Evaluation of insurance policies in the Saudi Arabian construction contracts.

The construction sector is more complicated and prone to risk than many other industries due to the size of the projects and the financial capital involved. Arranging insurance is the prudent course of action for risk management in the construction sector. There is a lack of clarity in insurance policies for public construction projects in the Kingdom of Saudi Arabia (KSA), which poses additional risks to all involved contracting parties. The aim of this research is to evaluate insurance policies in the KSA's public construction projects to identify the key deficiencies and obstacles and provide a road map for improvement in the insurance sector concerning insurance against financial losses, professional liability, defects' liability, hidden defects, and others. Forty-two contractors and forty-two owners in Saudi Arabia were surveyed, using a questionnaire to gather information for the study about their knowledge of and attitudes regarding risk transfer through insurance (professional liability, defects liability, and hidden defects). The study also covers the selection criteria for insurance policies for projects that potentially shift risk to the construction sector. Ten criteria were also examined as potential sources of liability issues and suggested as potential remedies in KSA. The findings indicate that the duty and liability of engineers and those participating in these projects can be offset by engineers' insurance against professional errors and hidden flaws, and by the construction industry's clear liability policy. Additionally, the research is envisaged to contribute to construction projects' overall quality and safety, ensuring that robust legal and financial safeguards protect all stakeholders.

Flood risk transfer analysis based on the "Source-Sink" theory and its impact on ecological environment: A case study of the Poyang Lake Basin, China.

Driven by climate change, the frequent occurrence of regional destructive floods poses a grave threat to socio-economic systems and ecological environments. Previous flood risk studies have disregarded risk transfer within a region, resulting in inadequate flood risk assessment and ineffective disaster prevention and mitigation outcomes. Therefore, this study introduced the "Source-Sink" theory into flood disaster field to constructing flood risk transfer model. Flood risk assessment and transfer was conducted in the Poyang Lake Basin, China, where the impacts of the initial and transfer statuses on ecosystem service values were quantified. The results showed that the flood risk in the Poyang Lake Basin was relatively low, with high spatial distribution characteristics in the central-north areas but low in the surrounding areas. High-risk zones were mainly distributed southwest of the Poyang Lake. The lower-risk zones exhibited a contiguous distribution and were surrounded by higher-risk zones. Following the completion of the flood risk transfer, high-risk zones increased significantly; but there were a few zones where the risk was transferred to other zones, thereby lowering their risks. Flood risk transfer occurs primarily in low- and medium-risk zones, with high-risk zones being the most important growth targets. The change in risk transfer was most evident in the area surrounding Poyang Lake, while that in the Upper Gan River Basin was lower and less sensitive to the transfer effect. Accounting for flood disaster risk, the ecosystem service values of the Poyang Lake Basin decreased by 8.18 %, with the most significant impacts observed in the surrounding environment and southwest Poyang Lake. After the completion of the flood risk transfer, the ecosystem service value in the Poyang Lake Basin declined by 24.66 %. This study provides a reference point for flood risk management and sustainable regional development that account for risk transfer.

Risk communication in multistakeholder engagement: A novel spatial econometric model.

Existing studies on the environmental Kuznets curve (EKC) neglect the inverse effect of pollution transfer from environmental regulation interactions on pollution reduction from a risk analysis perspective. Based on the regional differentiated attitudes on the environmental regulation reached in risk communication by the risk awareness biases of multiple interest groups, this article clarifies the causality between risk communication and risk transfer based on multistakeholder engagement processes; furthermore, the article incorporates the simultaneous action of the technological innovation effect and pollution risk transfer effect to construct a spatial environmental hyperbolic model with a bidirectional correlation between pollution emissions and economic growth in different regions. To verify our model, we select the pollution from agricultural watersheds in China as a sample to examine the two inverse effects. The results demonstrate that (1) agricultural watershed pollution and economic growth show an inverted U-shaped relation and a U-shaped relation in the local region and adjacent regions, respectively; (2) the pollution reduction assessment of the classical EKC model can be largely attributed to pollution risk transfer behavior; and (3) the turning point of the U-shaped curve appears earlier than that of the inverted U-shaped curve in the spatial hyperbola model. The findings suggest that stakeholders should consider the risk awareness bias caused by the imbalance of regional economic development and the scenarios that provide a "haven" for pollution risk transfer. Moreover, our study expands the theoretical connotation of the classical EKC hypothesis and is more suitable for pollution reduction scenarios in developing countries.

