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Are performance-based payment structures more strongly correlated with better health outcomes compared to solely fee-for-service payment for surgeons? 对外科医生来说,与单纯按服务收费相比,基于绩效的支付结构是否与更好的健康结果有更强的相关性?
IF 1.1 Q3 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2023-05-31 DOI: 10.47611/jsrhs.v12i2.4346
M. George, J. Anagnost
For years, the healthcare industry has compensated its surgeons with a simple fee-for-service model. With more payment structures becoming prevalent, we decided to review one specific type of payment structure, pay-for-performance, and its impact on patient health outcomes. We hypothesized that, on average, across all specialties, performance-based contracts would yield better health outcomes compared to fee-for-service payments alone. We also hypothesized that performance-based contracts might pressure physicians to get results and could lead to mistakes and a worse quality of care. We reviewed nine papers from 2006-2014, of which the majority were conducted in the United States, with one each from Italy and Germany. Our review included three literary/systematic reviews, three before & after studies, and two cross-sectional analyses. Many papers did not provide strong evidence of the effect of pay-for-performance on health outcomes, although examined papers agree on certain things. A common theme we found was the pay-for-performance increased documentation and the number of procedures done, but with minimal conclusions about outcomes. This may result from poor or non-standardized metrics being used to measure and report “performance.” However, two studies found that pay-for-performance improved patient health outcomes, despite limitations.  For example, Brosig-Koch et al., (2013) found that P4P was not cost-effective from a solely financial standpoint. 
多年来,医疗保健行业一直采用简单的按服务收费模式来补偿外科医生。随着越来越多的支付结构变得普遍,我们决定审查一种特定类型的支付结构,即按绩效付费,以及它对患者健康结果的影响。我们假设,平均而言,在所有专业中,基于绩效的合同比单独按服务收费的合同产生更好的健康结果。我们还假设,以绩效为基础的合同可能会给医生施加压力,要求他们取得结果,从而导致错误和更差的医疗质量。我们回顾了2006-2014年的9篇论文,其中大部分是在美国进行的,意大利和德国各有一篇。我们的综述包括3篇文献/系统综述、3篇前后研究和2篇横断面分析。许多论文没有提供强有力的证据来证明绩效工资对健康结果的影响,尽管被审查的论文在某些事情上是一致的。我们发现一个共同的主题是,按绩效付费增加了文件和完成的程序数量,但对结果的结论却很少。这可能是由于用于度量和报告“性能”的糟糕的或非标准化的度量标准造成的。然而,两项研究发现,尽管存在局限性,但按绩效付费改善了患者的健康状况。例如,brosigg - koch等人(2013)发现,仅从财务角度来看,P4P并不具有成本效益。
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引用次数: 0
The Effect of Overnutrition on Mediated Collagen in Drosophila Melanogaster Physiology 营养过剩对黑腹果蝇介导的胶原蛋白的影响
IF 1.1 Q3 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2023-05-31 DOI: 10.47611/jsrhs.v12i2.4429
Nicholas Kwok, Julianna Caulkins, Leya Joykutty
Obesity affects approximately 13% of the adult population, resulting in excessive fat cell deposition and metabolic dysfunction. Collagen, a protein that supports skin regeneration, muscle building, and pain relief, is studied in Drosophila melanogaster under different diet conditions. This experiment aims to test whether overnutrition affects physiology and collagen due to any anatomical changes in Drosophila Melanogaster, more commonly known as fruit flies. The research conducted over several weeks utilizes two diets: an obesity-inducing diet containing excessive glucose and coconut oil and a traditional diet of blue food medium, yeast, and water. The study groups include a wild-type, collagen-mutated, and obesity-mutated group, with multiple assays measuring how the obesity-inducing diet affects each population and their collagen levels. The results reveal that the obese group experienced higher food consumption levels but had lower locomotive ability than the other test groups. Hydroxyproline, the building amino acid for collagen, and collagen levels were higher in the obesity mutant than in the wild-type and collagen mutated group. The study shows that anatomical changes in organisms are influenced by both diet and movement. The obesity group, on an obesity-inducing diet, experienced decreased movement related to increased food intake and decreased neural activity. The high-fat and high-sugar diet suppressed neuronal autophagy, created inaccurate hunger and satiety perceptions, and increased collagen deposition. Anatomical changes were observed in collagen-heavy tissue areas, whereas decreased neural activity and increased feeding rates were behavioral changes. The study emphasized the importance of a healthy diet and exercise in promoting overall health.
