and severe financial constraints. Our results are robust to endogeneity concerns. Further analysis suggests that labor investment inefficiency leads to lower future performance. Overall, our results are consistent with the view that CSVs improve information quality, corporate governance, and access to finance, which in turn, mitigates inefficient labor investment.

Nanoscale: Society's Deep Impact on Science, Technology and Innovation in India by Pankaj Sekhsaria, and: Instrumental Lives: An Intimate Biography of an Indian Laboratory by Pankaj Sekhsaria (review).

Reviewed by: Nanoscale: Society's Deep Impact on Science, Technology and Innovation in India by Pankaj Sekhsaria, and: Instrumental Lives: An Intimate Biography of an Indian Laboratory by Pankaj Sekhsaria Hyungsub Choi (bio) Nanoscale: Society's Deep Impact on Science, Technology and Innovation in India By Pankaj Sekhsaria. Greater Noida: AuthorsUpFront, 2020. Pp. 182 Instrumental Lives: An Intimate Biography of an Indian Laboratory By Pankaj Sekhsaria. Oxon: Routledge, 2019. Pp. 126. As faculty member of a technical university in South Korea, I frequently receive unsolicited emails from newly minted Indian Ph.D.s in science and engineering. The standardized messages invariably come with CVs attached. Typically, the scientists possess degrees from respectable institutions in India, complete with peer-reviewed publications in indexed periodicals. Some successfully secure postdoctoral positions in South Korean universities, contributing to R&D projects funded by the national government or hightech industries. This is but a narrow slice of the global and transnational enterprise called contemporary science. The experience made me wonder about the vast scale and scope of India's scientific workforce. Thankfully, Pankaj Sekhsaria provides a valuable glimpse into the underbelly of Indian scientific research. The two books under review are products of Sekhsaria's doctoral research at Maastricht University in the Netherlands. He has conducted fieldwork in five nanoscience laboratories in Pune, Hyderabad, and Chennai, all in India. Sekhsaria's focus on nano may have been opportunistic, as at the time nanotechnology was the leading buzzword around the world. However, the survey opens a window for observing the state of scientific research in contemporary India. Nanoscale is a more popular rendition, succinctly outlining the research activities in the five labs; Instrumental Lives is a more scholarly version, focusing on one of them. In Instrumental Lives, Sekhsaria shines a spotlight on the scientific life of C. V. Dharmadhikari, a physicist at the University of Pune credited with the indigenous development of the scanning tunneling microscope (STM). Dharmadhikari completed his Ph.D. at Pune in 1979 and, like many good Indian scientists, continued his research career in the United States. By the mid-1980s, he was positioned squarely within the surface science community as the STM took off as a major scientific instrument (Mody, Instrumental Communities). When Dharmadhikari returned to Pune as faculty member, he set out to make his own STM there, successfully completing the first version by 1988. The city of Pune provided a fertile environment for Dharmadhikari to pursue his goals. Located 90 miles inland, in southeast Mumbai, Pune was [End Page 859] home to many educational and research institutions. It was also bustling with manufacturing and commercial activities in "thriving small and medium industry enterprises" and booming "junk markets" (pp. 43, 52). The lively urban environment shaped Dharmadhikari's scientific practice. Not only could he acquire diverse parts from bungee cords and stepping motors to tuning forks and bobbins (p. 40), he also had access to a wide range of experts in nearby institutions who shared his interest and would become "users" of his microscope. In short, Dharmadhikari utilized whatever resources were available to create his version of the STM, which he then used to produce scientific knowledge and skilled scientists of the nanoscale. In analyzing this case, Sekhsaria is primarily interested in identifying the nature of Dharmadhikari's work. Was it a "quintessentially Indian" (p. 10) mode of innovation, or a mere replica of original work by Western scientists? At this juncture, the recent debate on jugaad is useful. While difficult to translate into English, the term usually refers to "creative improvisation" (p. 30). An archetypal example of jugaad is the low-cost quadricycle made of wooden planks and a repurposed diesel engine. On one hand, these kuddukkas represent the ingenuity and resourcefulness of Indians under severe financial constraints. On the other hand, they are looked down on as something that falls short of "genuine innovation" (p. 32). By acknowledging Dharmadhikari's microscope as "technological jugaad" (ch. 5), Sekhsaria emphasizes the role of science and technology as solutions to mundane problems, eschewing the idolization of innovation as pursuit of high-tech agendas disengaged from everyday life. Scientists and technologists in the "underdeveloped" world (one could say postcolonial or non-Western, depending...

Open account, import decision and financial constraints: A cross‐country firm‐level study

AbstractThis paper uses cross‐country firm‐level data to investigate the influence of an open account on import decisions of firms facing financial constraints. In the open account method, buyers pay after shipment. We employ the sector‐location average as an instrumental variable to deal with the endogeneity problem. Our empirical results provide evidence that an open account positively affects import possibility, particularly, in large‐sized financially‐constrained firms. Our findings imply that large‐sized firms possess more bargaining power than small‐ and medium‐sized firms when negotiating payment terms in importing contracts, especially under severe financial constraints. These findings may suggest several vital implications for the import promotion policy.

