Developing Geostatistical Space–Time Models to Predict Outpatient Treatment Burdens from Incomplete National Data

Basic health system data such as the number of patients utilizing different health facilities and the types of illness for which they are being treated are critical for managing service provision. These data requirements are generally addressed with some form of national Health Management Information System (HMIS), which coordinates the routine collection and compilation of data from national health facilities. HMIS in most developing countries are characterized by widespread underreporting. Here we present a method to adjust incomplete data to allow prediction of national outpatient treatment burdens. We demonstrate this method with the example of outpatient treatments for malaria within the Kenyan HMIS. Three alternative modeling frameworks were developed and tested in which space–time geostatistical prediction algorithms were used to predict the monthly tally of treatments for presumed malaria cases (MC) at facilities where such records were missing. Models were compared by a cross-validation exercise and the model found to most accurately predict MC incorporated available data on the total number of patients visiting each facility each month. A space–time stochastic simulation framework to accompany this model was developed and tested in order to provide estimates of both local and regional prediction uncertainty. The level of accuracy provided by the predictive model, and the accompanying estimates of uncertainty around the predictions, demonstrate how this tool can mitigate the uncertainties caused by missing data, substantially enhancing the utility of existing HMIS data to health-service decision makers.     

年龄分层视角下医疗设施可达性对居民就医行为的影响——以上海市崇明岛为例

年龄是影响就医行为的重要因素,从年龄分层视角出发探讨医疗资源可达性对就医行为的影响有助于理解居民的就医行为决策机理.本文以崇明岛为案例,利用一手调查数据,结合两步移动搜寻算法和回归分析方法,探讨了医疗设施可达性对居民就医机构选择和惯常就医距离的影响,揭示了不同年龄群体之间就医行为影响机理的差异.研究发现,医疗设施可达性...     

基于GIS的农村医疗设施空间可达性分析——以河南省兰考县为例

针对农村医疗设施空间分布的公平性问题,提出了使用GIS技术和空间可达性指标评估医疗设施的区域分布特征。以兰考县乡级以上卫生院为例,建立人口分布、医疗设施位置、行政区域等地理数据库,选择人均医疗资源分配、就医的最近距离、选择医院的机会、重力模型及改进的重力模型5个空间可达性模型,计算了各乡镇、各行政村的医疗设施可达性指标,并制作了相应的专题地图;在此基础上对医疗设施的空间布局进行了分析。空间可达性指标全面地反映医疗设施的空间分布特征,鉴别出资源分配较薄弱的区位,是农村医疗改革中设施规划和资源分配的重要依据。     

Seizing the Means of Circulation: Choke Points and Logistical Resistance in Coco Solo,Panama

Recent studies of logistics have embraced the “choke point” thesis: the notion that a strategically positioned group of workers or insurgents can exercise outsize power by disrupting the circulation of goods through the supply chain. This article examines this proposition through the case of Coco Solo, Panama, an informal community situated at the epicentre of Panama’s transit economy but persistently excluded from its benefits. Between 2001 and 2014, as part of a protracted struggle over housing, Coco Solo residents repeatedly blockaded key ports and logistics facilities. Despite their location at a critical node in global capitalist commodity circuits, the community’s actions met with limited success. I draw on the case to refine existing theorisations of logistical resistance, emphasising the contingent factors that influence the effectiveness of such tactics, the diverse contexts in which they are mobilised, and the value of going beyond workerist and insurrectionist accounts of supply chain disruption.     

Designing Reliable Center Systems: A Vector Assignment Center Location Problem

The p‐center problem is one of the most important models in location theory. Its objective is to place a fixed number of facilities so that the maximum service distance for all customers is as small as possible. This article develops a reliable p‐center problem that can account for system vulnerability and facility failure. A basic assumption is that located centers can fail with a given probability and a customer will fall back to the closest nonfailing center for service. The proposed model seeks to minimize the expected value of the maximum service distance for a service system. In addition, the proposed model is general and can be used to solve other fault‐tolerant center location problems such as the (p, q)‐center problem using appropriate assignment vectors. I present an integer programming formulation of the model and computational experiments, and then conclude with a summary of findings and point out possible future work.     