肥胖影响了大约13%的成年人,导致过多的脂肪细胞沉积和代谢功能障碍。胶原蛋白是一种支持皮肤再生、肌肉形成和缓解疼痛的蛋白质,研究人员在不同的饮食条件下对黑腹果蝇进行了研究。本实验旨在测试营养过剩是否会由于果蝇的解剖学变化而影响生理和胶原蛋白。这项为期数周的研究采用了两种饮食:一种是含有过量葡萄糖和椰子油的肥胖饮食,另一种是含有蓝色食物培养基、酵母和水的传统饮食。研究小组包括野生型、胶原突变组和肥胖突变组,通过多次测定导致肥胖的饮食如何影响每个人群及其胶原蛋白水平。结果表明,肥胖组的食物消耗水平高于其他试验组,但运动能力低于其他试验组。肥胖突变体中胶原蛋白的构建氨基酸羟脯氨酸和胶原蛋白水平高于野生型和胶原蛋白突变组。研究表明,生物的解剖结构变化受到饮食和运动的影响。肥胖组,在肥胖诱导饮食中,经历了与食物摄入量增加和神经活动减少相关的运动减少。高脂肪和高糖饮食抑制神经元自噬,产生不准确的饥饿和饱腹感,并增加胶原蛋白沉积。在胶原蛋白重的组织区域观察到解剖变化,而神经活动的减少和摄食率的增加是行为变化。该研究强调了健康饮食和锻炼对促进整体健康的重要性。
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引用次数: 0
The Behavioral and physiological impacts of the hormesis of chemical contaminants on embryonic zebrafish 化学污染物致效效应对胚胎斑马鱼行为和生理的影响
Q3 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2023-05-31 DOI: 10.47611/jsrhs.v12i2.4409
Akshay Kumar, Leya Joykutty, Juliana Caulkins
Pharmaceutical chemicals are being produced, consumed, and excreted in human civilization at an increasing rate. These chemicals have the capacity to accumulate, especially in environments such as freshwater systems, but there have not been any major responses to this threat yet as the present concentrations of the chemicals is not viewed as dangerous. Previous research has shown that the developing concentrations of chemicals is an issue, supporting that these chemicals, though not present in large doses, have impacts on exposed organisms. However, prior research has not been conducted to examine the specific effects of chemicals at hormetic concentrations on freshwater organisms. “Hormetic concentration” defines the concentrations of chemicals at specific levels where the response to a low dose of chemical differs from the response to the high dose, and these were the ranges of concentration that were tested in this experiment. Zebrafish were acquired at zero days post fertilization, transferred to the medium containing the appropriate concentration of chemicals for the group that they would be a part of, and used as a model for aquatic organisms to show the resulting chemical, neural, and physical response to the chemical concentrations. The zebrafish were euthanized via bleaching and freezing prior to seven days post fertilization. The results of this experiment show that there is an ecological risk associated with the environmental accumulation of pharmaceutical chemical contaminants that is inherent to their use in human civilization, a result which makes it clear that this issue needs to be addressed.
在人类文明中,医药化学品正以越来越快的速度被生产、消费和排泄。这些化学物质具有积聚的能力,特别是在淡水系统等环境中,但由于目前的化学物质浓度不被视为危险,因此尚未对这一威胁作出任何重大反应。先前的研究表明,化学物质浓度的增加是一个问题,支持这些化学物质虽然不是大剂量存在,但对暴露的生物体有影响。然而,先前的研究尚未进行,以检查化学物质在致热浓度对淡水生物的具体影响。"辐射浓度"定义了特定水平下化学物质的浓度对低剂量化学物质的反应不同于对高剂量化学物质的反应,这些是在这个实验中测试的浓度范围。斑马鱼是在受精后第0天获得的,将其转移到含有适当浓度的化学物质的培养基中,用于水生生物的模型,以显示对化学物质浓度产生的化学,神经和物理反应。斑马鱼在受精后7天前通过漂白和冷冻安乐死。这项实验的结果表明,在人类文明中使用药物化学污染物所固有的环境积累会带来生态风险,这一结果清楚地表明,这个问题需要得到解决。
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引用次数: 0
Research on the Security System of Social Assistance in Rural China 中国农村社会救助保障制度研究
IF 1.1 Q3 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2023-05-31 DOI: 10.47611/jsrhs.v12i2.4281
Yuyang Feng, Wentao Gu
China's rural social assistance security system is a national system that meets the basic survival needs of the rural poor, safeguards their rights to survival, and helps them get out of the survival crisis. It is the last layer of safety net to maintain social stability, promote rural economic development, and guarantee the basic living for peasants. China's rural social assistance security system has gone through decades of the development from emergency relief to guaranteed assistance, and many experts and scholars have conducted in-depth research and discussions on it. On the basis of fully searching for domestic and foreign literature, systematic reading of literature content, careful analysis and screening of experts' views, this paper classifies and summarizes the views and discussion of experts and scholars, trying to reflect the development of China's rural social assistance security system and running status. It can make readers further study China's rural social security system, at the same time, providing a reference for other developing countries in the world to improve the progress of social security.
