With the deepening of China’s health-care reform,an integrated delivery system has gradually emerged with the function of improving the efficiency of the health-care delivery system.For China’s integrated delivery s...With the deepening of China’s health-care reform,an integrated delivery system has gradually emerged with the function of improving the efficiency of the health-care delivery system.For China’s integrated delivery system,a medical consortium plays an important role in integrating public hospitals and primary care facilities.The first medical consortium policy issued after the COVID-19 pandemic apparently placed hope on accelerating the implementation of a medical consortium and tiered health-care delivery system.This paper illustrates the possible future pathway of China’s medical consortium through retrospection of the 10-year process,changes of the series of policies,and characteristics of the policy issued in 2020.We considered that a fully integrated medical consortium would be a major phenomenon in China's medical industry,which would lead to the formation of a dualistic care pattern in China.展开更多
In 2009, China strengthened its public health service system. Since then, the country has made remarkable achievements in community-based chronic disease prevention and control;however, certain groups still have unmet...In 2009, China strengthened its public health service system. Since then, the country has made remarkable achievements in community-based chronic disease prevention and control;however, certain groups still have unmet needs. During 2019 to 2029, China will consolidate the top-level design of its medical health system. During this period, the coordination of department policies, improvement of service delivery mechanisms, building an integrated health service system, and other issues will be highlighted. This study will provide a basis for designing China’s chronic disease prevention and control system during the next stage of development. We will consider the unmet needs of patients with chronic diseases as an indicator for remodeling the prediction system in combination with the elements and structural theories of complex health systems. In this article, we first introduce the definition and measurement methods of unmet needs. Second, we identify the existing unmet needs found among patients with chronic diseases with reference to the chronic disease prevention and control policies of China as well as current service items. Finally, we propose the design of community chronic disease service package for the next development stage based on unmet needs of patients with chronic diseases. We also provide suggestions for how to improve China’s chronic care delivery system.展开更多
In this study,we introduce an integrated schedule of order picking and delivery for instant delivery.Order picking,including order batching and picking sequencing,is scheduled online under real-time order arrival,whic...In this study,we introduce an integrated schedule of order picking and delivery for instant delivery.Order picking,including order batching and picking sequencing,is scheduled online under real-time order arrival,which integrates order delivery by depicting order location dispersion in an online order picking strategy.Order delivery,including delivery person assignment and route planning,is modeled to minimize the total duration of order fulfillment by considering the influence of the order picking completion time.A rule-based online order picking strategy is established,and a customized ant colony optimization(ACO)algorithm is proposed to optimize order delivery.Experiments on 16 simulated instances of different scales demonstrate that our online order picking schedule considering order delivery outperforms existing approaches and that the customized ACO algorithm for order delivery is effective.展开更多
With the launch of the U.S.Green Building Council’s Leadership in Energy and Environmental Design(LEED^(■))rating system,new building construction in the United States has rapidly begun adopting this guide as the st...With the launch of the U.S.Green Building Council’s Leadership in Energy and Environmental Design(LEED^(■))rating system,new building construction in the United States has rapidly begun adopting this guide as the standard for sustainable building.The rating system profoundly alters the design and operation of buildings,however,to date,little has been documented on the cumulative effects of the rating system across different phases of the project lifecycle:planning,architecture/design,engineering,construction and operational facility management(AEC+P+F).Further,the ability to gain efficiencies in the building phase itself is still unknown.Implications of the delivery system in LEED^(■)attainment also have not been clearly associated with the level of AEC+P+F integration.To pursue this goal,project participants are becoming involved earlier in the process;information exchanges take place throughout the project lifecycle;and the results of those frequent exchanges impact the value to the owner through focus on attainment of a particular green rating score.These features are confi guring a framework for green project delivery.This framework approaches lean thinking by generating value to the owner,improving the flow of information,and transforming the inputs required for the selection of materials and systems,to outputs in the form of a sustainability rating certification.This research focuses on exploring associations between LEED^(■)criteria,project lifecycle,the stakeholders’interests,lean process improvements and typical delivery systems used in building construction.The paper proposes a matrix of weighted indexes to explain and provide increased collaboration among project participants,improved efficiency throughout the project lifecycle,and new techniques which may be incorporated into the construction process.展开更多
