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1.
Heliyon ; 10(7): e29130, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38601668

RESUMO

In response to the epochal demand for high-quality development in early childhood education in China, it is imperative and necessary to improve the competency level of early childhood educators. The study aims to investigate the relationship between psychological contracts and teacher competency, and to verify the mediating roles of job crafting and professional identity in the relationship between psychological contracts and teacher competency. This study employed validated measurement scales regarding psychological contracts, teachers' professional identity, job crafting, and teacher competency. Each of these scales has established internal consistency coefficients. Data were collected from 318 early childhood teachers in Sichuan, China. The results highlight the significant impact of psychological contracts on the prediction of teacher competency. It is worth mentioning that the psychological contracts, together with their distinct components such as normative responsibility and development responsibility, have a direct and favorable impact on teacher competency. This implies that developing the psychological contracts might be an effective technique for improving teacher competence. The individual mediation of job crafting and professional identity in the link between psychological contracts and teacher competency has been well-established. However, the combined or chain mediating influence of these factors provides a unique and valuable perspective on the phenomenon of job crafting leading to professional identity, which in turn impacts teacher competency. The study found that psychological contracts have a positive predictive effect on teacher competency, while job crafting and professional identity both have independent and chain mediating roles in the relationship between psychological contracts and teacher competency. Therefore, this study suggests a comprehensive enhancement of the psychological contracts level from aspects such as normative responsibility, interpersonal responsibility, and development responsibility. By stimulating job crafting and professional identity levels in both internal and external environments, we can improve the competency level of early childhood educators.

2.
Front Public Health ; 12: 1358184, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38605878

RESUMO

The rapid development of the Hospital Information System has significantly enhanced the convenience of medical research and the management of medical information. However, the internal misuse and privacy leakage of medical big data are critical issues that need to be addressed in the process of medical research and information management. Access control serves as a method to prevent data misuse and privacy leakage. Nevertheless, traditional access control methods, limited by their single usage scenario and susceptibility to single point failures, fail to adapt to the polymorphic, real-time, and sensitive characteristics of medical big data scenarios. This paper proposes a smart contracts and risk-based access control model (SCR-BAC). This model integrates smart contracts with traditional risk-based access control and deploys risk-based access control policies in the form of smart contracts into the blockchain, thereby ensuring the protection of medical data. The model categorizes risk into historical and current risk, quantifies the historical risk based on the time decay factor and the doctor's historical behavior, and updates the doctor's composite risk value in real time. The access control policy, based on the comprehensive risk, is deployed into the blockchain in the form of a smart contract. The distributed nature of the blockchain is utilized to automatically enforce access control, thereby resolving the issue of single point failures. Simulation experiments demonstrate that the access control model proposed in this paper effectively curbs the access behavior of malicious doctors to a certain extent and imposes a limiting effect on the internal abuse and privacy leakage of medical big data.


Assuntos
Pesquisa Biomédica , Blockchain , Big Data , Simulação por Computador , Comportamentos Relacionados com a Saúde
3.
Sensors (Basel) ; 24(7)2024 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-38610418

RESUMO

The technology landscape has been dynamically reshaped by the rapid growth of the Internet of Things, introducing an era where everyday objects, equipped with smart sensors and connectivity, seamlessly interact to create intelligent ecosystems. IoT devices are highly heterogeneous in terms of software and hardware, and many of them are severely constrained. This heterogeneity and potentially constrained nature creates new challenges in terms of security, privacy, and data management. This work proposes a Monitoring-as-a-Service platform for both monitoring and management purposes, offering a comprehensive solution for collecting, storing, and processing monitoring data from heterogeneous IoT networks for the support of diverse IoT-based applications. To ensure a flexible and scalable solution, we leverage the FIWARE open-source framework, also incorporating blockchain and smart contract technologies to establish a robust integrity verification mechanism for aggregated monitoring and management data. Additionally, we apply automated workflows to filter and label the collected data systematically. Moreover, we provide thorough evaluation results in terms of CPU and RAM utilization and average service latency.

