Policy Restrictions Research Articles

Priority Research Topics and Patient and Family Needs in a National Sample of Hospice Agencies.

Various contextual factors surrounding hospice care have reinforced the need for scholars to pursue practice-relevant research questions. Although priority-setting is a primary approach to streamline such efforts, research appears yet to have conducted priority-setting with hospice professionals. To describe the areas of needed research and clinical focus voiced by a national probability sample of US hospice agency representatives. A national probability sample of 600 hospice agencies proportionately stratified by state and profit status was surveyed. At the end of the survey, participants indicated whether or not they were willing to answer two additional open-ended questions. These two questions requested participants' input on areas of needed attention related to (1) research topics and (2) unmet needs for patients and families. Responses were content analyzed. A total of 317 surveys were completed (response rate=61.8%). Viable responses were recorded by 129 participants responding to at least one item. Content analysis generated the following five categories (and various subcategories): earlier access to hospice, education (outside physicians, patients and families, public), policy barriers to hospice enrollment (hospice eligibility and reimbursement, gaps in insurance coverage), effects of policy restrictions on hospice care (reimbursement for care, pain management, clinician issues), and improving the provision of in-home hospice care (community resources, supports for caregivers, supports for when caregiver assistance is inadequate, needs already are being met). These findings presented by hospice agency representatives reflect directions for research and clinical development. Efforts are needed to cohere professional- and patient-reported areas of needed attention.

Application of Artificial Intelligence for managing Diabetes Mellitus patients during the Covid-19 pandemic

The Covid-19 quarantine policy and mobility restriction were carried out to break coronavirus transmission. These were implemented for several months to affect the quality of life, especially in patients with diabetes mellitus. To overcome this, technology such as applications with artificial intelligence can be used. This literature aims to identify the use of Artificial Intelligence systems in managing diabetes mellitus during pandemics. This review conducted a narrative review method. Articles were searched using databases, such as PubMed, Science Direct, and EBSCO. The keywords were based on the medical subheading (MeSH) term and combined using a boolean operator. Articles were selected using inclusion criteria, namely the year of publication between 2016-2021, articles in English, full text, and open access. The articles that were duplicated and articles that did not fit the research topic were excluded. We found that six articles met the criteria. These discussed four programs, namely diabetes retinopathy screening, blood glucose monitoring, lifestyle management programs, and insulin therapy guidelines. The four programs can be used in the home care services for diabetes mellitus patients during the Covid-19 pandemic

What Tweets and YouTube comments have in common? Sentiment and graph analysis on data related to US elections 2020.

Most studies analyzing political traffic on Social Networks focus on a single platform, while campaigns and reactions to political events produce interactions across different social media. Ignoring such cross-platform traffic may lead to analytical errors, missing important interactions across social media that e.g. explain the cause of trending or viral discussions. This work links Twitter and YouTube social networks using cross-postings of video URLs on Twitter to discover the main tendencies and preferences of the electorate, distinguish users and communities' favouritism towards an ideology or candidate, study the sentiment towards candidates and political events, and measure political homophily. This study shows that Twitter communities correlate with YouTube comment communities: that is, Twitter users belonging to the same community in the Retweet graph tend to post YouTube video links with comments from YouTube users belonging to the same community in the YouTube Comment graph. Specifically, we identify Twitter and YouTube communities, we measure their similarity and differences and show the interactions and the correlation between the largest communities on YouTube and Twitter. To achieve that, we have gather a dataset of approximately 20M tweets and the comments of 29K YouTube videos; we present the volume, the sentiment, and the communities formed in YouTube and Twitter graphs, and publish a representative sample of the dataset, as allowed by the corresponding Twitter policy restrictions.

Associations Between COVID-19 Alcohol Policy Restrictions and Alcohol Sales in British Columbia: Variation by Area-Based Deprivation Level.