In 2012,an estimated 8.6 million people developed tuberculosis(TB)and 1.3 million died from the disease.With its recent resurgence with the human immunodeficiency virus(HIV);TB prevention and management has become fur...In 2012,an estimated 8.6 million people developed tuberculosis(TB)and 1.3 million died from the disease.With its recent resurgence with the human immunodeficiency virus(HIV);TB prevention and management has become further challenging.We systematically evaluated the effectiveness of community based interventions(CBI)for the prevention and treatment of TB and a total of 41 studies were identified for inclusion.Findings suggest that CBI for TB prevention and case detection showed significant increase in TB detection rates(RR:3.1,95%CI:2.92,3.28)with non-significant impact on TB incidence.CBI for treating patients with active TB showed an overall improvement in treatment success rates(RR:1.09,95%CI:1.07,1.11)and evidence from a single study suggests significant reduction in relapse rate(RR:0.26,95%CI:0.18,0.39).The results were consistent for various study design and delivery mechanism.Qualitative synthesis suggests that community based TB treatment delivery through community health workers(CHW)not only improved access and service utilization but also contributed to capacity building and improving the routine TB recording and reporting systems.CBI coupled with the DOTS strategy seem to be an effective approach,however there is a need to evaluate various community-based integrated delivery models for relative effectiveness.展开更多
INTRODUCTION The level of man-made CO_(2) emissions worldwide climbed to a new record of 30 billion tons in 2010.In 2011,at the COP17 U.N.Climate Change Conference in Durban,South Africa,high-ranking representatives f...INTRODUCTION The level of man-made CO_(2) emissions worldwide climbed to a new record of 30 billion tons in 2010.In 2011,at the COP17 U.N.Climate Change Conference in Durban,South Africa,high-ranking representatives from around the world met again to discuss solutions.For the building sector,numerous energy-efficiency market changes and benchmarking resolutions,like the mandatory E.U.“nearly Net-Zero-Energy-Building(NET-ZEB’s)2018 and 2020 regulations”for all new public and privately owned buildings are now set up to help minimizing carbon emissions and reverse the negative impact.1 In the United States,the American Institute of Architects(AIA)adopted the 2030 Challenge as a voluntary program,where participating buildings aim to achieve a 90%fossil fuel reduction by 2025,and carbon-neutrality by 2030.2 To accomplish these energy goals,designers must strive to best design and utilize the resources available on a site.However,are these goals of achieving carbon-neutral buildings possible?How can NET-ZEB’s become the curricular standard and practical routine in education and the profession?To date,the basic curricular design process components with integrated project delivery metrics for a robust 3-D/4-D-net-zero regulatory design framework are either incomplete or missing,However,formally-based curriculums have begun to weave carbon-neutral design tools into their pedagogy.This research paper critically compares how these new criteria for digital 3-D-building information modeling(BIM),and“Integrated Project Delivery”are mandating a better integration of collaborative carbon-neutral designs into the curriculum and practice of the profession.The majority of those in architectural academia have been using generative computation primarily for pure,aesthetic form-finding,without applying zero-carbon-energy-driven global performance metrics and CO_(2)e reduction strategies to reiterate derived carbon-neutral designs.The advantage of 3-D-parametric design is that it links variables,dimensions,and materials to geometry in a way that when an input or simulation value changes,the 3-D/4-D model automatically updates all life-cycle scenarios and components simultaneously.展开更多
基金supported by the National Natural Sciences Foundation of China(No.71874058 and No.72174068).
文摘With the deepening of China’s health-care reform,an integrated delivery system has gradually emerged with the function of improving the efficiency of the health-care delivery system.For China’s integrated delivery system,a medical consortium plays an important role in integrating public hospitals and primary care facilities.The first medical consortium policy issued after the COVID-19 pandemic apparently placed hope on accelerating the implementation of a medical consortium and tiered health-care delivery system.This paper illustrates the possible future pathway of China’s medical consortium through retrospection of the 10-year process,changes of the series of policies,and characteristics of the policy issued in 2020.We considered that a fully integrated medical consortium would be a major phenomenon in China's medical industry,which would lead to the formation of a dualistic care pattern in China.
基金National Natural Science Foundation of China(No. 71603278)Key Program of the National Natural Science Foundation of China(No.71734003)+1 种基金Youth Project of Educational Reform of China Pharmaceutical University(No. 2017XJQN32)a research project on postgraduate educational reform under "double first-class" capability construction from China Pharmaceutical University(No. 3151920118)。
文摘In 2009, China strengthened its public health service system. Since then, the country has made remarkable achievements in community-based chronic disease prevention and control;however, certain groups still have unmet needs. During 2019 to 2029, China will consolidate the top-level design of its medical health system. During this period, the coordination of department policies, improvement of service delivery mechanisms, building an integrated health service system, and other issues will be highlighted. This study will provide a basis for designing China’s chronic disease prevention and control system during the next stage of development. We will consider the unmet needs of patients with chronic diseases as an indicator for remodeling the prediction system in combination with the elements and structural theories of complex health systems. In this article, we first introduce the definition and measurement methods of unmet needs. Second, we identify the existing unmet needs found among patients with chronic diseases with reference to the chronic disease prevention and control policies of China as well as current service items. Finally, we propose the design of community chronic disease service package for the next development stage based on unmet needs of patients with chronic diseases. We also provide suggestions for how to improve China’s chronic care delivery system.
基金supported by the National Natural Science Foundation of China(72032001,71972071)the Ministry of Education,Humanities and Social Sciences Research Planning Foundation(21YJA630057).