Throwing the Baby Out with the Bathwater: Australia’s New Policy on Treaty-Based Investor-State Arbitration and its Impact in Asia

Abstract

Treaties allowing investors to initiate arbitration claims directly against host states for illegally interfering with cross-border investments are becoming increasingly common in Asia, but Australia announced in 2011 that it will no longer include such protections in future treaties. The backdrop to this decision includes keen interest from Asia in foreign direct investment (FDI) into Australia’s resources sector, meaning that potential investors may not be significantly deterred by a lack of arbitration provisions in future treaties. This article argues, however, that Australia’s policy shift risks undermining the entire investor-state arbitration (ISA) system, with the earliest impact being felt by major pending treaty negotiations by Australia with Japan, China and Korea (respectively); and that the shift may significantly reduce FDI flows or have other adverse effects. The article criticises the cost-benefit analysis of ISA protections in one pivotal study conducted in 2010 by an Australian Government think-tank, arguing that this assessment is insufficiently nuanced. Instead, the article presents a justification for more tailored and moderate changes to ISA provisions in future treaties. Its tentative interest-group analysis suggests, however, that there may be surprisingly few public or private constituencies that would prefer such moderate reforms, and that most may well prefer the more extreme position recently adopted by Australia, despite the damage that will be done to the ISA system as a whole. The article also argues that Australia’s policy shift and think-tank analysis may make Asian countries more cautious about ISA, especially those (like the Philippines and Vietnam) which have traditionally been more cautious about this dispute resolution system.     

THE SUPPLY-DRIVEN INPUT-OUTPUT MODEL: A NEW INTERPRETATION BUT STILL IMPLAUSIBLE

ABSTRACT. In this reply, I argue that the production function proposed by Gruver provides a theoretical foundation for the supply model only in a most trivial case. He proposes a more general alternative which is, however, still very implausible. Furthermore, against Rose and Allison, I argue that small input-coefficient changes provide an insufficient excuse for using the supply model for impact studies, and I show that employment estimates may be quite different depending on the approach used.     

Local government perceptions of water related issues in rural Australia

Water supply has long been regarded as a limiting resource in the further development of Australia. Active management has been necessary in both more densely settled areas and in areas of moderate settlement density but low rainfall such as the Murray-Darling system. The recently released Water 2000 Report details current knowledge about the quality and distribution of these resources. Following on from this Report this article presents perceived problems with water quantity and quality (in particular, salinisation) obtained from a survey sent to rural local governments in late 1982. The survey requested information on the relevance of twenty-two land use issues, known from earlier work to be representative of common concerns throughout Australia. Public perceptions were remarkably similar to the results of the Water 2000 Report. Water quantity/quality and salinisation issues were the sixth and seventh most commonly cited issues throughout Australia, but were of much greater concern in specific areas. Tasmanian local governments reported major problems of water supply, those in southwest Western Australia exhibited a very high level of concern with dry land salinisation, local governments in the Murray-Darling Drainage Division reported concern with salinisation, droughts, floods and general water quality, while local governments in the Gulf of Carpentaria Drainage Division consistently cited flooding as being a major problem. Information from surveys such as this, and others where the respondents are the end-users, need to be combined with expert opinion in order to increase the effectiveness of the management of our water resources.     

Rural–Urban Migration and Gender Disparities in Child Healthcare in China and India

This article assesses the impact of rural–urban migration on gender disparities in children's access to healthcare in China and India. Much research has shown widespread discrimination against girl children in both countries, including in health investments, contributing to the well‐known problem of Asia's ‘missing’ women. Much less clear is the impact of the massive rural–urban migration now occurring in China and India on discrimination against daughters. Migration is usually thought to have a positive effect on child health, because of improved access to healthcare facilities, but this is not necessarily equally beneficial for both sons and daughters. Based on fourteen months of fieldwork with rural migrant families in Shenzhen (China) and Mumbai (India), this article argues that where migration improves access to healthcare, it may increase rather than decrease the gender gap in treatment of child illness in the short term, as resources are concentrated on the treatment of sons. Furthermore, it is not the case that rural–urban migration necessarily leads to better access to healthcare even for sons: some forms of migration may actually have an overall negative effect on child health outcomes. For these two reasons, development strategies focusing on large‐scale rural–urban migration should not be seen as a short‐term solution to problems of gender inequity in child health.     

