Is There a Rural Penalty in Language Acquisition? Evidence From Germany's Refugee Allocation Policy.

Emerging evidence has highlighted the important role of local contexts for integration trajectories of asylum seekers and refugees. Germany's policy of randomly allocating asylum seekers across Germany may advantage some and disadvantage others in terms of opportunities for equal participation in society. This study explores the question whether asylum seekers that have been allocated to rural areas experience disadvantages in terms of language acquisition compared to those allocated to urban areas. We derive testable assumptions using a Directed Acyclic Graph (DAG) which are then tested using large-N survey data (IAB-BAMF-SOEP refugee survey). We find that living in a rural area has no negative total effect on language skills. Further the findings suggest that the "null effect" is the result of two processes which offset each other: while asylum seekers in rural areas have slightly lower access for formal, federally organized language courses, they have more regular exposure to German speakers.

The Health Value of Kidney Exchange and Altruistic Donation.

OBJECTIVES: Living donor kidney transplantation (LTx) is the preferred treatment for patients with end-stage renal disease. Kidney exchange programs (KEPs) promote LTx by facilitating exchange of donors among patients who are not compatible with their donors. We analyze and maximize the efficacy and effectiveness of KEPS from a health value perspective and the health value of altruistic donation in KEPs. METHODS: We developed a Markov model for the health outcomes of patients, which was embedded in a discrete event simulation model to assess the effectiveness of allocation policies in KEPs. A new allocation policy to maximize health value was developed on the basis of integer programing techniques. The evidence-based transition probabilities in the Markov model were based on data from the Dutch KEP using a variety of econometric models. Scenarios analysis was presented to improve robustness. RESULTS: The efficacy of the Dutch KEP without altruistic donation is reflected by the increase in expected discounted quality-adjusted life-years (QALYs) by 3.23 from 6.42 to 9.65. The present Dutch policy and the policy to maximize the number of transplants achieve 63% of the potential efficacy gain (2.11 discounted QALYs). The new policy achieves 69% of this gain (2.33 discounted QALYs). When systematically enrolling altruistic donors in the KEP, the new policy increased expected discounted QALYs by 4.05 to 10.27 and reduced inequities for patients with blood type O. CONCLUSIONS: The Dutch KEP can increase health value for patients by more than half. An allocation policy that maximizes health outcomes and maximally allows altruistic donation can yield significant further improvements.

Inter-basin hydropolitics for optimal water resources allocation.

Efficient, just, and sustainable water resources' allocation is difficult to achieve in multi-stakeholder basins. This study presents a multi-objective optimization model for water resources allocation and reports its application to the Sefidrud basin in Iran. Available water resources are predicted until 2041with the artificial neural network algorithm (ANN). This is followed by multi-objective optimization of water resource allocation. The first objective function of the optimization model is maximization of revenue, and the second objective function is the achievement of equity in water resources allocation in the basin. This study considers two scenarios in the optimization scheme. The first scenario concerns the water allocation with existing dams and dams under construction. The second scenario tackles water allocation adding dams currently in the study stage to those considered in Scenario 1. The Gini coefficient is about 0.1 under the first scenario, indicating the preponderance of economic justice in the basin. The Gini coefficient is about 0.4 under the second scenario, which signals an increase of injustice in water allocation when considering the future operation of dams currently under study.

Decreasing patient length of stay via new flexible exam room allocation policies in ambulatory care clinics.