Government alcohol sales data were used to investigate associations between estimates of per capita age 15+ alcohol consumption, policy restrictiveness, and area-level deprivation. We analyzed weekly consumption data (expressed as per capita age 15+ Canadian standard drinks [13.45 g of pure ethanol]) collected from all 89 local health areas in British Columbia, Canada, between April 2017 and April 2021. Our analyses were stratified by outlet type (total, on-premise, and off-premise). Our intervention was alcohol policy restrictiveness (operationalized by the Restrictiveness of Alcohol Policy Index), and our moderator was area-level deprivation (Canadian Index of Multiple Deprivation). The Restrictiveness of Alcohol Policy Index included hours of trading, the number of people permitted on site for on-premise venues, the proportion of outlets in operation, and the extent of permissible home delivery. Higher policy restrictiveness was associated with decreased consumption across all outlet types (ps < .001): when the most restrictive policies were implemented, consumption was reduced by 9% and 100% in off- and on-premise outlets, respectively. Area-based deprivation level modified the effect of policy restriction on per capita alcohol consumption (ps < .007): for total and off-premise consumption, the decrease was greatest among more economically deprived areas (ps < .001); for on-premise outlets, areas with a high proportion of racial and ethnic minorities increased their consumption (ps < .001). Alcohol-specific policy restrictions implemented in response to the COVID-19 pandemic were associated with reduced consumption. However, the magnitude and direction of change was moderated by area-based deprivation level, albeit inconsistently across various deprivation measures.

ІНСТРУМЕНТАРІЙ ПОЛІТИКИ СПРИЯННЯ ІНОЗЕМНИМ ІНВЕСТИЦІЯМ: МОНІТОРИНГ ТА ВИКЛИКИ В УМОВАХ ВІДНОВЛЕННЯ УКРАЇНСЬКОЇ ЕКОНОМІКИ

Background. The purpose of the article is to develop proposals for improving the policy of foreign investment promotion under the conditions of recovery of the Ukrainian economy considering the peculiarities of the methods and mechanisms of using foreign investment promotion tools, generalizing the domestic experience of their application. The article critically summarizes the experience of developing the Ukrainian foreign investment promotion policy, which allows for determining the direction of its adaptation in modern conditions. Methods. A definition is provided for the concept of "policy to promote foreign investment". In accordance with the objectives of the study, monitoring of fiscal, financial, and administrative instruments is carried out, and the selection of methods and policy instruments is based on the author's approaches to their typology. Results. An assumption has been made that the recovery of Ukraine's economy based on the attraction of foreign investments needs to take into account the results of the previous domestic experience of using the tools of the investment promotion policy. The limitations of the use of fiscal policy instruments, which necessitate the coordination of the system of the country's economic policies, are determined. Defects in the practice of applying financial policy instruments are identified. The experience of reforming the system of administrative instruments is summarized. Based on the results of the research, the factors that lead to the formation of a new political cycle of determining priorities, goals, tasks, and designing policy measures for the promotion of foreign investments have been identified. Сonclusions. The article substantiates the importance of designing measures to influence the investment environment and investment activity based on a comprehensive and coordinated approach to the use of policy instruments, ensuring the balance of stakeholders' interests, taking into account changes in the external environment of policy formation, restrictions and challenges related to the current state of the economy.

Globalisation versus Deglobalisation

One of the biggest questions in recent years concerns the future of globalisation. Some argue that the rivalry between the USA and China, certain trade policy restrictions and the repercussions of the coronavirus pandemic that threatened global production and supply chains could mean the end of globalisation. In fact, however, we are witnessing a fundamental transformation of the globalised world economy. Identifying the main directions of change is a crucial task for economists as well as a precondition for prudent economic policy action.

Shades of Perception: Non-White Refugee Flows and Migration Policy Restrictiveness

Shades of Perception: Non-White Refugee Flows and Migration Policy Restrictiveness

Exploration of Financing Models and Risks Management in Healthcare Industry

With accelerated aging of population and increased life expectancy in China, there has been increasing demand for medical and health services. In recent years, China's medical and health industry has witnessed rapid development to become a focus of economic structure transformation and upgrading, while the weakness in financing is a restraining factor. Proceeding from current situation of financing in the medical and health industry, this paper analyzes the models of various financing channels of medical enterprises. Due to the large initial investment amount and prolonged investment cycle, the demand of medical enterprises for financing often faces great policy restrictions. In view of the financing difficulties, innovative financial policies are proposed to support the medical and health industry, accompanied by suggestions for risk management.

The impact of the COVID-19 pandemic and stringent social distancing measures on health-related quality of life and COVID-19 infection rates in patients with rheumatic disease: a longitudinal analysis through the pandemic.