中国农村社会救助保障制度是满足农村贫困人口基本生存需要,保障农村贫困人口生存权利,帮助农村贫困人口摆脱生存危机的一项全国性制度。它是维护社会稳定、促进农村经济发展、保障农民基本生活的最后一道安全网。中国农村社会救助保障制度经历了从紧急救助到保障救助的几十年发展历程,许多专家学者对此进行了深入的研究和探讨。本文在充分检索国内外文献、系统阅读文献内容、认真分析筛选专家观点的基础上,对专家学者的观点和论述进行了分类总结,力图反映中国农村社会救助保障制度的发展和运行状况。可以使读者进一步研究中国农村社会保障制度,同时为世界上其他发展中国家提高社会保障的进步提供借鉴。
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引用次数: 0
Evaluating Machine Learning Models on Predicting Change in Enzyme Thermostability 评估机器学习模型对酶热稳定性变化的预测
IF 1.1 Q3 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2023-05-31 DOI: 10.47611/jsrhs.v12i2.4364
Avnith Vijayram, J. Luu
Enzymes are efficient catalysts for biological reactions and can potentially be designed to speed up non-biological reactions, such as reactions in industrial processes. However, physically experimenting with new protein designs is time consuming, and an efficient method to predict protein stability is needed. Our research problem is finding the best machine learning model to predict the change in enzyme thermostability after a single point mutation in the amino acid sequence. We trained several machine learning models and found that the XGBoost model had the best performance with an R2 score of 0.593 (R2 score is a metric where higher is better and a perfect model would have a score of 1).
酶是生物反应的有效催化剂,可以被设计成加速非生物反应,如工业过程中的反应。然而,对新的蛋白质设计进行物理实验是耗时的,并且需要一种有效的方法来预测蛋白质的稳定性。我们的研究问题是寻找最佳的机器学习模型来预测氨基酸序列单点突变后酶热稳定性的变化。我们训练了几个机器学习模型,发现XGBoost模型具有最佳性能,R2得分为0.593 (R2得分是一个度量,越高越好,完美的模型得分为1)。
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引用次数: 0
Biological Sex and the Medical Community 生物性与医学界
IF 1.1 Q3 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2023-05-31 DOI: 10.47611/jsr.v12i2.1891
A. Gómez, Kayla Branstetter
There are numerous contributing factors to the overall health of a person as well as factors that dictate the best course of treatment. A great contributor to that decision is the biological sex, it can influence every decision that a medical provider makes for their patient. With transgenderism, let us not forget that in the medical community, knowing the biological sex of the patient is crucial for proper patient care and accurate diagnosis. In healthcare, the sex of a patient means more than just "male" or "female". It gives a clearer understanding of what the underlying issue may be. That includes taking reproductive organs into account for possible causes of abnormal signs and symptoms. As an even clearer picture, being able to identify the proper sex-chromosome pair (XX or XY) allows professionals to be concious of X- linked recessive disorders.
