Impact of human settlements quality on urban vitality based on multisource data:A case study of Shahekou District,Dalian,China

Urban geography has always been concerned about the influence of human settlements on urban vitality,but few studies reveal the influence of human settlements on urban vitality at a micro-scale.This paper analyzes the spatial distribution characteristics of human settlements’quality and urban vitality at the micro-scale using Geodetectors and geographic weighted regression to analyze the relationship between human settlements and urban vitality.The results are shown as follows:there is still a significant development space for human settlements quality in Shahekou District,with obvious spatial dependence characteristics and significant gaps between various systems;the urban vitality of Shahekou District has obvious timeliness,and the urban vitality undergoes significant changes over time,which is related to the human settlements quality.The spatial distribution presents a single core spatial distribution structure with strong relative stability.The spatial distribution of cold and hot spots shows a pattern of“high in the north and low in the south,high in the east and low in the west”,with an increasing trend from southwest to northeast;the reachability of public transport has a significant impact on urban vitality.Its synergy with other variables is the leading force forming the spatial distribution of urban vitality.The environmental system,support system and social system are the significant factors affecting the urban vitality of Shahekou District.

Nature and Operation of Kost Private Rental Housing in Urban Settlement Development of Jakarta, Indonesia

As one type of the highly sought after housing facilities in Indonesia, Kosts have formed unique heterogeneous living environment while also been a part of fast growing urban settlement developments in Indonesia＇s capital, Jakarta. This paper investigates the nature and operation of Kost private rental housing developed with various conditions and arrangements, as well as its position among other dwelling types, based on on-site investigations, literature reviews and statistical analyses. It is necessary to understand the development of Kost as it shows potentials to overcome the lack of affordable and adequate housing in the country. An accurate checking process during the application of building permit may early identify Kosts. Undefined standard of operation and arrangement may hinder improvement opportunities to its quality of services. Efforts to educate the community and easy access to related regulations are necessary for improvement and compliance awareness. Moreover, increased collaborative design and public education may improve the knowledge of self-builders on building design, planning and construction. Associations of self-organized housing and platforms offering affordable design services that meet the guidelines and standards are promising ootions.

Measures for the Construction Cost Budget and Settlement Audit

With the deep and sustainable development of the market economy,the competitive environment and development pattern faced by China’s construction industry are becoming more and more severe.In this context,construction projects should actively incorporate the development trends of the market economy and focus on analyzing relevant influencing factors and risk content.Considering previous experience,the audit effect of construction project budget and settlement has a major impact on the quality and economic benefit of construction projects to a certain extent.In view of this,this paper mainly focuses on the content and method of the construction cost budget and settlement audit as well as suggests measures for the construction cost budget and settlement audit,so as to improve the construction cost management level.

Community-led initiatives for the rehabilitation and management of vernacular settlements in Oman:a phenomenon in the making

Once abandoned for more than three decades,vernacular settlements in Oman are now being progressively reinvested in to foster the country’s heritage tourism sector.The present research focuses on the emerging phenomenon of community-led initiatives for vernacular heritage rehabilitation and adaptive reuse in Oman.Through an examination of three case studies,its aim is to describe this process and its modes of action and discuss its efects on vernacular settlement transformations.A mixed research methodology was designed to include(A)analyses of relevant primary and secondary data,(B)documented onsite observations,(C)interviews with local community representatives and key players in the operations of rehabilitation,and(D)extractions and analyses of quantitative data from a hotel booking website.The research sheds light on unsuspected interrelations within and between the projects being implemented in these settlements and their operating modes.It reveals the focal role of a local community in a kind of‘bottom-up’management of its built heritage,coupled with a‘horizontal cooperation’between the three initiatives studied in this research.Moreover,it shows that a heavily centralised and top-down policy for the feld of heritage conservation and management is among the main obstacles that hinder such initiatives.Furthermore,community-led operations of vernacular heritage rehabilitation are being undertaken under insufcient regulations in terms of land use,building restoration and adaptive reuse.In this context,the paper discusses some of the serious threats and concerns faced by such initiatives and proposes actionable solutions to mitigate these hindrances.