The aim was to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic and stringent social isolation measures on patients with rheumatic disease (RD) from the beginning of the pandemic (April 2020). In this UK-based single-centre, prospective, observational cohort study, all RD follow-up patients at our centre were invited by SMS text message in April 2020 to participate in the study. Participants completed questionnaires at four time points between April 2020 and December 2021. We collected demographics, clinically extremely vulnerable (CEV) status, short form 12 mental (MCS) and physical health component scores (PCS) for health-related quality of life, vaccination status, COVID-19 infection rates and incidence of long COVID. We enrolled 1605 patients (female, 69.0%; CEV, 46.5%); 906 of 1605 (56.4%) completed linked responses to our final questionnaire. MCS improved (+0.6, P < 0.05), whereas PCS scores deteriorated (-1.4, P < 0.001) between April 2020 and December 2021. CEV patients had worse mental and physical health scores than non-CEV patients at entry (PCS, 36.7 and 39.3, respectively, P < 0.001; MCS, 40.9 and 43.0, respectively, P < 0.001) and at each time point throughout the study; both mental and physical health outcomes were worse in CEV compared with non-CEV patients (P < 0.001 and P = 0.004, respectively). At study close, 148 of 906 (16.3%) reported COVID infection, with no difference in infection, vaccination or long COVID rates between CEV and non-CEV patients. Mental and physical health in RD patients has changed throughout the pandemic; outcomes for both metrics of health were worse in CEV patients, although there were no differences in infection rates between the groups. These data might assist the understanding and planning of future health-care policy and social restrictions in RD patients. ClinicalTrials.gov, www.clinicaltrials.gov, NCT04542031.

The lived experiences of health care professionals regarding visiting restrictions in the emergency department during the COVID-19 pandemic: A multi-perspective qualitative study.

To explore the lived experiences of emergency department (ED) healthcare professionals regarding visiting restrictions during the COVID-19 pandemic. A qualitative phenomenology study. Semi-structured interviews were undertaken. Participants consisted of 10 physicians, 20 clinical nurses, and three managers, who were purposefully selected from two EDs in China between April and July 2021. Colaizzi's approach guided data analysis. Four themes arose: (i) burden moral injury, (ii) higher workload to provide and support patient- and family-centered care, (iii) dissatisfied and unsafe healthcare service for patients and families, and (iv) tailoring strategies to provide family-centered care. This study explored the lived experiences of ED health care professionals regarding visiting restrictions during the COVID-19 pandemic. Noted challenges included communicating with families and ethical decision making. Strategies that support ED clinician welfare, and communication with families are warranted if visiting policy restrictions are continued or re-introduced.

The association of herd performance indicators with dairy cow longevity: An empirical study.

The associations between reproductive performance, milk yield and health status with the risk of culling, and thus with a cow's longevity, have been well documented at the individual cow level. Associations at individual cow level may, however, not be valid at herd level due to interrelated herd management aspects and/or policy restrictions. The objective of this study was to explore the association of herd performance indicators with herd-level dairy cow longevity under Dutch production conditions. Longevity was expressed by three different measures, viz. age at culling, lifetime milk production of culled cows and culling rate. The evaluated herd performance indicators included factors on milk production, youngstock rearing, reproduction and health performance as registered on 10 719 Dutch commercial dairy herds during the period 2007-2016. Averaged over herds and the evaluated period, the age of culled milking cows was 2 139 days (5.8 years, SD±298 days), the lifetime milk production of culled cows was 31 238 kg (SD±7,494 kg), and the culling rate was 0.24 (SD±0.08). A mixed linear regression modelling approach was applied to evaluate the association of each of the three longevity measures with the selected herd performance indicators. The results indicated that only four herd performance indictors (herd size, herd expansion, heifer ratio and the proportion of cows with potential subclinical ketosis) shared significant associations with all three longevity variables. Generally, the strength of the associations between each of the evaluated longevity measures and herd performance indicators was only limited. The absence of strong associations between the longevity measures and herd performance indicators reveal that there is potential of extending cattle longevity without affecting the herd performance in terms of milk production, reproduction and health. Moreover, only part of the observed variance in longevity among the herds over time was explained by the herd performance variables, indicating that differences in longevity at herd level may predominantly be determined by other factors, like farmers' attitude and strategic management.

Exploring Patient Perspectives Surrounding Telemedicine Versus In-Person Preoperative Visits.