Using the VERA-2R, professional and organisational aspects.

Introduction: Violent extremism risk assessments of individuals suspected or convicted of terrorism are relevant for legal decisions, in prison and probation settings, and in inter-professional risk collaboration. These risk assessment reports by professionals should be applicable to and usable for the different judicial contexts. Informal and formal clinical practice evaluations, in the form of practitioners feedback and standardised evaluation of professional violent extremism risk reports are needed to gain insight in the use and quality of violent extremism risk assessments. Methods: In this study we examined how forensic professionals from three different countries (Sweden, Belgium and the Netherlands) use the VERA-2R in different judicial contexts. We also investigated which organizational aspects are important for the use of the VERA-2R. We focused on the perspective of the forensic professionals and their judicial organisations. We did a standardised survey among 86 VERA-2R trained professionals and a standardised interview with 20 executives and managers of organizations working with the VERA-2R. Results: This study showed that professionals find the VERA-2R useful for structuring information and speaking a common risk language. However, using the VERA-2R comes with a variety of challenges, both on the professional and organisational level. VERA-2R trained professionals had few opportunities to use the instrument and when they did, they were not always offered regular supervision, intervision and booster training. Also, organisational issues in collaboration between judicial partner organisations and the lack of risk transfer information to professionals came to light. Discussion: More research on the topic of risk transfer is needed. Policy implications are advised, for example the development of booster trainings, more organizational support, regulations on re-assessments, providing expertise and knowledge to indirect stakeholders and clear writing guidelines.

Genebanks at Risk: Hazard Assessment and Risk Management of National and International Genebanks.

Genebanks are crucial for safeguarding global crop diversity but are themselves exposed to several risks. However, a scientific basis for identifying, assessing, and managing risks is still lacking. Addressing these research gaps, this study provides risk analysis for three key risk groups: natural hazards, political risks, and financial risks, carried out on a sample of 80 important national and international genebanks, comprising at least 4.78 million accessions or roughly 65% of the reported total of ex situ conserved accessions worldwide. The assessment tool of Munich Re "Natural Hazards Edition" allowed a location-specific comparison of the natural hazard exposure. Results showed that genebanks in the Asia-Pacific region are most exposed to natural hazards, while institutions in African and some Asian countries are rather vulnerable to political risks. Financing is a major problem for national genebanks in developing countries, whereas the Global Crop Diversity Trust achieved considerable financial security for international genebanks. Large differences in the risk exposure of genebanks exist, making a location- and institution-specific risk assessment indispensable. Moreover, there is significant room for improvement with respect to quality and risk management at genebanks. Transferring risks of genebanks to third parties is underdeveloped and should be used more widely.

The effect of subcontractor status on occupational injury and disease incidence: a cross-sectional study using the 9th Occupational Safety and Health Company Survey.

BACKGROUND: Despite the efforts of contractors to identify and reduce any occupational risk that exists in subcontracted works, if the associated risks cannot be eliminated and reduced and subcontractors have to take risks, this situation can be called 'risk transfer.' The hypothesis of this study is that the contractor-subcontractor status of a company affects the risk of occupational injury or occupational disease. The inside subcontractor and outside subcontractor represent subcontractors located inside and outside the contractor workplace, respectively. METHODS: The dataset from the 9th Occupational Safety and Health Company Survey (OSHCS) with 5219 workplaces, which was conducted in South Korea, was used. After the exclusion of 45 workplaces with no reported employees, 5174 workplaces with a total of 1,072,583 employees were used for analysis. Poisson regression was applied with the contractor-subcontractor category as the independent variable and the number of both occupational injury and disease cases per workplace as the dependent variable. Poisson regression is an appropriate model for the count-data analysis of rare events that do not follow a normal distribution but rather follow a right-skewed distribution. RESULTS: Compared to the 'contractor' category, the 'outside contractor' reported the highest risk ratio, 1.66 (95% Confidence Interval, CI 1.09-2.41). The 'inside contractor' reported the second highest risk ratio, 1.39 (95% CI 1.07-1.78). In contrast, the 'both contractor and subcontractor' category reported a statistically significant decreased risk ratio of 0.69 (95% CI 0.57-0.84). The 'neither contractor nor subcontractor' category showed a statistically equivocal risk ratio of 0.91 (95% CI 0.76-1.07). CONCLUSION: This study confirmed the increased risk of occupational injuries and diseases for subcontractors, whether located inside or outside the contractor workplace (1.66-fold and 1.39-fold increased risk, respectively). Future individual-based epidemiologic studies such as case-control and cohort studies could provide more detailed information such as specific risk factors associated with subcontracted works and confounders according to industry classification.