Delta River Swampy Areas Earth Fill Embankments Primary Consolidation Management Issues

It is well known that soft silty clayey and even peaty soils especially existing in Great River Deltas Swampy Areas,under important Earth Fill Embankment Construction experience huge and hardly bearable primary consolidations settlements along with the minor but not negligible consequent secondary consolidation effects.In order to properly manage these particular huge settlements environments,it is very important to follow up the settlements monitoring data,by a macroscopic soil volume interpretation along with some amendments namely some mathematical added variabilities of the classic Terzaghi Primary Consolidation Equation,which are examined in a companion paper recently published in this Journal.In this paper some indications are given about how to face the macroscopic soil volume primary consolidation settlements,and especially it is suggested how to interpret the misleading laboratory consolidation test values of the coefficient of consolidation.Moreover,some design alternative solutions are examined to grasp both the potential technical and economic benefits along with their consequent disadvantages.Finally,this paper underlined the primary role of the supervision engineer to get a good estimate in the settlements forecasting and his related ability to understand the meaning of anomalous monitoring data and to timely make and match the primary consolidation settlements forecasting calculation adjustments.

DRG支付背景下临床科室超支情况分析及管理策略——以某三级综合医院心血管内科为例

目的分析临床科室疾病诊断相关分组(DRG)结算病例超支的影响因素,为科室精细化管理提供思路。方法选取2022年某三级综合医院心血管内科1495例DRG结算病例的医保结算信息、病案信息及费用信息,使用单因素分析及多因素Logistic回归模型分析DRG结算病例超支的影响因素。结果单因素分析结果显示,结余病例组和超支病例组在年龄、住院天数、医保类型、病例类型、疾病严重程度、治疗操作类型、相对权重(RW),以及药品占比、耗材占比、检查检验占比、医疗服务占比方面的差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,住院天数≥5 d、城乡居民医保、低倍率或高倍率病例、高药品占比、高耗材占比是DRG结算病例超支的危险因素(P<0.05),非手术室操作、RW≥2是DRG结算病例超支的保护因素(P<0.05)。结论临床科室可从主动适应医保规则,落实临床路径管理,加强医疗成本控制,兼顾学科高质量发展等方面持续改进,促进DRG精细化管理,助力医院可持续发展。

基于医保结算的耗材精细化管理策略

目的探讨高效的医用耗材精细化管理模式和方法,助力公立医院高质量发展。方法从科室人均卫材费用、病组人均费用、医保结回率入手,对各科室疾病诊断相关分组病种消耗、耗材采购价格及院内流通等进行管控;以住院患者人均总费用、人均卫材费用为指标进行效果比对。结果住院患者人均总费用和人均卫材费用分别下降8.55%和5.85%。结论在基础建设、医护人员、床位数相对恒定的状态下,通过医用耗材的精细化管理,可有效降低患者就医负担,提高医保支付率,提升医院核心竞争力。

《黑图档•道光朝》所见盛京官地之建造用地管理

盛京官地之建造用地主要用于官房的修建。官房的修建工作已于康熙年间结束,至道光年间多为官房的维修等事宜。《黑图档•道光朝》中存在许多记载官房管理的相关档案,通过梳理,将其划分为人员管理、日常运营管理与纠纷处理三个方面。本文以《黑图档•道光朝》为基础,结合其他相关史料,论述盛京相关部门对盛京官地之建造用地的具体管理事宜及处理流程,以期为学界进一步研究盛京各部管理盛京官房的具体内容提供借鉴与参考。

清水江文书中的“用益物权”

清水江文书中的“用益物权”,以“讨”字文书的形式呈现。清水江文书中的地役权存在着“需役物”与供役地等不典型的地役权以及需役地与供役地的典型地役权两种模式;清水江文书中的居住权同样具有典型的“居住权”以及“保留占有、使用权买卖”的居住权两种模式;清水江文书中所呈现出的土地承包经营权则在占有、使用、收益的权利方面存在明显的限制性。纵观清水江文书中的三种用益物权,其背后蕴涵了以“礼”为主的法治观念价值和以“和谐”为主的法治实践价值,其对解决目前民法典用益物权编的某些现实问题以及建设中国特色社会主义法治体系均可能做出有益贡献。