影响一个人整体健康的因素有很多,也有决定最佳治疗方案的因素。生理性别是决定的一个重要因素,它可以影响医疗提供者为病人做出的每一个决定。关于跨性别,让我们不要忘记,在医学界,了解病人的生理性别对于适当的病人护理和准确的诊断至关重要。在医疗保健中,病人的性别不仅仅意味着“男性”或“女性”。它让我们更清楚地了解潜在的问题是什么。这包括考虑生殖器官可能引起的异常体征和症状。更清楚的是,能够识别正确的性染色体对(XX或XY)可以让专业人员意识到X连锁隐性疾病。
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引用次数: 0
Effects of Parasocial Relationships and Identification with TV Characters on Teens 副社会关系与电视角色认同对青少年的影响
IF 1.1 Q3 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2023-05-31 DOI: 10.47611/jsrhs.v12i2.4314
Lara Grosskopf
With the rise of “binge watching” and increasing use of social media, teens are interacting more with tv shows, or more specifically the characters. Previous research has identified that parasocial relationships (PSR) and identification impact loneliness, body image, and one’s personality and behaviors, but has failed to address the extent to which the effects are positive or negative. PSR and Identification have also not been studied together, despite the likelihood of someone who has formed a relationship with a character to also put themselves in the shoes of said character. My study addressed these gaps and aimed to explore the extent to which the effects of PSR and identification with tv characters are negative on teens ages 14-18. My study also explored the subquestion, are ineffective age-ratings a possible cause of any specific negative effects of PSR and/or identification? I conducted a phenomenological study using a quantitative survey method. I determined participants’ level of PSR and identification with their favorite tv-show character and the number of positive, negative, and neutral effects the phenomenons had on them. A strong correlation between one’s level of PSR and identification confirmed that the two should be studied together. However, no correlation was found between one’s level of PSR or Identification and the positivity or negativity of effects. My subquestion did reveal that PSR and identification pose a problem when with characters from shows rated for an older audience. These findings may have implications on the presence and use of parental controls on television. 
随着“剧迷”的兴起和社交媒体的使用,青少年与电视节目的互动越来越多,或者更确切地说,是与角色的互动。以前的研究已经发现,副社会关系(PSR)和身份认同会影响孤独、身体形象、一个人的个性和行为,但未能解决这种影响的积极或消极程度。PSR和身份认同也没有被放在一起研究,尽管与角色建立关系的人可能也会把自己放在角色的立场上。我的研究填补了这些空白,旨在探索PSR和对电视角色的认同在多大程度上对14-18岁的青少年产生负面影响。我的研究还探讨了子问题,无效的年龄分级是PSR和/或识别的任何特定负面影响的可能原因吗?我用定量调查的方法进行了现象学研究。我确定了参与者的PSR水平和对他们最喜欢的电视节目角色的认同,以及这些现象对他们产生的积极、消极和中性影响的数量。一个人的PSR水平与识别之间的强烈相关性证实了这两者应该一起研究。然而,没有发现一个人的PSR或识别水平与积极或消极影响之间的相关性。我的子问题确实揭示了PSR和识别在针对老年观众的节目中的角色时构成了一个问题。这些发现可能会对家长控制电视的存在和使用产生影响。
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引用次数: 0
Effects of Work-Family Conflict on Working Women 工作-家庭冲突对职业女性的影响
IF 1.1 Q3 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2023-05-31 DOI: 10.47611/jsrhs.v12i2.4329
Jea-Won Kim
This paper is mainly about the work-family conflict women face in this society. This paper shows the relationship between work-family conflict and various factors such as social support, turnover intention, and low job engagement. To find the effects of work-family conflict on working women, the survey was sent out to the people who currently have a workplace. The majority of the participants were women, as the research’s main focus was on working women. The results proved the positive correlation between work-family conflict and turnover intention. In addition, surprisingly, the survey showed that the control variables such as age, tenure, gender, and the number of children had insignificant impacts on the work-family conflict.  