单体饭店委托管理成功关键影响因素实证分析

委托管理作为饭店连锁经营的主要途径,能够为单体饭店提升饭店竞争能力.但是在我国饭店委托管理的实践中,业主和管理公司之间纠纷较多,管理合同提前终止现象时有发生.如何有效实施委托管理,成为业主、饭店管理公司共同关注的热点问题.本文在文献研究与访谈的基础上,建立了成功实施单体饭店委托管理的关键影响因素的理论假设模型及指标体系,并通过问卷调查与统计分析进行了实证研究.研究结果表明,单体饭店委托管理成功实施的影响因素可分为5个维度:业主自身角色正确定位、饭店硬件匹配、合同全面合理、业主对管理公司准确选择和管理公司对合同有效实施,具体有27个关键影响因素.     

中国城市的企业家精神——时空分布与影响因素

本文以每万人拥有的中小企业数量为代理变量,分析了中国城市企业家精神的空间分布格局、变化趋势和影响因素。结果表明,企业家精神整体提升的同时,地区差异也在扩大;空间自相关显著,集聚趋势不断增强;变化强度呈西减东增的趋势。互联网设施、人口多样性、沿海区位和资源环境压力、较高的女性比重、较少的政府干预和较低的国企占比和外资占比有促进作用;未发现集聚和房价的显著影响;而平均教育水平与企业家精神显著负相关,说明我国的创业类型、教育体制和内容还有待提升。     

Dispersion of Nodes Added to a Network

For location problems in which optimal locations can be at nodes or along arcs but no finite dominating set has been identified, researchers may desire a method for dispersing p additional discrete candidate sites along the m arcs of a network. This article develops and tests minimax and maximin models for solving this continuous network location problem, which we call the added-node dispersion problem (ANDP). Adding nodes to an arc subdivides it into subarcs. The minimax model minimizes the maximum subarc length, while the maximin model maximizes the minimum subarc length. Like most worst-case objectives, the minimax and maximin objectives are plagued by poorly behaved alternate optima. Therefore, a secondary MinSumMax objective is used to select the best-dispersed alternate optima. We prove that equal spacing of added nodes along arcs is optimal to the MinSumMax objective. Using this fact we develop greedy heuristic algorithms that are simple, optimal, and efficient (O( mp )). Empirical results show how the maximum subarc, minimum subarc, and sum of longest subarcs change as the number of added nodes increases. Further empirical results show how using the ANDP to locate additional nodes can improve the solutions of another location problem. Using the p-dispersion problem as a case study, we show how much adding ANDP sites to the network vertices improves the p-dispersion objective function compared with (a) network vertices only and (b) vertices plus randomly added nodes. The ANDP can also be used by itself to disperse facilities such as stores, refueling stations, cell phone towers, or relay facilities along the arcs of a network, assuming that such facilities already exist at all nodes of the network.     

北京市公共服务设施供需协调发展的时空演化特征——以教育医疗设施为例

公共服务设施的优化配置是构建和谐社会、改善民生的内在要求。本文通过构建协调发展度模型,对北京市2001年和2012年16个区县教育医疗设施供需关系及二者协调发展的时空演化特征进行研究。研究认为:①教育设施"供不应需",供需差距增大;协调发展等级总体较低且有下降趋势;协调发展水平由"东高西低"向"南高北低"格局演变,空间差异增大。②医疗设施"供不应需",供需差距缩小;供需协调发展等级较低但有上升趋势,空间格局由"中心集聚"向"南高北低"演变,空间差异减小。     

基于地方秩序嵌套的人类活动研究

活动的地方秩序嵌套"这一概念源于瑞典时间地理学者哈格斯特朗对人类活动复杂性及其背后蕴含的社会规则的思考,强调人类活动与其发生所需的时空资源配置之间的关系,隐含人类行为背后所需的各种资源在时间上的排列和空间上的组合规律。本文系统解读了"(活动的)地方秩序嵌套"的概念内涵、形成与符号表达,借助已有研究案例梳理不同地理空间尺度下地方秩序及其嵌套过程,以及目前这一领域的最新研究进展,在此基础上尝试提出这一概念在中国城市空间行为与规划中的研究与应用方向。     