4.
PeerJ Comput Sci ; 10: e1933, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38660154

RESUMO

The robust development of the blockchain distributed ledger, the Internet of Things (IoT), and fog computing-enabled connected devices and nodes has changed our lifestyle nowadays. Due to this, the increased rate of device sales and utilization increases the demand for edge computing technology with collaborative procedures. However, there is a well-established paradigm designed to optimize various distinct quality-of-service requirements, including bandwidth, latency, transmission power, delay, duty cycle, throughput, response, and edge sense, and bring computation and data storage closer to the devices and edges, along with ledger security and privacy during transmission. In this article, we present a systematic review of blockchain Hyperledger enabling fog and edge computing, which integrates as an outsourcing computation over the serverless consortium network environment. The main objective of this article is to classify recently published articles and survey reports on the current status in the domain of edge distributed computing and outsourcing computation, such as fog and edge. In addition, we proposed a blockchain-Hyperledger Sawtooth-enabled serverless edge-based distributed outsourcing computation architecture. This theoretical architecture-based solution delivers robust data security in terms of integrity, transparency, provenance, and privacy-protected preservation in the immutable storage to store the outsourcing computational ledgers. This article also highlights the changes between the proposed taxonomy and the current system based on distinct parameters, such as system security and privacy. Finally, a few open research issues and limitations with promising future directions are listed for future research work.

5.
Sensors (Basel) ; 24(6)2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38544159

RESUMO

In contemporary data-driven economies, data has become a valuable digital asset that is eligible for trading and monetization. Peer-to-peer (P2P) marketplaces play a crucial role in establishing direct connections between data providers and consumers. However, traditional data marketplaces exhibit inadequacies. Functioning as centralized platforms, they suffer from issues such as insufficient trust, transparency, fairness, accountability, and security. Moreover, users lack consent and ownership control over their data. To address these issues, we propose DataMesh+, an innovative blockchain-powered, decentralized P2P data exchange model for self-sovereign data marketplaces. This user-centric decentralized approach leverages blockchain-based smart contracts to enable fair, transparent, reliable, and secure data trading marketplaces, empowering users to retain full sovereignty and control over their data. In this article, we describe the design and implementation of our approach, which was developed to demonstrate its feasibility. We evaluated the model's acceptability and reliability through experimental testing and validation. Furthermore, we assessed the security and performance in terms of smart contract deployment and transaction execution costs, as well as the blockchain and storage network performance.

6.
Comput Biol Med ; 173: 108347, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38554663

RESUMO

Despite recent advancements in monitoring brain activity, causal relationships within the brain during responsibility identification in construction contracts remain unexplored. We aimed to understand the neural mechanisms involved in the cognitive components and their interactions related to contract text reading by delving into the brain mechanisms of contract responsibility identification. This study investigated students' brain connectivity using electroencephalography (EEG) data during a text-based contract responsibility-identification task. It employed an adaptive directed transfer function based on Granger causality to simulate directed and time-varying information flow in observed brain activity. We evaluated the EEG records of 18 participants under two reading conditions (involving or not involving contractor responsibility). During responsibility identification, the most substantial information exchange occurs in the somatosensory area of the brain. The results revealed a "top-down" cortical mechanism for responsibility identification, with the left parietal-occipital area (PO3) as the central hub promoting connectivity structures. These findings indicate that the perceptual processing of contract responsibility texts is associated with higher visual learning and memory quality. Contracts without contractor-responsibility clauses resulted in more substantial information flow output in the frontal cortex and consumed more cognitive resources. Our findings advance the understanding of cognitive processes involved in contract responsibility identification, providing a framework for investigating causal relationships within the brain and novel insights into cortical mechanisms. By identifying the neural basis of responsibility identification, stakeholders can develop effective training programs for negotiators and enhance their ability to interpret and implement construction contracts.


Assuntos
Encéfalo , Negociação , Humanos , Eletroencefalografia/métodos , Córtex Cerebral , Mapeamento Encefálico/métodos
7.
Philos Trans A Math Phys Eng Sci ; 382(2270): 20230160, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38403054

RESUMO

Law is a critical tool that humans have created to assist them in managing complex social interactions. Computational Law holds the potential to significantly enhance our capacity to express and manage legal complexity, and a number of advantages can result from restating public and private legal rules in computable form. Capturing that potential depends in part on the approaches taken to automation. One set of choices involves whether to translate directly into code from existing natural language statements of laws, regulations and contracts or whether to step back, envision the basic structure underlying those statements and build a software approach that reflects that structure in a code-native manner. We argue that many advantages can flow from the second approach, and we present a specific use case of a simplified insurance policy as an example of this approach. Large language models may assist in this process, but are not yet a replacement for a code-native utility. This article is part of the theme issue 'A complexity science approach to law and governance'.