Telemedicine was increasingly used to provide patients with an alternative to in-office visits during the COVID-19 pandemic. While previous studies have described the role of telemedicine for preoperative visits for other surgical specialties, the role of this modality in preoperative visits for gynecologic surgery has not been thoroughly explored. The aims of the study are to explore and compare patient experience, decision making, and satisfaction among women undergoing telemedicine or in-person preoperative visits. This was a qualitative study of women who underwent a preoperative appointment with a urogynecologic surgeon or minimally invasive gynecologic surgeon at a single academic institution from April to May of 2021. Data were collected using semistructured phone interviews, which focused on visit content, visit type decision making, surgical preparedness/confidence, and past surgical experiences. Interviews were thematically analyzed until theoretical saturation was achieved in accordance with grounded theory. Theoretical saturation occurred with 20 interviews. Participants were evenly divided between in-person and telemedicine visits. Major themes included visit content, experience/quality, surgeon perception, and surgical preparedness. Advantages of telemedicine visits were convenience and safety. Advantages of in-person visits were social factors, perceived medical or surgical severity, and preoperative physical examination. Disadvantages for telemedicine visits included technology concerns and difficulty accessing preoperative materials. The disadvantage of an in-person visit was the inability to have family present because of COVID hospital policy restrictions. Participants in both groups felt prepared for surgery and reported high satisfaction with their care. Decision making for selecting an in-person or telemedicine visit is complex and involves balancing multiple advantages and disadvantages. Participant experience was similar for both visit types with high satisfaction.

The emergence of custodial health nursing as a specialty whose time has come: An Australian experience.

Nurses provide healthcare in prisons worldwide. Working within security restraints, in environments not designed for nursing care, custodial health nurses (CHNs) use specialist nursing skills and knowledge to do essential work. Rapid increases in prisoner age, infirmity and ill-health of prisoners mandate their access to these nurses. To raise awareness of the CHNs struggle for specialty status within the nursing profession, public health frameworks and prisons. Publicly available information is organised and analysed through the author's lens of 20 years working in the Australian prison system as a general nurse and nurse practitioner. CHNs efforts towards becoming a specialty within nursing, public health and prisons are ongoing. Overcoming barriers and maximising facilitators to effective CHN practice would be indicators of successful incorporation of nursing models that assist prisoner patients. Prison healthcare contexts are unique regarding prisoner health and funding that impacts the CHNs resourcing, their scope of practice and acceptance of nursing in prison systems and the broader healthcare sectors. Greater visibility of the CHNs will help promote policy reforms regarding nursing services within a changing prisoner demographic. Changes to educational and professional support for CHNs are needed. Policy restrictions on funding for CHN models in Australia fall short of international standards for prison healthcare; however, political and organisational commitment in this area will be necessary to attain community-equivalent healthcare standards across the custodial setting. Professional structures, competencies and specialty policy frameworks are required to promote CHNs as advocates for prisoners needing care and their professional development. CHNs at the forefront of policy development and review will benefit all stakeholders in custodial health.

Hoping for state policy and “policy-based resistance”: contested representations of a good society in a Chinese mining town

Following the resurgence of anthropological interest in resistance studies, I show how resistance can be based on firm adherence to government policies, and can thus ideologically strengthen the state. Though it is common for anthropologists to conceptualize policies as political technologies of control, Chinese scholars have shown that policies can also be appropriated by citizens for purposes of resistance. These different views on policies imply a dichotomy between the state and society. However, drawing on ethnographic data on the resistance experiences of peasants and workers in a Chinese mining town (Pingan), I explore how Pingan people’s imagination of state policy implicates a “state-family” relationship in which “policy-based resistance” was bounded by a political-moral nexus. Pingan peasants and workers used state policies as a tool of resistance despite the policy restrictions placed on social life. They did not see state policies as offering opportunities of resistance but also saw them as resources for hoping the central state’s policies would bring them a happy family life. I illustrate this with three case studies in which Pingan people’s spatial imaginations of state policies connect to the notion of “family” (家). This article concludes by reflecting on the concept of “refusal,” arguing that those who employed policy-based resistance refused to acknowledge the local government as effective policy enforcer but accepted the central state as a benevolent policy-maker, offering them hope and allowing them to imagine a good society.