战略需求导向下的资金集中管理模式变革研究——基于美的集团的纵向案例分析

基于美的集团纵向单案例,分析企业资金集中管理模式随战略需求变化而动态调整的实施效果。研究发现,从机会成长阶段—规模成长阶段—优化升级阶段,美的集团战略需求呈现出“异地扩张—产业扩张—国际化与多元化扩张”的变化态势,其资金集中管理模式经历了“结算中心异地结算模式—数据大集中模式—财务公司”的动态调整,资金集中管理模式对应职能也在动态调整中完成了“异地资金管理能力—跨业务协调能力—金融发展能力”的叠加。美的集团根据战略需求变化动态调整资金集中管理模式是资金集中管理活动成功的关键,这一研究发现对战略需求影响资金集中管理模式的理论解释提供了案例依据,也为集团企业的资金集中管理模式选择提供了启示。

临床试验中实现受试者诊疗过程信息化管理的探索与实践

目的探索临床试验开展过程中对受试者诊疗过程的信息化管理方法,提升临床试验效率及质量,确保临床试验的开展符合现行版《药物临床试验质量管理规范》。方法2021年起,笔者在海南省人民医院医院信息系统(HIS)中对临床常规诊疗流程根据临床试验开展需求进行功能改造,探索实践内容包括建立临床试验集中随访诊区模块、项目字典库及对应的记账结算方式、研究者及受试者信息关联试验项目、专用电子病历模板、自动生成相应查询报表等。结果实现受试者在就诊随访中相关诊疗医嘱的信息化开具、执行及结算,并与普通诊疗相关医嘱区分。结论通过实践临床试验相关诊疗操作的信息化管理,解决由于多科室合作、多人员参与、多项目并举的特点带来的诸多困难,使管理流程更加规范,推动临床试验的合规高效实施。

水管理视野下的莆田平原空间和社会结构探析

莆田平原是典型的水管理主导的人居环境地理单元,具有圩区和灌区的双重特征,然而迄今规划学科鲜有关注其水利特征与传统人居环境关系的研究成果。首先,从水文角度梳理了莆田平原各个时期的历史沿革;其次,从自然基底、水利系统与聚落系统三方面分析快速城镇化之前的莆田平原的空间布局,总结其形态特征;然后,着重剖析由灌区分水和圩区防洪而衍生的水管理模式,这很大程度上形成了以仪式联盟为核心的社会结构,并通过仪式事件增加社区凝聚力。这种清晰的水利空间和社会结构的相互关系为理解类似地区的传统人居结构及当代转型发展提供了重要借鉴。

甘肃省某三级医院DRGs支付方式改革实践探索

目的探讨公立医院实施医保精细化管理方案,以应对DRGs支付方式改革的顺利进行。方法自2023年起,医院实施了一系列医保管理措施,包括:设立“医保专员”管理制度,开展PDCA循环的医保精细化管理与培训,严格控制费用与监管基金;持续提升医疗技术水平,规范诊疗行为,优化病种结构,建立基于DRGs的医保支付临床路径;加强编码员队伍建设,提升数据质量;开发病案管理信息化辅助工具,引入院内智能监管系统;利用PDCA循环持续改进病案质量;开展基于DRGs的绩效考核与成本核算等。结果从DRG入组情况、服务能力、服务效率、费用控制、医疗安全、医保监管6个维度分析实施效果,结果显示:未入组、歧义组和入组错误病例占比下降;出院患者平均住院日、均次费用、药占比和耗占比均显著下降;低风险病死率和高倍率人次占比下降;DRG组数增加,治愈、好转率和总权重上升。结论DRGs精细化管理的实施,增强了医护人员的全员参与意识,提升了病案首页和医保结算清单的数据质量,提高了医疗技术与服务能力,降低了住院费用,合理分配了医疗资源。然而,CMI值和三、四级手术占比略有下降,原因在于科室发展不均衡、本地支付政策欠合理、患者选择范围扩大、高值耗材费用昂贵以及疫情影响病种结构等。实践结果为医院顺利应对DRGs支付方式改革、实现高质量医疗服务提供了依据。

成本管理视角下的建筑工程造价预结算编制准确性研究

为促进建筑工程造价预结算编制准确性的提升,在成本管理视角下,本文开展了对建筑工程造价预结算编制优化研究。通过建立材料价格波动模型、工程量计算误差模型等,实现建筑工程造价预结算编制准确性数学模型分析。结合模型分析结果,提出材料价格对冲策略、优化工程量计算方法、变更管理流程等对策。通过实例论证分析得出,新对策的应用可以有效降低建筑工程造价预结算编制中工程量计算误差率,提高套价符合率,使预结算编制更准确。