8.
AJPM Focus ; 3(2): 100190, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38357553

RESUMO

Introduction: The majority of large public universities have exclusive pouring rights contracts with beverage companies that produce and market sugar-sweetened beverages. Pouring rights contracts contain provisions that conflict with recommendations from major public health organizations that institutions reduce sugar-sweetened beverage availability, marketing, and consumption. This study assessed the following among students at 3 public universities: student perception of pouring rights contracts (the extent to which they favored or opposed pouring rights contracts), the association between student socioeconomic characteristics and perception of pouring rights contracts, student estimates of pouring rights contract revenue, and the association between student pouring rights contract revenue estimates and perception of pouring rights contracts. To contextualize results, actual pouring rights contract revenue as a percentage of total revenues was estimated. Methods: A cross-sectional exploratory study was conducted among a convenience sample of 1,311 undergraduate sugar-sweetened beverages-consuming students recruited from 3 large and diverse public universities in Northern California. On an online questionnaire, undergraduate students indicated the extent to which they favored or opposed pouring rights contracts on a 10-point scale (oppose=1-5, favor=6-10) and provided a numeric estimate of the percentage of total university revenue they thought their university's pouring rights contract generated. Regression models were used to analyze differences in perception of pouring rights contracts by student socioeconomic characteristics and estimates of university revenues generated by pouring rights contracts. In addition, pouring rights contracts and financial reports were obtained from the 3 universities to estimate actual pouring rights contract revenue as a percentage of total revenues. Survey data were collected between August and November 2018 and analyzed in August 2022. Results: A large majority of students (81%) opposed pouring rights contracts, and the opposition did not significantly differ by student socioeconomic characteristics, including by levels of food security, need-based financial aid, participation in federal food assistance or healthcare programs, parental education, or parental income (all ps>0.14). The median student estimate for pouring rights contract revenue as a percentage of total university revenue was 10%. In contrast, the estimated actual annual revenue generated from the pouring rights contracts ranged from 0.01% to 0.04% at these schools. Revenue estimates were not significantly associated with participants' opposition or favoring of pouring rights contracts (p=0.65). Conclusions: A large majority of students opposed pouring rights contracts, and this opposition was similar regardless of student socioeconomic characteristics or student estimates of pouring rights contract revenues. Students markedly overestimated (by >100-1,000-fold) the percentage of university revenue that came from pouring rights contracts. University administration should consider student views on pouring rights contracts when deciding whether to exit or continue with pouring rights contracts.

9.
Network ; : 1-19, 2024 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-38293964

RESUMO

This research introduces an innovative solution addressing the challenge of user authentication in cloud-based systems, emphasizing heightened security and privacy. The proposed system integrates multimodal biometrics, deep learning (Instance-based learning-based DetectNet-(IL-DN), privacy-preserving techniques, and blockchain technology. Motivated by the escalating need for robust authentication methods in the face of evolving cyber threats, the research aims to overcome the struggle between accuracy and user privacy inherent in current authentication methods. The proposed system swiftly and accurately identifies users using multimodal biometric data through IL-DN. To address privacy concerns, advanced techniques are employed to encode biometric data, ensuring user privacy. Additionally, the system utilizes blockchain technology to establish a decentralized, tamper-proof, and transparent authentication system. This is reinforced by smart contracts and an enhanced Proof of Work (PoW) mechanism. The research rigorously evaluates performance metrics, encompassing authentication accuracy, privacy preservation, security, and resource utilization, offering a comprehensive solution for secure and privacy-enhanced user authentication in cloud-based environments. This work significantly contributes to filling the existing research gap in this critical domain.