How to Understand the Role of Insurance Mechanism in a Global Pandemic?

The COVID-19 epidemic has seriously affected global economic and social development. The extent to which insurance can play a role in preventing and transferring the risk of infectious diseases has become one of the major concerns of the community. This paper first analyzes the main contents of the U.S. Pandemic Risk Insurance Act during the COVID-19 epidemic and its insights to the global audiences. Then, on the basis of the definition of global pandemic, this paper analyzes the great challenges faced by the insurability of the infectious diseases' catastrophe from the regional impact, risk accumulation, correlation with capital markets, and accuracy of catastrophe model, and the insurability of local infectious diseases. Finally, this paper presents the key points of the top-level design of the risk transfer mechanism of infectious disease insurance in China. This paper is informative in understanding the role of insurance in the risk transfer of infectious diseases.

In-house Contractors' Exposure to Risks and Determinants of Industrial Accidents; With Focus on Companies Handling Hazardous Chemicals.

BACKGROUND: The series of serious industrial accidents in recent years at contractors to large companies has highlighted risk outsourcing as a real and urgent problem. This study aims to review the difference in the degree of risk exposure and the occurrence of industrial accidents depending on the type of company relations. Among in-house contractors, the focus will be on those handling hazardous chemicals that include companies for which outsourcing requires approval. METHODS: This study uses the 9th wave of the Industrial Safety and Health Survey (2018). For determining the degree of risk exposure, the occurrence of industrial accidents, and industrial accident rate, multivariate, logistic, and fractional logit, regression analyses were used, respectively. RESULTS: First, In-house contractors' degree of risk exposure is higher than that of the client companies. In particular, this gap is even greater for companies dealing with chemicals. Second, among only those that handle hazardous chemicals, in-house contractors do show a significantly higher rate of industrial accident occurrence. Third, In-house contractors have a significantly higher rate of industrial accidents from diseases than client companies. CONCLUSION: The analysis supports the intent of the legal amendment that strengthens the protection of in-house contracted workers who handle hazardous chemicals. Second, the results of this study suggest that safety and health management must go beyond legal compliance and ensure that it has substance and effectiveness. Last, there should be policy consideration is necessary to reduce attempts to hide industrial accidents.

Mechanism Study on Risk Sharing and Transfer of Drug Marketing Authorization Holders Based on Drug Defects / 中国药房

OBJECTIVE：To explore the mechanism of risk sharing and transfer of drug marketing authorization holders （MAH）based on drug defects ，and to promote the smooth implementation of MAH system in China. METHODS ：Firstly，the types of drug defects in the whole drug life cycle were analyzed ，and then the sources and “fault party ”of different types of drug defects in the open commissioning environment of the industry chain under the MAH system were also analyzed. Based on it ，the mechanism of risk sharing and transfer of MAH was established combined with foreign experience and China ’s actual situation. RESULTS & CONCLUSIONS ：Drug defects were divided into design defects ，manufacturing & operation & storage & transportation quality defects and use defects ，among which design defects and manufacturing & operation & storage & transportation quality defects were the two most important defects. Design defects mainly included those caused by human factors and those could not be found by current level of science and technology ，the“fault party ”according to different circumstances may be both the research and development institutions and may be the MAH. The “fault party ”of production & operation & storage & transportation quality defects was the drug production & operation & storage & transportation enterprises. For design defects ，it was recommended to establish China ’s adverse drug reaction compensation mechanism through a combination of insurance and relief. For production & operation & storage & transportation quality defects ，it was recommended that the drug quality liability insurance as the main ，contractual agreement as the supplement ，so that the “fault party ”should assume due responsibility.