基于信息化管理的责任护士床旁出院结算模式探索与实践

目的探讨基于信息化管理的责任护士床旁出院结算模式应用效果。方法选取2021年2月-2023年1月某三甲医院出院患者作为研究对象,将2021年2月-2022年1月的研究对象设为对照组,2022年2月-2023年1月的研究对象设为观察组。对照组实施传统收费处窗口出院结算模式,观察组则实施基于信息化管理的责任护士床旁出院结算模式。比较2组患者在出院结算时间、患者满意度、患者对出院结算流程投诉率、收费处出院结算工作人数等评价指标的差异。结果观察组出院结算时间为(0.23±0.37)d,低于对照组(4.76±2.17)d;患者满意度(95.56±1.67)分,高于对照组(91.97±1.93)分;患者对出院结算流程投诉率0.01%,低于对照组0.49%,各项指标差异均有统计学意义(P<0.05)。此外,收费处出院结算工作人数由11人减少为3人。结论基于信息化管理的责任护士床旁出院结算模式显著缩短了出院结算时间,提高了患者满意度,降低了患者对出院结算流程投诉率,减少了医院收费处窗口出院结算工作人数,优化了临床医疗机构出院结算流程,提升了医院出院结算服务质量。

医保基金与医药企业直接结算风险防控探析

医保基金与医药企业直接结算有利于推进药品集中带量采购深入开展,也为控制医疗费用不合理上涨提供了新方法,但也可能给基金安全运行带来新的风险因素。本文在全面剖析结算方式变化的基础上,运用风险管理理论识别药品集中带量采购和直接结算业务的风险因素,分析风险成因,提出风险应对措施,建议提高医保业务程序化和标准化建设水平,稳步有序推进直接结算政策实施。

洪涝灾害预警时期的应急人员安置与物资配送联合优化

严重的洪涝灾害威胁着受灾地区的居民生命安全,及时的人员安置与物资保障有助于降低自灾害带来的负面影响。本研究对洪涝灾害预警时期的人员安置与物资配送两项工作进行共同考虑,由人员安置方案确定各地的物资需求量,作为物资配送优化的基础,最终得到一套联合工作方案。本研究以人员转移时间最短、人员未转移惩罚最小、物资未满足比例最低为目标,建立了该问题的数学模型。在时间划分上,本研究将应急物流工作的时间划分为多个等长的周期,并将每个周期划分为一段工作时间和一段休整时间。在工作时间内,车辆可以连续进行多次行程,以实现载具的最大化使用;在休整时间内,车辆不开始配送任务,以此应对计划外耗时带来的影响。最后,本研究基于安徽省阜阳市的蓄洪区位置构造算例,并使用遗传算法对算例求解,通过对比“联合优化”方案与“就近安置”方案,证实了人员安置与物资配送的联合优化能够让应急工作在整体上达到更好的效果。

提升医疗保险结算数据质量的路径探析

目的提高CHS-DRG(国家医疗保障疾病诊断相关分组)支付的医疗保险结算数据质量。方法实施干预措施:(1)DRG事中管理系统嵌入电子病历系统,用于结算后分析。(2)建立医保结算清单审核系统用于结算。(3)明确病案首页、医保结算清单填写规范,开展CHS-DRG相关培训。运用SPSS26.0统计分析数据。结果干预后22个科室入组率提高,其中8个科室入组率显著提高。结论建立DRG智慧管理系统,开展多部门协同合作,有利于提高医保结算数据质量,助力医院精细化管理。

高速铁路工程施工项目质量管理研究

结合某省城际高速铁路轨道工程项目,对铁路工程施工项目质量管理进行研究。在施工技术管理中主要对路基沉降观测及评估技术进行分析介绍,同时从人员管理、材料及设备管理、制订标准化实施方案等方面对铁路工程施工项目质量管理的要点进行分析并提出建议。

建筑工程造价结算审核工作中的问题及对策

造价结算审核作为保障项目经济合理性与合法性的核心环节,随着建设项目日益复杂和规模的扩大,工程造价结算涉及的各项费用与合同条款的繁杂性也愈发显著。因此,审慎而精确的审核过程对于确保结算的公正性、合规性与准确性至关紧要。文章剖析当前建筑工程造价结算审核中存在的问题,并提出相应的对策,以期为构建更为完备与高效的结算审核体系提供有益参考。