Liquid asset sheltering, or cost of capital? The effect of political corruption on corporate cash holdings

I posit that political corruption affects firms through an entrenchment between entrepreneurs and politicians instead of coercive extortion. Based on this postulate, I refute the claim that firms in a more corrupt environment hold less cash due to liquid assets sheltering from political extraction. Instead, I propose that firms in a more corrupt environment hold less cash because of the high cost of capital. In fact, I find that firms in more corrupt countries hold cash beyond their optimum for the given cost of carry due to severe financial constraints. This excess cash results in value destruction. I call this phenomenon the financial effect of corruption. Thus, I challenge the conventional wisdom and argue that the effects of political corruption on corporate cash holdings are primarily indirect through financial mechanisms.

Economic Policy Uncertainty and Corporate Bank Credits: Evidence from China

ABSTRACT This paper studies the relationship between economic policy uncertainty (EPU) and corporate bank credits for Chinese listed companies. We find that high EPU reduce the corporate bank credits. The negative association is less obvious in state-owned companies, that is, SOEs have a higher capacity to resist uncertainty than non-SOEs. Further research indicates that the positive effect of state-owned status on bank credit lines during times of rising EPU is stronger among companies facing more severe financing constraints.

Co-payments and equity in care: enhancing hospitalisation policy for Palestine refugees in Lebanon

BackgroundThis paper measures the impact of introducing a 10% co-payment on secondary care hospitalization costs for Palestine refugees living in Lebanon (PRL) in all UNRWA contracted hospitals, except for the Red Crescent Society. This ex-post analysis provides a detailed insight on the direction and magnitude of the policy impact in terms of demand by hospital type, average length of stay and treatment costs.MethodsWith a complete population episode level dataset, we use multinomial logit, negative binomial, and linear models to estimate impacts on the different dependent variables, controlling for disease, patient and hospital characteristics.ResultsAfter the implementation patients were at least 4 pp (p <0.01) more likely to choose a Red Crescent Society hospital for secondary care, instead of one with co-payment. Average length of stay was not affected in general, despite the increase in control at all UNRWA contracted hospitals. Except for the decrease in UNRWA contribution, did not find a statistically significant impact of the co-payment on costs, nor for the provider or for the patient. Findings suggest that introducing a 10% co-payment for secondary hospital care had an impact on patients’ health care budget, leading to demand shifts towards cheaper options - i.e., patients had to chose care based on financial constraints rather than on their treatment preferences.ConclusionBefore changing healthcare payment schemes in different types of hospitals, facilities offering free of charge treatment should be assessed and prepared for potential demand shifts to avoid overcapacity and the collapse of health care services for such a fragile population. In addition, exemptions from co-payments should be considered for patients with severe health conditions and financial constraints, who, according to our results, are the most likely to change their pattern of care due to an increase in treatment costs.

CASE STUDY ON SMALL LUNG CELL CARCINOMA IN A 26-YEAR-OLD MALE

Introduction: A small-cell lung carcinoma is an aggressive form of lung cancer that is strongly associated with cigarette smoking and tends to early disseminate in the body. It represents about 20 per cent of all lung cancer. Increasing evidence has implicated autocrine growth loops, proto-oncogenes, and tumour-suppressor genes in its development as well as cigarette smoking, exposure to occupational carcinogens such as radon, asbestos, arsenic, crystalline silicon and benzopyrene e.t.c.&#x0D; Materials and Methods: This case study reports the management of suspected small lung cell cancer in a resource-limited centre diagnosed from transthoracic pleural biopsy in a 26-year-old male who had a history of cigarette smoking from preteen years (9 years). He was stabilized at the emergency with insertion of chest tube, antibiotics, analgesics and oxygen but couldn't commence treatment for lung cancer owing to the late diagnostic test done as a result of severe financial constraints and died three weeks post-hospital admission.&#x0D; Results: This case shows that early exposure to risk factors associated with lung cancer such as cigarette smoking, exposure to harmful chemicals in Plaster of Paris can lead to aggressive lung cancers like small cell lung cancer in young people.&#x0D; Recommendations: Increase public awareness of tobacco smoking in all age groups, adequate healthcare financing and insurance schemes and adequate funding for small cell lung cancer research to improve and promote prevention, early detection and proper treatment of the disease.

Does the Carbon Emissions Trading Policy Increase Corporate Tax Avoidance? Evidence from China

Based on the natural experiment of carbon emissions trading pilots in China, this paper investigates the effect of environmental regulation on corporate tax avoidance. The results show that: 1) Market-incentivized environmental regulation significantly increase the level of corporate tax avoidance. 2) Heterogeneity analysis shows that the effect is more obvious on the non-state-owned firms, firms with severe financing constraints, and firms in highly competitive industries. 3) We find that the reduction of cash flow is the channel for environmental regulation to affect corporate tax avoidance. 4) Further analysis shows that government subsidies can alleviate the enhancement of tax avoidance by environmental regulation. The more government subsidies a company receives, the less tax avoidance it has.

Does managerial ability affect corporate financial constraints? Evidence from China

We study the effect of managerial ability on financial constraints of Chinese listed companies. Our results indicate a negative relationship between managerial ability and corporate financial constraints. Further analyses show that managerial ability helps alleviate financial constraints probably through lowering information asymmetry, reducing agency conflicts and enhancing corporate profitability. In addition, we find evidence that private firms suffer from more severe financial constraints than state- and foreign-owned firms, and the effect of managerial ability in alleviating financial constraints is more pronounced for private firms. Overall, our findings help understand the role and highlight the importance of managerial ability in alleviating financial constraints.