10.
Heliyon ; 10(1): e23622, 2024 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-38223731

RESUMO

Disruptions in the supply chains/networks result in both performance failures and a poor return on investment (ROI) of network assets. We propose that addressing this situation requires the governance of exchange relationships through contracts guided by sustainability principles. Specifically, we refer to these contracts in the supply and distribution context as "sustainable network contracts", and the overall framework as the "sustainable contracting framework (SCF)/theory". Despite the critical role of sustainable network contracts for all key stakeholders in the network, we identify a gap in the existing literature regarding the theory of sustainable network contracts. We bridge this gap by extending the extant dimensions of contracts, as described in Transaction Cost Economics and Relational Exchange Theory, to include sustainability dimensions - constituting the 'what' of theory building. To inform sustainable contracts, we propose and employ three factors: costs, benefits, and risks (CBR). We present the 'how' of the theory building, outlined in a five-step approach along with an analytical tool, to demonstrate the practical application of our framework. Additionally, we provide a rationale for adopting sustainable network contracts (the 'why' of the theory building). Our research methodology involves collecting interview-based data from senior executives (CXOs) (secondary and primary), collecting primary and secondary cost data (objective), integrating behavioral elements (subjective), and employing constrained optimization techniques to determine quantity allocation under various contract policies. Further, we map the proposed eight distinct contract types onto the CBR-space, thereby highlight the relevance of the contract types to real-world practices. This mapping considers network externalities, risks, and allows for a coordinated sustainable approach to contracting from the buyer's (retailer's) perspective. For managers, our framework would serve as an important tool that would inform the contract evaluation process, facilitate local versus global decision-making, safeguard network investments, and help align the interests of buyers and suppliers in each contracting cycle.

11.
Br J Gen Pract ; 2024 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-38296357

RESUMO

BACKGROUND: There is little evidence and no agreement on what constitutes full-time working for general practitioners (GPs). This is essential for workforce planning, resource allocation and accurately describing GP activity. AIM: To clarify the definition of full-time working for general practitioners, how this has changed over time and whether these changes are explained by GP demographics. DESIGN AND SETTING: Repeated cross-sectional national surveys between 2010 and 2021. METHOD: Comparison of three measures of working time commitments (hours and sessions per week and hours per session) plus a measure of workload intensity across survey years. Multiple regression to adjust the changes over time for age, sex, ethnicity, contract type, area deprivation, and rurality. Unadjusted hours and sessions per week were compared to definitions of full-time working. RESULTS: Average hours and sessions per week reduced from 40.5 (95% CI: 38.5, 42.5) to 38.0 (36.3, 39.6) and 7.3 (7.2, 7.3) to 6.2 (6.2, 6.3) respectively between 2010 and 2021. In 2021, 54.6% of GPs worked at least 37.5 hours per week and 9.5% worked at least 9 sessions. Hours per session increased from 5.7 (5.7, 5.7) to 6.2 (6.2, 6.3) between 2010 and 2021. Partners worked more hours, sessions and hours per session. Adjustments increased the increase in hours per session from 0.54 to 0.61. CONCLUSION: At the current average duration of sessions, six sessions per week aligns with the NHS definition of full-time hours. However, hours per week is a more consistent way to define full-time work for GPs.

12.
Med Health Care Philos ; 27(1): 15-30, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37851211

RESUMO

In this paper, I assess the role responsibility argument that claims suicidal agents have obligations to specific people not to kill themselves due to their roles. Since the plausibility of the role responsibility argument is clearest in the parent-child relationship, I assess parental obligations. I defend a view that says that normative roles, such as those of a parent, are contractual and voluntary. I then suggest that the normative parameters for some roles preclude permissible suicide because the role-related contract includes a promise to provide continuing care and emotional support. I propose that as we have established criteria for morally acceptable reasons for cancelling, voiding, or amending a contract, we can apply these to the role responsibility argument to establish grounds for releasing a parent from his role-related and contractual obligations. Failure to fulfil one's contractual roles may not be blameworthy, depending upon the circumstances. I propose the factors determining culpability in failure to fulfil one's role-related obligations are: intention, voluntariness, diminished responsibility, mental capacity, and foreseeability.


Assuntos
Obrigações Morais , Suicídio , Humanos , Ideação Suicida , Pais , Dissidências e Disputas , Responsabilidade Social
13.
Expert Rev Pharmacoecon Outcomes Res ; 24(2): 293-301, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37883069

RESUMO

OBJECTIVE: To understand the use of alternative payment models to address the reimbursement challenges of cell and gene therapies (CGT) in the U.S.A.. METHODS: A literature search focused on CGT reimbursement in the U.S. market was conducted to identify information gaps and inform survey development. U.S. developers (n = 100) and payers (n = 195) were invited to complete an online survey between June and August 2022. RESULTS: The overall response rate was 16%; payer respondents represented 98 plans covering 338 million lives. Most developers (81%) and payers (84%) had implemented or were planning to implement at least one alternative payment model. Payers pursued these models to 'reduce product performance uncertainties' (81%), 'align therapy costs with benefits' (58%), and 'manage actuarial uncertainty' (54%). Developers aimed to 'streamline patient access' (92%) and 'mitigate budget impact' (77%). Common perceived barriers included increased administrative burden (developers 79% and payers 67%), defining performance measures (developers 71%, payers 83%) and addressing patient mobility (developers 71% and payers 63%). Both parties expressed a willingness to use real-world evidence for contract adjudication. CONCLUSION: Although limited by the number of participants, this survey indicates early discussions coupled with understanding motivations are essential for developing contracts that appeal to both parties and ensure patient access.