这篇论文主要是关于女性在这个社会中所面临的工作家庭冲突。本文研究了工作家庭冲突与社会支持、离职倾向、低工作投入等因素的关系。为了找出工作与家庭冲突对职业女性的影响,这项调查被发给了目前有工作的人。大多数参与者是女性,因为这项研究主要关注的是职业女性。结果表明,工作家庭冲突与离职倾向呈正相关。此外,令人惊讶的是,调查显示,年龄、任期、性别、子女数量等控制变量对工作家庭冲突的影响不显著。
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引用次数: 0
Why We Speak Up: The Effect of Preconceived Cause of Sexual Orientation on Heterosexual Engagement in the Homosexual Movement for Social Equality 我们为什么大声疾呼:在争取社会平等的同性恋运动中,性取向的先入为主的原因对异性交往的影响
IF 1.1 Q3 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2023-05-31 DOI: 10.47611/jsrhs.v12i2.4243
Simran Goraya
Despite the increasing societal acceptance of homosexual individuals, the perception of homosexuality by heterosexual individuals is polluted by personal bias. My study observed the interaction between 422 heterosexuals and the homosexual community. First, my subjects self reported their beliefs on the determinant of sexual orientation (genetic or lifestyle). Next, they took the Activism Orientation (AO) and Sexual Prejudice (SP) Scales as a baseline measure of their relationship with members homosexual community. Subjects were randomly assigned to listen to an interview of two fictional homosexual individuals that spoke of life experience which either supported or contradicted the subjects’ self reported beliefs. Additionally, subjects were assigned to a high or low empathy condition toward the interviewee. After listening to the interview, subjects were given the choice to allocate $0 - $8,000 in support of a pro - LGBT charity. Subjects then retook the AO and SP scales to measure for significant changes in perception of homsexuals after the fictional scenario. Results indicated a significant decrease in the AO of subjects that viewed interviews that contradicted their beliefs. Additionally, subjects assigned to the low empathy condition donated significantly larger amounts. The present study has two main implications: Heterosexual individuals’ generalize their advocacy toward the LGBT community based on the actions of a singular homosexual. Furthermore, many activists naturally approach issues regarding social justice from a place of empathy, it is more sustainable to approach social justice movements from a logical perspective to allow for more meaningful and long term participation in a social justice movement.
尽管社会对同性恋个体的接受程度越来越高,但异性恋个体对同性恋的看法却受到个人偏见的污染。我的研究观察了422名异性恋者和同性恋者之间的互动。首先,我的研究对象自我报告了他们对性取向决定因素的信念(基因或生活方式)。接下来,他们以行动主义取向(AO)和性偏见(SP)量表作为衡量他们与同性恋群体成员关系的基准。实验对象被随机分配听两个虚构的同性恋者的采访,他们讲述的生活经历要么支持,要么与实验对象自我报告的信念相矛盾。此外,受试者被分配到对受访者的高或低同理心条件。在听完访谈后,受试者被要求选择拨出0 - 8000美元来支持一个支持LGBT的慈善机构。然后,研究对象重新使用AO和SP量表来测量虚构场景后对同性恋认知的显著变化。结果表明,观看与他们的信念相矛盾的采访的受试者的AO显着下降。此外,被分配到低同理心条件下的受试者捐赠的金额明显更多。目前的研究有两个主要的含义:异性恋个体基于单一同性恋者的行为来推广他们对LGBT群体的支持。此外,许多积极分子自然地从同理心的角度来处理社会正义问题,从逻辑的角度来处理社会正义运动,以允许更有意义和长期参与社会正义运动,这是更可持续的。
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引用次数: 0
Pancreatic Cancer and the Promise of Personalized Medicine 胰腺癌和个性化医疗的前景
IF 1.1 Q3 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2023-05-31 DOI: 10.47611/jsr.v12i2.1920
L. Kim, Yujin Lee
Pancreatic cancer, among which pancreatic ductal adenocarcinoma (PDAC) is the most common type, has a nearly identical incidence to mortality rate. Difficulties in early detection, diagnosis, and treatment are primarily responsible, all of which are further complicated by the molecular biology and etiology of the disease. To succeed in improving treatment options and survival rates, a deeper understanding of pancreatic cancer pathogenesis, as well as the pathogenesis of individual patients, is crucial. This is where personalized medicine comes into play, as it allows for a more specific diagnosis and choice of treatment that utilizes the genetic and cellular makeup of an individual’s cancer cells to provide a basis for the diagnosis and treatment. Personalized medicine is a rapidly growing field that shows promise in overcoming challenges in treating pancreatic cancer, all of which are explored in this article.
胰腺癌以胰腺导管腺癌(Pancreatic ductal adencarcinoma, PDAC)为最常见的类型,其发病率和死亡率几乎相同。早期发现、诊断和治疗的困难是主要原因,所有这些都因疾病的分子生物学和病因学而进一步复杂化。为了成功地改善治疗选择和生存率,深入了解胰腺癌的发病机制以及个体患者的发病机制是至关重要的。这就是个性化医疗发挥作用的地方,因为它允许更具体的诊断和治疗选择,利用个人癌细胞的遗传和细胞组成为诊断和治疗提供基础。个性化医疗是一个快速发展的领域,在克服治疗胰腺癌的挑战方面显示出希望,所有这些都在本文中进行了探讨。
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引用次数: 0
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Journal of Student Affairs Research and Practice
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