To address prolonged lengths of stay (LOS) in ambulatory care clinics, we analyze the impact of implementing flexible and dynamic policies for assigning exam rooms to providers. In contrast to the traditional approaches of assigning specific rooms to each provider or pooling rooms among all practitioners, we characterize the impact of alternate compromise policies that have not been explored in previous studies. Since ambulatory care patients may encounter multiple different providers in a single visit, room allocation can be determined separately for each encounter accordingly. For the first phase of the visit, conducted by the medical assistant, we define a dynamic room allocation policy that adjusts room assignments based on the current state of the clinic. For the second phase of the visit, conducted by physicians, we define a series of room sharing policies which vary based on two dimensions, the number of shared rooms and the number of physicians sharing each room. Using a discrete event simulation model of an outpatient cardiovascular clinic, we analyze the benefits and costs associated with the proposed room allocation policies. Our findings show that it is not necessary to fully share rooms among providers in order to reduce patient LOS and physician idle time. Instead, most of the benefit of pooling can be achieved by implementation of a compromise room allocation approach, limiting the need for significant organizational changes within the clinic. Also, in order to achieve most of the benefits of room allocation policies, it is necessary to increase flexibility in the two dimensions simultaneously. These findings are shown to be consistent in settings with alternate patient scheduling and distinctions between physicians.

Coeficientes técnicos de uso direto da água em termos monetários para regiões hidrográficas nos setores da agricultura irrigada e do abastecimento urbano: o caso de uma das bacias receptoras do Eixo Norte do Projeto de Integração do São Francisco / Technical coefficients of direct use of water in monetary terms for river basin districts in areas of irrigation for agriculture and urban water supply: the case of one of the recipients of the North Basin of The North Axis of São Francisco Transboundary Project

RESUMO O Projeto de Integração do São Francisco (PISF) é uma obra do governo federal, prevendo duas captações no rio para complementar a oferta de água local no Ceará (CE), no Rio Grande do Norte (RN), na Paraíba (PB) e em Pernambuco (PE). O Eixo Norte levará água para as Bacias do Piranhas-Açu (PB e RN) e do Jaguaribe (CE), que serão as maiores receptoras das águas da transposição. Neste trabalho foram propostas metodologias para obter e obtêm-se a partir delas, nas diferentes regiões hidrográficas da Bacia do Piranhas-Açu, coeficientes técnicos de uso direto da água em termos monetários para os setores econômicos associados ao abastecimento urbano (AU) e à agricultura irrigada (AI). Esses coeficientes são uma forma alternativa de apresentar os bem estabelecidos coeficientes técnicos da teoria básica de Análise de Insumo-Produto. No caso dos setores econômicos associados ao AU, os coeficientes obtidos mostraram que, a partir de certo nível de urbanização, as quantidades de água utilizadas crescem mais que o produto econômico associado ao setor. Os coeficientes da AI obtidos são bem menores do que os do AU e quando calculados por cultura mostraram que na bacia há um mix de cultivos inadequados associados a baixas eficiências no uso, o que resulta em baixos valores econômicos por m3 de água alocado no setor. Isso demonstra que, para ambos os setores econômicos, há necessidade de incentivos para que o uso da água seja mais eficiente na bacia estudada.

ABSTRACT The São Francisco Transboundary Project (SFTP) is a Federal Government project, which includes two diversions of the River to supplement the supply of local water in Ceará, Rio Grande do Norte, Paraíba and Pernambuco. The North branch will deliver water to Piranhas-Açu (Paraiba and Rio Grande do Norte States) and Jaguaribe (Ceará State) reservoirs, which will become the largest recipients of the transboundary. In this paper we propose methodologies by which technical coefficients of direct use of water in different hydrographic regions of the Piranhas-Açu basin under study can be stated in monetary terms for the economic sectors associated with urban supply (US) and the agricultural irrigation (AI). The technical coefficients we have calculated are a different means of presenting well-established coefficients in the basics of Input-Output Analysis. In the case of economic sectors associated with the US, the coefficients showed that at a certain level of urbanization, the amountof water used increases more than the economic product of the sector. The coefficients of AI obtained are much lower than those of the USand, when calculated by crop, showed that in the basin, trhee is an inadequate mix of crops and a low water use efficiency, resulting in low economic value per cubic meter of water allocated to the sector. This implies, for both economic sectors, a need for incentives to use water in a more efficient way in the basin.