A Probabilistic Paradigm for the Parametric Insurance of Natural Hazards.

There is a pressing need for simple and reliable risk transfer mechanisms that can pay out quickly after natural disasters without delays caused by loss estimation, and the need for long historical claims records. One such approach, known as parametric insurance, pays out when a key hazard variable exceeds a predetermined threshold. However, this approach to catastrophe risk, based on making deterministic binary predictions of loss occurrence, is susceptible to basis risk (mismatch between payouts and realized losses). A more defensible approach is to issue probabilistic predictions of loss occurrence, which then allows uncertainty to be properly quantified, communicated, and evaluated. This study proposes a generic probabilistic framework for parametric trigger modeling based on logistic regression, and idealized modeling of potential damage given knowledge of a hazard variable. We also propose various novel methods for evaluating the quality and utility of such predictions as well as more traditional trigger indices. The methodology is demonstrated by application to flood-related disasters in Jamaica from 1998 to 2016 using gridded precipitation data as the hazard variable. A hydrologically motivated transformation is proposed for calculating potential damage from daily rainfall data. Despite the simplicity of the approach, the model has substantial skill at predicting the probability of occurrence of loss days as demonstrated by traditional goodness-of-fit measures (i.e., pseudo-R2 of 0.55) as well as probabilistic verification diagnostics such as receiver operating characteristics. Using conceptual models of decisionmaker expenses, we also demonstrate that the system can provide considerable utility to involved parties, e.g., insured parties, insurers, and risk managers.

Practice and Thought on Medical Dispute Mediation Committee as Third Party Participating in Pre - Operative Testimony Mechanism / 中国医学伦理学

Objective: To explore the effect and significance of medical dispute mediation committee as third party participating in pre - operative testimony mechanism. Methods: For 116 operations from Oct 2015 to May 2017, the medical dispute mediation committee as third party witnessed preoperative communication to patients and their families and signature, and we put forward suggestions for risk guarantee. Results: There were no medical disputes in any of the witness case, of which 43 cases purchased medical accident insurance and achieved risks transfer. Conclusion: Medical dispute mediation committee as third party participating in pre - operative testimony mechanism helps both doctors and patients clear risks, supervises the fulfillment of informed consent, promotes the landing of medical accident insurance, and achieves the recognition and transformation of medical risks.

Assessing the transfer of risk due to transportation of agricultural products.

Health risk assessment (HRA) is the process used to estimate adverse health effects on humans. The importance and sensitivity of food chains to HRA have been observed, but the impact of the transportation of food has generally been ignored. This study developed an exposure assessment to demonstrate the significance of the transportation of agricultural products in HRA. The associated case study estimated the health risks derived from various sources of arsenic emissions in Taiwan. Two assessment scenarios, self-sufficiency and transportation of agricultural products, were compared to calculate risk transfer ratios that show the impact of agriculture transportation. The risk transfer ratios found by the study range from 0.22 to 42.10, indicating that the quantity of transportation of agricultural products is the critical factor. High air deposition and high agricultural production are the two main contributors to the effect of the transportation of agricultural products on HRA. Risk reduction measures could be applied to high-pollution areas as well as to areas with high agricultural productivity to reduce ingestion risks to residents. Certain areas that are sensitive to the transportation of agricultural products may incur more risks if emissions increase in agriculturally productive counties.

Transfer of radiation related leukemia risk from Japanese population to Chinese population / 中华放射医学与防护杂志

Objective To estimate the averaged excess relative risk(ERR) in Chinese population based on the radiogenic cancer risk of leukemia in Japanese atomic bomb survivor cohort,and to discuss proper method suitable for risk transfer between populations.Methods Based on BEIR Ⅶ radiogenic cancer model and population transfer model,and the 2009 Chinese leukemia baseline rates given in 2012 Chinese Cancer Registry Annual Report,comparison was made of population incidences in seveal countries to adjust the weighting factors.Results The ERR of three subtypes of leukemia as a whole was obtained,and the weighting factors for risk transfer model was assumed.The additive factor for male was 0.2,and the multiplicative factor was 0.8,while the additive factor for female was 0.15,and the multiplicative factor was 0.85.Conclusions For the risk transfer between populations,weighting factor was adjusted as a whole to obtain the ERR value for estimating the risk to Chinese population.The risk transfer method suitable for Chinese population was obtained by using the incidence rate available for Chinese population to directly transfer radiation-induced leukemia risk to Chinese from Japanese.