14.
J Prev (2022) ; 45(1): 107-121, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38017294

RESUMO

BACKGROUND: Health status, type of contract, education and age might affect labour force participation (LFP). We investigated possible factors associated with LFP among European countries. METHODS: European Union Statistics on Income and Living Conditions (EU-SILC) data of 149,798 individuals were used and the odds ratios were calculated in logistic regression analyses. RESULTS: LFP rates were higher among those in good health. Self-perceived poor health frequencies were higher in people with temporary contracts than in those with permanent contracts in Bulgaria, Finland, and Hungary, while they were lower in Republic of Serbia. Multivariate analyses revealed that having temporary contract, poor health, oldest age group, and lower educational level were associated with lower probability of being in paid employment in the total study population. Poor health was stronger driver of lower LFP than temporary contracts in Austria, Hungary, Iceland, Netherlands. Temporary contracts were stronger driver of lower LFP than poor health in Greece, Spain, Finland, Portugal, Serbia, Slovenia and total study population. CONCLUSION: Both poor health and temporary contracts were associated with lower LFP. The magnitude of these associations varied among countries. Worker's health status differed by type of contract in Bulgaria, Hungary, Finland and Serbia.


Assuntos
Emprego , Nível de Saúde , Humanos , Contratos , Escolaridade , Sérvia
15.
Interface (Botucatu, Online) ; 28: e230084, 2024.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1534631

RESUMO

Com o objetivo de compreender o desenvolvimento da integração ensino-serviço-comunidade (Iesc) no município de Bragança Paulista, São Paulo, por meio do Contrato Organizativo de Ação Pública Ensino-Saúde (Coapes), realizou-se um estudo de caso. Uma amostra intencional com dez integrantes do Comitê Gestor Local que participaram de entrevistas semiestruturadas, em ambiente virtual, gravadas e transcritas na íntegra. Os relatos passaram por análise de conteúdo na modalidade temática e os resultados indicaram que a condução da Iesc e do Coapes foi bem-sucedida. A sustentabilidade e os êxitos da contratualização estão relacionados a estratégias, como aproximação, diálogo institucional, igualdade de valor e transparência, provenientes de discussões técnicas, compreensão do processo, escolha do formato, sensibilização e engajamento dos atores. A combinação desses elementos, aliada a novos projetos e atitudes, aponta caminhos para a consolidação da Iesc no território, que apresenta desafios a serem superados.


Con el objetivo de comprender el desarrollo de la integración enseñanza-servicio-comunidad (IESC) en el municipio de Braganza Paulista (Estado de São Paulo), a partir del Contrato Organizativo de Acción Pública Enseñanza-Salud (Coapes), se realizó un estudio de caso. Una muestra intencional con diez integrantes del Comité Gestor Local participó en entrevistas semiestructuradas, realizadas en ambiente virtual, grabadas y transcritas integralmente. Los relatos pasaron por un análisis de contenido en la modalidad temática. Los resultados indicaron que la conducción de la IESC y del Coapes fue exitosa. La sostenibilidad y los éxitos de la contractualización están relacionados con estrategias tales como la aproximación, el diálogo institucional, la igualdad de valor y transparencia, provenientes de discusiones técnicas, comprensión del proceso, elección del formato, sensibilización y compromiso de los actores. La combinación de esos elementos, aliada a nuevos proyectos y actitudes, señala caminos para la consolidación de la IESC en el territorio que presenta desafíos que hay que superar.


To comprehend the evolution of education-service-community integration (ESCI) in the municipality of Bragança Paulista, SP, through the Teaching-Health Public Action Organizational Contract (Coapes), a case study was conducted. An intentional sample of ten members from the Local Management Committee participated in semi-structured interviews, conducted virtually, recorded, and transcribed in full. The narratives underwent thematic content analysis. The results indicated that the implementation of IESC and Coapes was successful. The sustainability and achievements in contractualization are related to strategies such as approaching, institutional dialogue, equal value, and transparency, resulting from technical discussions, understanding of the process, format selection, sensitization, and actor engagement. The combination of these elements, along with new projects and attitudes, points towards the consolidation of IESC in the territory, which presents challenges to be overcome.