573: FAMILY COMMUNICATION IN THE ICU: CHALLENGES AND SOLUTIONS

Introduction: The COVID-19 pandemic created major barriers to communication with patient families, impacting patient care and staff satisfaction. We surveyed an interprofessional group of medical intensive care unit (MICU) stakeholders to identify their concerns surrounding family communication and solicited recommendations for performance improvement. Methods: An anonymous survey was distributed electronically to 260 MICU physicians, advanced practice providers (APPs), nurses, and physical, occupational, and respiratory therapists, with a 1 week reminder. The results were analyzed using thematic analysis. Results: Thirty-nine participants (response rate 15%) completed the survey, providing 95 unique comments. Major themes included challenges created by visitor policy restrictions (providers unable to connect well with families by phone; families not understanding how to work video platforms; frequent misunderstandings); medical system distrust (antivaccine and overall hostility, unrealistic expectations, challenging treatment decisions); trainee communication concerns (lack of communication training, not seeing the “big picture”, nurse not knowing whether families were contacted/what was discussed), and A2F bundle failures (F component not organized, family updates too infrequent, distorted messages). This feedback prompted a quality improvement initiative to strengthen our family communication process. The responsible resident or APP is now encouraged to use a “Get to Know Me Board” to structure the collection of relevant social history with patient and family on admission, establishing an initial relationship and line of communication. Our rounding template was modified to discuss the family communication plan each day using a tiered structure (brief summary/introduction on admission; update; serious update/acute event; goals of care; transition to comfort) and clarify which team members will be present for the conversation. Afternoon rounds were also modified to routinely confirm successful family contact and address any concerns. Conclusions: We describe the results of our interprofessional survey to define the barriers to family communication during the COVID-19 pandemic, and process improvements in our MICU to make daily family involvement and contact feasible and efficient within our daily workflow.

The Existing Crisis of China's Large Real Estate Enterprises and Corresponding Amelioration Strategies Based on Evergrande and Vanke

In recent years, large Chinese real estate companies, especially Evergrande and Vanke, have faced an unprecedented financial crisis and development barriers due to a series of regulatory policies introduced by the Chinese government, the decline in housing demand for long-term incentives owing to the increased in household leverage, the high leverage caused by the rapid expansion of real estate companies, and the impact of the COVID-19 epidemic. Consequently, how accurately identifying the deviations and loopholes in policies, finance, marketing models, and development strategies and then coming up with countermeasures is the key for real estate enterprises to broaden their development prospects and maintain industry prosperity. In light of this, this paper expounds on the current situation of the real estate industry from three aspects: the bubble of urban housing prices, the demand side, and the supply side. Additionally, through the analysis of real estate enterprises, this paper summarizes the risks and crises of most large Chinese real estate enterprises, such as policy restrictions on real estate enterprises, difficulties in financing and development, and the impact of COVID-19. Combined with the advantages of the development strategy of non-Chinese mainland real estate enterprises (mainly Sun Hung Kai), the corresponding solutions and suggestions are given as well. With strong universality and practicability, this paper is intended to provide feasible solutions and strategies for the financial and development prospects of large real estate enterprises in China, expecting to give some inspiration and help to Chinese real estate enterprises under multiple adverse factors such as the impact of the epidemic.

High-Resolution Mapping of Seaweed Aquaculture along the Jiangsu Coast of China Using Google Earth Engine (2016–2022)

Seaweed aquaculture produces enormous economic and ecological service benefits, making significant contributions to achieving global Sustainable Development Goals (SDGs). However, large-scale development of seaweed aquaculture and the unreasonable use of aquaculture rafts may trigger green tide, bringing negative ecological, social, and economic impacts. Therefore, it is vital to monitor the seaweed aquaculture industry accurately. Here, we mapped 10-m-resolution seaweed aquaculture along the Jiangsu coast of China based on active and passive remote sensing (Sentinel-1/2) and Random Forest using Google Earth Engine. The results demonstrate satisfactory model performance and data accuracy. The square seaweed aquaculture in the Lianyungang Offshore (Mode-I) has gradually expanded to the deep sea since 2016, with a maximum area of 194.06 km2 in 2018. Between 2021 and 2022, the area of the strip-shaped seaweed aquaculture in Subei radiation shoals (Mode-II) was considerably reduced, with most of the reduced land lying on the east side of the Dafeng Elk National Nature Reserve. In general, the area of the seaweed aquaculture in the prohibited breeding area was reduced from 20.32 km2 to 3.13 km2, and the area of the seaweed aquaculture in the restricted breeding area was reduced from 149.71 km2 to 33.15 km2. Results show that under the policy restriction, the scale of unsustainable seaweed aquaculture along the Jiangsu coast has been greatly reduced within seven years. This study can provide an efficient approach for the medium-scale extraction of seaweed aquaculture and provide decision support for the sustainable development of marine aquaculture.