广州城市公共服务设施供给空间分异研究

转型期以来,政府治理制度的变革及公私部门关系的重构使我国城市公共服务设施供给主体、供给机制逐步多元化,其分布形态也由空间均衡趋向分异。本文以广州为案例,研究结果表明:广州城市公共服务设施分布总体上呈核心-边缘空间格局,区域供给规模差异大且与人口分布不相协调,区际及不同类型设施的空间聚集水平差异显著;传统计划经济条件下城市公共服务设施空间均衡分布模式被市场经济条件下高收入地区指向的集中布局模式所取代,表现出类似西方国家城市公共资源配置的"反比例服务法则"。     

Securing the Sinews of Sea Power: British Intervention in the Baltic 1780–1815

This article argues that Britain's standing as a maritime nation must be considered if we are to fully understand the objectives behind British foreign policy in the late eighteenth and early nineteenth centuries. It focuses on one of the most important challenges successive British governments faced during this period; the need to secure shipbuilding resources. Both British economic prosperity and national security depended upon the continued supply of naval stores. These resources could only be procured from the Baltic region, which meant the region took on a crucial strategic importance for policy-makers. This article will focus on Britain's relationship with the Baltic between 1780 and 1815 tracing Britain's sensitivity to the changing political environment in Sweden, Denmark, Prussia, and particularly Russia, and outlining how this came to dictate foreign policy. Britain hoped to rely on diplomacy and economic interdependence to maintain the movement of naval stores from the Baltic; however intransigence from the Baltic powers forced Britain to resort to military measures on three occasions between 1800 and 1815, such was the importance of these shipbuilding resources.     

Agricultural Transformation and the Politics of Hydrology in Northern Thailand

Tensions over water resources in upland areas of northern Thailand are often attributed to reductions in water supply caused by forest clearing. This article argues that the hydrological evidence for such reductions in supply is very weak and that, rather, the key hydrological issue in upland catchments is a significant increase in water demand, especially during the dry season. The arguments are illustrated with a detailed examination of the Mae Uam catchment, located in Chiang Mai province, where the development of dry–season soybean cultivation appears to have tested the hydrological limit of the catchment, and even exceeded this limit in drier years. The author argues that a shift in focus from water supply to water demand has fundamentally important political implications. As long as the focus of public debate is on water supply, the regulatory focus will be on those resident in the forested upland areas that are seen as being crucial in securing downstream flows. But if the water management focus is shifted to water demand, then regulatory attention must shift to the diverse sources of demand that exist throughout the hydrological system.     

On the Finite Optimality Set of the Vector Assignment p‐Median Problem

The vector assignment p‐median problem (VAPMP) is one of the first discrete location problems to account for the service of a demand by multiple facilities, and has been used to model a variety of location problems in addressing issues such as system vulnerability and reliability. Specifically, it involves the location of a fixed number of facilities when the assumption is that each demand point is served a certain fraction of the time by its closest facility, a certain fraction of the time by its second closest facility, and so on. The assignment vector represents the fraction of the time a facility of a given closeness order serves a specific demand point. Weaver and Church showed that when the fractions of assignment to closer facilities are greater than more distant facilities, an optimal all‐node solution always exists. However, the general form of the VAPMP does not have this property. Hooker and Garfinkel provided a counterexample of this property for the nonmonotonic VAPMP. However, they do not conjecture as to what a finite set may be in general. The question of whether there exists a finite set of locations that contains an optimal solution has remained open to conjecture. In this article, we prove that a finite optimality set for the VAPMP consisting of “equidistant points” does exist. We also show a stronger result when the underlying network is a tree graph.     

