Using stochastic programming to solve an outpatient appointment scheduling problem with random service and arrival times

We study a stochastic outpatient appointment scheduling problem (SOASP) in which we need to design a schedule and an adaptive rescheduling (i.e., resequencing or declining) policy for a set of patients. Each patient has a known type and associated probability distributions of random service duration and random arrival time. Finding a provably optimal solution to this problem requires solving a multistage stochastic mixed‐integer program (MSMIP) with a schedule optimization problem solved at each stage, determining the optimal rescheduling policy over the various random service durations and arrival times. In recognition that this MSMIP is intractable, we first consider a two‐stage model (TSM) that relaxes the nonanticipativity constraints of MSMIP and so yields a lower bound. Second, we derive a set of valid inequalities to strengthen and improve the solvability of the TSM formulation. Third, we obtain an upper bound for the MSMIP by solving the TSM under the feasible (and easily implementable) appointment order (AO) policy, which requires that patients are served in the order of their scheduled appointments, independent of their actual arrival times. Fourth, we propose a Monte Carlo approach to evaluate the relative gap between the MSMIP upper and lower bounds. Finally, in a series of numerical experiments, we show that these two bounds are very close in a wide range of SOASP instances, demonstrating the near‐optimality of the AO policy. We also identify parameter settings that result in a large gap in between these two bounds. Accordingly, we propose an alternative policy based on neighbor‐swapping. We demonstrate that this alternative policy leads to a much tighter upper bound and significantly shrinks the gap.     

消防员心理健康量表的初步编制

通过因素分析建立消防员心理健康量表,包括幸福感和快乐感、冲动、抑郁与焦虑、躯体化、社交退缩、信任与自信、孤独、性心理障碍、猜疑、社交攻击10个一级因素,心理幸福和心理痛苦2个二级因素.经检验分析,该量表符合心理测量学标准,适合用于对我国消防员心理健康状况的评定.     

最低价中标情况下的施工管理研究

最低价中标法作为国际上通行的建筑工程招投标方法,随着我国建筑市场的 发展和工程量清单计价制度的推行,已经具备其实施的客观条件。针对目前实施最低价中 标法工程施工阶段存在的问题,提出结合工程量清单计价从合同管理、保证金制度、工程保 险、质量管理等方面提出了解决的思路。     

Health Insurance,Health Conditions,and Veteran Health Care Utilization

Abstract

The utilization of health care services by veterans has received much attention in recent years. However, the impact of the large array of factors affecting the veterans’ demand for health care services remains understudied. These factors include individual socio-demographic and economic characteristics, the availability of various sources of health insurance, and the prevalence of medical conditions. We use public data to analyze how veterans’ utilization of health care services varies with these factors. We also analyze how the reliance on VA services varies when alternative sources of health insurance are available to veterans. Based on the estimated relationships, we use a micro-simulation model to forecast future health care utilization, both inside and outside of VA.     

消防部队基层干部心理问题分析与对策研究

消防部队基层干部面临个体需求与现实满足存在较大差距时出现的心理问题,受个体与周围环境因素的影响。面对心理问题,在重视部队传统教育的基础上,大胆借鉴现代企业管理经验和理念,充分利用压力的正效应,结合物质鼓励和精神激励,合理疏导,妥善处理。     

火控系统故障预测与健康管理技术

故障预测和健康管理(PHM)技术具有故障诊断、故障预测以及健康管理的功能,对降低火控装备维修成本、增强火控系统的完备性以及提高火控系统管理效率具有重要意义。根据通用火控系统发展现状及应用需求,将PHM技术引入到火控系统中。首先介绍了PHM技术原理和国内外发展现状,重点讨论了PHM关键技术和通用火控系统PHM体系结构。最后展望了火控系统PHM技术的发展趋势。     

未就业随军配偶社会保险问题研究

未就业随军配偶的社会保险存在着险种少、标准低、接续难等问题,使未就业随军配偶的社会保险权益受到损害。分析当前未就业随军配偶社会保险存在的问题,提出随军未就业配偶社会保险问题的解决路径。     

完善抢险救灾中心理危机干预机制研究

随着武警部队抢险救灾任务的日益增加,完善心理危机干预机制势在必行。通过分析武警部队完善危机干预机制的意义和目前存在的问题,提出了相应的对策和建议。心理危机干预机制的建立,对于维护武警部队官兵心理健康,保证部队稳定,增强整体战斗力,具有战略意义。     

网络多媒体技术结合案例教学法在《心理健康教育》教学中的应用

科学信息的快速发展给高校心理健康教育提出了新的挑战,网络多媒体相结合案例教学的教育模式已成为高校教育模式发展的趋势。文章阐述了在《心理健康教育》教学中运用网络多媒体技术结合案例教学的心得体会,分析了网络多媒体结合案例教学的优势。     

学员心理健康状况的调查与分析

为了进一步在教学中实施心理健康教育及心理干预,笔者对武警学院2003级学员的心理健康状况进行了调查。结果发现,武警学院学员在人际关系、偏执和精神病性因子上显著低于军队常模,在躯体化、焦虑、精神病性因子上显著高于地方常模,人际关系、抑郁、敌对因子上显著低于地方常模。分析研究学员心理健康状况,对于学员的健康成长具有重要意义。