Transformation Path of Ecological Product Value and Efficiency Evaluation: The Case of the Qilihai Wetland in Tianjin.

In order to protect wetland resources, China has developed wetland conservation policies and has made significant conservation investments, but there is still a lack of pathways for the conversion to economic value, making it difficult to meet the demand for continuous investment. We have explored a sustainable ecological conservation mechanism using the Seven Mile Sea as a case study, so that ecological conservation costs can be transformed into economic development behaviors and ecological benefits and socio-economic development can be integrated. This paper assesses the ecological product value of the Qilihai Wetland based on the ecosystem service function value assessment method, which designs the realization path of ecological product value and predicts the value transformation efficiency. The results show the following: (1) The total value of ecological products in the study area is CNY 569.06 million (USD 78.36 million), and the main sources of value are plant products in the supply service and water purification functions in the regulation service, accounting for 54.05% and 26.10% of the total, respectively. (2) The predicted value realization of ecological products, ideally, is CNY 689.65 million (USD 94.96 million), with a value realization rate of 111.60%. Considering the management policy restrictions in different areas of the Qilihai Wetland, the actual value realization volume is CNY 391.94 million (USD 53.97 million), with a value realization rate of 63.42%. (3) Owing to the restriction of the development policy of supply services and cultural services, the value realization path mainly contains two types: one is to drive the development of supply services and cultural services in the surrounding areas, along with product premiums, to realize value transformation. This path is mainly aimed at the supply of local characteristic products and the development of tourism. The second is to realize the value of regulating services through ecological compensation and ecological equity trading. This path is mainly for the adjustment and support services in the core area and buffer area. According to the pre-accounting results, the contribution rates of the two paths are 62.25% and 37.75%, respectively. The second path should be further effectively developed to improve the contribution rate. This study helps assess the ecological value and important ecological elements of the Qilihai Wetland to ensure effective protection and development of important ecological resources and to achieve the sustainable development of wetland resources. It provides a reference for exploring feasible paths to realize the value of ecological goods.

Uncovering familialism: cash-for-care schemes in England and Finland

This article compares cash-for-care schemes supporting older people with health-related social care needs, as well as their informal carers, in England and Finland. The meso-level policy analysis drills down into the governance arrangements underpinning cash-for-care schemes, including their eligibility criteria, generosity and territorial variations. It explores their implicit and explicit intentions, function and effects in defamilialising, familialising or refamilialising families’ caring responsibilities. This reveals inconsistencies in the familialising and defamilialising effects of schemes according to individuals’ characteristics, choices and policy restrictions. It also exposes an overarching tendency to familialise or refamilialise the activity of caring for older people, which is exacerbated by austerity-related politics.

Risk path identification and factor analysis of project capital operation of small and medium-sized real estate enterprises based on the DEMATEL-ISM model

To investigate the risk path identification and factor analysis of project capital operation of small and medium-sized real estate enterprises, this paper compiles 18 risk indicators affecting engineering finance of small and medium-sized real estate enterprises in China based on literature research, and analyzes them based on the Decision-making Trial and Evaluation Laboratory (DEMATEL) method combined with the explanatory structural model (ISM) model, calculate the interrelationship and importance of each risk factor, and systematically stratify them according to their logical structure. The results show that the three indicators of "uncontrolled development progress, inadequate financing channels, and insufficient funds" have the greatest influence on the capital risk of small and medium-sized real estate enterprises, while the three indicators of "lack of an independent capital budgeting system, the imbalance between market supply and demand, and national macro policy restrictions" are the most influential factors. The three indicators of "lack of independent capital budgeting system, unbalanced market supply and demand, and national macro policy restrictions" are the underlying factors affecting the capital risk of small and medium-sized real estate enterprises. The analysis of risk transmission paths and underlying factors conducted in this paper has important warning implications for the project capital management of small and medium-sized real estate enterprises.