Aquatic Identities,Fluid Economies: Water Affinities and Authenticating Narratives of Belonging in East Timorese Myth and Ritual

ABSTRACT Customary land tenure claims provide a useful analogy for customary access and usage rights to critical water resources. In an increasingly water‐constrained future, such rights are at risk of political and economic contestation and local communities may find themselves abruptly divested of critical water resources just when they need them most. The new nation of East Timor is not abundantly endowed with water and inland sources are particularly vulnerable to the impacts of reduced rainfall and groundwater contamination. Recently McWilliam (2003) has suggested that in future disputes over Timorese sea tenures, the recognition of customary access or exclusive property rights to specific water resources will depend upon clearly articulated evidence of longstanding cultural associations and interactions with the aquatic landscape. The ethnographic literature provides substantiating accounts of the centrality of water in the local cosmologies of various East Timorese ethnic groups. This paper extends McWilliam's marine argument to inland water resources by reviewing the salient ethnographic evidence for Bunaq, Mumbai and Eastern Tetum populations to show that water is a key organising metaphor in the expression of Timorese kingroup affiliation, social identity and power relations. Local ritual practices further affirm customary rights of access and water use. There is an urgent need for such customary rights to water to be recognized in the current redistribution and demarcation of internal boundaries in East Timor, as well as in future struggles against vested economic and political interests.     

Identifying Critical Facilities in Hub‐and‐Spoke Networks: A Hub Interdiction Median Problem

The hub location problem has been widely used in analyzing hub‐and‐spoke systems. The basic assumption is that a large number of demands exist to travel from origins to destinations via a set of intermediate transshipment nodes. These intermediate nodes can be lost, due to reasons such as natural disasters, outbreaks of disease, labor strikes, and intentional attacks. This article presents a hub interdiction median (HIM) problem. It can be used to identify the set of critical facilities in a hub‐and‐spoke system that, if lost, leads to the maximal disruption of the system's service. The new model is formulated using integer linear programming. Special constraints are constructed to account for origin‐to‐destination demand following the least‐cost route via the remaining hubs. Based on the HIM problem, two hub protection problems are defined that aim to minimize the system cost associated with the worst‐case facility loss. Computational experiment results are presented along with a discussion of possible future work. El problema de la ubicación de la central (hub) ha sido ampliamente analizado para el caso de los sistemas de sistemas radiales (hub‐and‐spoke). La presunción inicial es que existe un gran número de demandas que viajan desde puntos de origen hasta sus puntos de destino a través de un set de nodos intermedios de trasbordo. Estos nodos intermedios pueden perderse por diferentes motivos, como desastres naturales, brotes de enfermedades, huelgas de trabajadores, o ataques intencionales. Este artículo presenta un problema de tipo mediana de interdicción de hub, conocido como hub interdiction median‐HIM. Puede usarse para identificar un set de instalaciones críticas de un sistema tipo hub‐and‐spoke que, si se pierde, conduce a la máxima interrupción del servicio del sistema. El nuevo modelo se ha formulado utilizando programación entera lineal, (integer linear programming‐ILP). El modelo construye restricciones especiales para dar cuenta de la demanda de “origen‐a‐destino” (O‐D), siguiendo la ruta de menor costo, a través de los hubs restantes. Basándonos en el problema de HIM, se definen dos problemas de protección de hub que buscan minimizar el costo asociado al peor caso posible de pérdida de instalaciones. Se presentan además, resultados de experimentos computacionales, así como a una discusión sobre posibles futuros trabajos en la materia. 枢纽区位研究已广泛应用于中枢辐射型系统分析,其基本假设条件为起始点到目的地之间存在大量旅行需求的中间转运节点。但自然灾害、突发疾病、劳务罢工和蓄意攻击等因素可能导致中间转运节点的丧失。本文提出了一种枢纽封闭中心模型（HIM）,可用于识别中枢辐射型系统的重要节点,一旦这些节点丧失,将导致整个系统服务最大程度的瓦解。新模型通过整数线性规划公式建立。模型特殊约束条件的建立基于最小成本路径通过余下枢纽的花费来解释始发到目的地（ origin‐to‐destination）需求量。基于HIM问题,双枢纽保护问题被定义为旨在最小化系统花费及其与之关联的最坏情况下节点丢失问题。最后,根据计算的经验结果讨论未来可能深入的研究。