文摘In this study,we introduce an integrated schedule of order picking and delivery for instant delivery.Order picking,including order batching and picking sequencing,is scheduled online under real-time order arrival,which integrates order delivery by depicting order location dispersion in an online order picking strategy.Order delivery,including delivery person assignment and route planning,is modeled to minimize the total duration of order fulfillment by considering the influence of the order picking completion time.A rule-based online order picking strategy is established,and a customized ant colony optimization(ACO)algorithm is proposed to optimize order delivery.Experiments on 16 simulated instances of different scales demonstrate that our online order picking schedule considering order delivery outperforms existing approaches and that the customized ACO algorithm for order delivery is effective.
文摘With the launch of the U.S.Green Building Council’s Leadership in Energy and Environmental Design(LEED^(■))rating system,new building construction in the United States has rapidly begun adopting this guide as the standard for sustainable building.The rating system profoundly alters the design and operation of buildings,however,to date,little has been documented on the cumulative effects of the rating system across different phases of the project lifecycle:planning,architecture/design,engineering,construction and operational facility management(AEC+P+F).Further,the ability to gain efficiencies in the building phase itself is still unknown.Implications of the delivery system in LEED^(■)attainment also have not been clearly associated with the level of AEC+P+F integration.To pursue this goal,project participants are becoming involved earlier in the process;information exchanges take place throughout the project lifecycle;and the results of those frequent exchanges impact the value to the owner through focus on attainment of a particular green rating score.These features are confi guring a framework for green project delivery.This framework approaches lean thinking by generating value to the owner,improving the flow of information,and transforming the inputs required for the selection of materials and systems,to outputs in the form of a sustainability rating certification.This research focuses on exploring associations between LEED^(■)criteria,project lifecycle,the stakeholders’interests,lean process improvements and typical delivery systems used in building construction.The paper proposes a matrix of weighted indexes to explain and provide increased collaboration among project participants,improved efficiency throughout the project lifecycle,and new techniques which may be incorporated into the construction process.
文摘In 2012,an estimated 8.6 million people developed tuberculosis(TB)and 1.3 million died from the disease.With its recent resurgence with the human immunodeficiency virus(HIV);TB prevention and management has become further challenging.We systematically evaluated the effectiveness of community based interventions(CBI)for the prevention and treatment of TB and a total of 41 studies were identified for inclusion.Findings suggest that CBI for TB prevention and case detection showed significant increase in TB detection rates(RR:3.1,95%CI:2.92,3.28)with non-significant impact on TB incidence.CBI for treating patients with active TB showed an overall improvement in treatment success rates(RR:1.09,95%CI:1.07,1.11)and evidence from a single study suggests significant reduction in relapse rate(RR:0.26,95%CI:0.18,0.39).The results were consistent for various study design and delivery mechanism.Qualitative synthesis suggests that community based TB treatment delivery through community health workers(CHW)not only improved access and service utilization but also contributed to capacity building and improving the routine TB recording and reporting systems.CBI coupled with the DOTS strategy seem to be an effective approach,however there is a need to evaluate various community-based integrated delivery models for relative effectiveness.
文摘INTRODUCTION The level of man-made CO_(2) emissions worldwide climbed to a new record of 30 billion tons in 2010.In 2011,at the COP17 U.N.Climate Change Conference in Durban,South Africa,high-ranking representatives from around the world met again to discuss solutions.For the building sector,numerous energy-efficiency market changes and benchmarking resolutions,like the mandatory E.U.“nearly Net-Zero-Energy-Building(NET-ZEB’s)2018 and 2020 regulations”for all new public and privately owned buildings are now set up to help minimizing carbon emissions and reverse the negative impact.1 In the United States,the American Institute of Architects(AIA)adopted the 2030 Challenge as a voluntary program,where participating buildings aim to achieve a 90%fossil fuel reduction by 2025,and carbon-neutrality by 2030.2 To accomplish these energy goals,designers must strive to best design and utilize the resources available on a site.However,are these goals of achieving carbon-neutral buildings possible?How can NET-ZEB’s become the curricular standard and practical routine in education and the profession?To date,the basic curricular design process components with integrated project delivery metrics for a robust 3-D/4-D-net-zero regulatory design framework are either incomplete or missing,However,formally-based curriculums have begun to weave carbon-neutral design tools into their pedagogy.This research paper critically compares how these new criteria for digital 3-D-building information modeling(BIM),and“Integrated Project Delivery”are mandating a better integration of collaborative carbon-neutral designs into the curriculum and practice of the profession.The majority of those in architectural academia have been using generative computation primarily for pure,aesthetic form-finding,without applying zero-carbon-energy-driven global performance metrics and CO_(2)e reduction strategies to reiterate derived carbon-neutral designs.The advantage of 3-D-parametric design is that it links variables,dimensions,and materials to geometry in a way that when an input or simulation value changes,the 3-D/4-D model automatically updates all life-cycle scenarios and components simultaneously.