Risk transfer formula for individual and small group markets under the Affordable Care Act.

The Affordable Care Act provides for a program of risk adjustment in the individual and small group health insurance markets in 2014 as Marketplaces are implemented and new market reforms take effect. The purpose of risk adjustment is to lessen or eliminate the influence of risk selection on the premiums that plans charge. The risk adjustment methodology includes the risk adjustment model and the risk transfer formula. This article is the third of three in this issue of the Medicare & Medicaid Research Review that describe the ACA risk adjustment methodology and focuses on the risk transfer formula. In our first companion article, we discussed the key issues and choices in developing the methodology. In our second companion paper, we described the risk adjustment model that is used to calculate risk scores. In this article we present the risk transfer formula. We first describe how the plan risk score is combined with factors for the plan allowable premium rating, actuarial value, induced demand, geographic cost, and the statewide average premium in a formula that calculates transfers among plans. We then show how each plan factor is determined, as well as how the factors relate to each other in the risk transfer formula. The goal of risk transfers is to offset the effects of risk selection on plan costs while preserving premium differences due to factors such as actuarial value differences. Illustrative numerical simulations show the risk transfer formula operating as anticipated in hypothetical scenarios.

Personality, coping, risky behavior, and mental disorders in the offspring of parents with bipolar disorder: a comprehensive psychosocial assessment.

OBJECTIVES: It has been proposed that the offspring of parents with bipolar disorder (OBD), through genetic mechanisms and early family interactions, develop a heightened sensitivity to stress, maladaptive coping, and dysregulated behavior, which ultimately increases the risk for affective disorders. The current study tested certain predictions of this model by assessing different psychosocial and health-related outcomes in the OBD, including personality, coping style, smoking, suicidality, high-risk sexual behaviors, criminality, and mental health. METHOD: The sample was composed of 74 OBD and 75 control offspring, who were between 14 and 27 years of age (mean: 19.38±3.56). Participants underwent a diagnostic interview and a structured interview to assess high-risk behavior and other maladaptive outcomes, and they completed the Revised NEO Personality Inventory and Coping in Stressful Situations questionnaire. RESULTS: The rates of affective (31.1%) and non-affective (56.8%) disorders were elevated in the OBD compared to controls (9.5% and 32.4%). Relative to controls, OBD endorsed fewer task-oriented and more distraction coping strategies [Wilk׳s λ=.83, F(1, 136) =6.92, p<.01], and were more likely to report engaging in high-risk sexual behavior (OR=2.37; Wald=4.13, 1 df, p<05). Importantly, OBD reported elevated high-risk sexual behavior relative to controls, irrespective of affective disorder diagnosis. CONCLUSION: The results highlight a potential risk profile for the OBD, consisting of ineffective coping strategies and risky sexual behavior and are discussed in the context of current knowledge of stress and coping in this population. LIMITATIONS: The present findings were based on cross-sectional data and relied on offspring self-report. It would be useful to corroborate these findings with biobehavioural and longitudinal measures.

Reduction of construction wastes by improving construction contract management: a multinational evaluation.

The Canadian construction industry generates 30% of the total municipal solid waste deposited in landfills. Ample evidence can be found in the published literature about rework and waste generation due to ambiguity and errors in contract documents. Also, the literature quotes that disclaimer clauses in contract documents are included in the contractual agreements to prevent contractor claims, which often cause rework. Our professional practice has also noted that there are several disclaimer clauses in standard contract documents which have the potential to cause rework (and associated waste). This article illustrates a comparative study of standard contractual documents and their potential to create rework (and associated waste) in different regions of the world. The objectives of this study are (1) to analyse standard contractual documents in Canada, the USA and Australia in terms of their potential to generate rework and waste, and (2) to propose changes/amendments to the existing standard contract documents to minimise/avoid rework. In terms of construction waste management, all the reviewed standard contract documents have deficiencies. The parties that produce the contract documents include exculpatory clauses to avoid the other party's claims. This approach tends to result in rework and construction waste. The contractual agreements/contract documents should be free from errors, deficiencies, ambiguity and unfair risk transfers to minimise/avoid potential to generate rework and waste.

Transfer of ERR for radiation-related leukemia from Japanese population to Chinese population / 中华放射医学与防护杂志

Objective To establish a transfer model for excess relative risk (ERR) for radiation-related leukemia from Japanese population to Chinese population.Methods Combined ERR of several subtypes of leukemia published in 1994, with the corresponding leukemia baseline incidence rates obtained from Cancer Incidence in Five Continents Vol.Ⅸ (CI5-Ⅸ) for Japanese population and Chinese population, a weighted risk transfer model was employed between an additive model and a multiplicative model, to execute ERR transfer.Results A range of weighing factors was proposed for risk transfer models:weighing factor was 0.4 for male and 0.3 for female, acute lymphoblastic leukemia, acute myeloid leukemia and chronic myeloid leukemia.The uncertainty for ERR transfer was characterized by lognormal distribution.Conclusions Based on the difference of baseline incidence rate for subtypes of leukemia between Japanese population and Chinese population, the transfer model and these weighing factors discussed in the present study could be applicable to transfer ERR for radiation-related leukemia from Japanese population to Chinese population.

Sistemas de salud locales: Análisis de la relación entre aseguramiento y mecanismos de contratación y pago en Córdoba, Salta y Tucumán / Local health systems: analysis of the relationship between insurance and contract and payment mechanisms in Cordoba, Salta and Tucuman

INTRODUCCIÓN: Los mecanismos de contratación y pago en salud generan un impacto diverso en la cantidad y calidad de los servicios médicos, en la transferencia de riesgo entre actores y en la eficiencia de la utilización de los recursos. OBJETIVO: Analizar la estructura del mercado de servicios de salud en las provincias de Córdoba, Salta y Tucumán durante los últimos cinco años. MÉTODO: Se consideraron las condiciones socio-económico-sanitarias locales, el marco institucional, la historia de los actores más relevantes del sector y las conductas adquiridas como respuesta a la estructura. La metodología incluyó un mapeo de los actores claves del sector salud cada provincia así como la administración de un cuestionario a una muestra de establecimientos públicos y privados de cada jurisdicción. RESULTADOS: Los ministerios de salud provinciales son los principales financiadores del sistema público de salud y el Instituto Nacional de Servicios Sociales para Jubilados y Pensionados (PAMI) y las obras sociales provinciales lo son del sistema privado. CONCLUSIONES: PAMI tiene una política nacional que lo torna menos flexible para contemplar las particularidades locales, mientras que las obras sociales provinciales se presentan como los actores idiosincrásicos, siendo más permeables a las demandas locales. En la medida en que el PAMI coordine con los ministerios y la obra social provincial, se podría converger a modelos más homogéneos de atención y mecanismos de pago, generando incentivos para una mayor eficiencia en la asignación de recursos y una mayor equidad en salud

INTRODUCTION: The contracting and payment mechanisms in health generate different impact on the quantity and quality of medical services, the transfer of risk among actors and the efficient use of resources. OBJECTIVES: To analyze the market structure of health services in the provinces of Cordoba, Salta and Tucuman during the past five years. We considered the local socioeconomic and health conditions, institutional framework, the history of the most relevant actors, and their behaviour in response to the structure. The methodology included a mapping of key actors in the health sector in each province and the administration of a questionnaire to a sample of local public and private health institutions. RESULTS: The results show that the provincial ministries of health are the primary funders of the public services and the national insurance for retired people (PAMI) and the provincial social insurances are the primary funders of the private system. CONCLUSION: PAMI has a national policy which makes it self less flexible to consider the local particularities,while the provincial social insurances present themselves as idiosyncratic actors, being more receptive to local demands. If PAMI were coordinated with the structure of the local social insurance and the ministries of health, it could beachieved homogeneous models of health care and payment mechanisms, generating incentives for a more efficient resources allocation and equity in health