16.
Psychol Sport Exerc ; 70: 102532, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37678644

RESUMO

BACKGROUND: Financial incentives are a promising tool to help people increase their physical activity, but they are expensive to provide. Deposit contracts are a type of financial incentive in which participants pledge their own money. However, low uptake is a crucial obstacle to the large-scale implementation of deposit contracts. Therefore, we investigated whether (1) matching the deposit 1:1 (doubling what is deposited) and (2) allowing for customizable deposit amounts increased the uptake and short term effectiveness of a deposit contract for physical activity. METHODS: In this randomized controlled trial, 137 healthy students (age M = 21.6 years) downloaded a smartphone app that provided them with a tailored step goal and then randomized them to one of four experimental conditions. The deposit contract required either a €10 fixed deposit or a customizable deposit with any amount between €1 and €20 upfront. Furthermore, the deposit was either not matched or 1:1 matched (doubled) with a reward provided by the experiment. During 20 intervention days, daily feedback on goal progress and incentive earnings was provided by the app. We investigated effects on the uptake (measured as agreeing to participate and paying the deposit) and effectiveness of behavioral adoption (measured as participant days goal achieved). FINDINGS: Overall, the uptake of deposit contracts was 83.2%, and participants (n = 113) achieved 14.9 out of 20 daily step goals. A binary logistic regression showed that uptake odds were 4.08 times higher when a deposit was matched (p = .010) compared to when it was not matched. Furthermore, uptake odds were 3.53 times higher when a deposit was customizable (p = .022) compared to when it was fixed. Two-way ANCOVA showed that matching (p = .752) and customization (p = .143) did not impact intervention effectiveness. However, we did find a marginally significant interaction effect of deposit matching X deposit customization (p = .063, ηp2 = 0.032). Customization decreased effectiveness when deposits were not matched (p = .033, ηp2 = 0.089), but had no effect when deposits were matched (p = .776, ηp2 = 0.001). CONCLUSIONS: We provide the first experimental evidence that both matching and customization increase the uptake of a deposit contract for physical activity. We recommend considering both matching and customization to overcome lack of uptake, with a preference for customization since matching a deposit imposes significant additional costs. However, since we found indications that customizable deposits might reduce effectiveness (when the deposits are not matched), we urge for more research on the effectiveness of customizable deposit contracts. Finally, future research should investigate which participant characteristics are predictive of deposit contract uptake and effectiveness. PRE-REGISTRATION: OSF Registries, https://osf.io/cgq48.


Assuntos
Daucus carota , Motivação , Humanos , Adulto Jovem , Exercício Físico , Renda , Recompensa
17.
Int J Health Plann Manage ; 39(2): 583-592, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38123527

RESUMO

Value-based payment (VBP) models are designed and implemented to improve outcomes at the same or lower costs. Their adoption requires significant changes in the way healthcare organisations and insurance companies operate. Usually, before VBP models are widely implemented, pilot projects are conducted. Payers need to have a comprehensive set of requirements to enter into agreements with healthcare organisations on these pilots. In this short communication, we outline key elements reported in the literature, inside and outside healthcare organisations, as well as within the contract, that need to be considered in a pilot VBP model. Discussions regarding the introduction of VBP models may be strongly affected by external contextual factors, including regulations, which are outside the control of healthcare organisations. It requires collaboration between organisations, including primary care organisations and hospitals, while within organisations, it frequently requires creating multidisciplinary teams. The focus is on ensuring transparency, collaboration, and shared decision-making, realised by standardising communication processes and regular meetings. Additionally, effective leadership is needed, in which leaders set goals and priorities, as well as manage change. In the contractual agreements between payers and healthcare organisations, outcome measures need to be adequately defined and measured, including individual patient outcomes and composite scores, as well as absolute and relative performance measures. These measures should be tested periodically and catered to the organisations adopting the model. Also, incentives should have adequate size and frequency and be intrinsic and extrinsic. The consideration of these sets of key elements by the payers is essential when implementing VBP model pilot projects.


Assuntos
Instalações de Saúde , Hospitais , Humanos , Liderança
18.
Adv Life Course Res ; 57: 100562, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-38054861

RESUMO

Previous research suggests that lack of employment security can lead young adults to experience a higher degree of insecurity with regard to their future life. We test the relationship between life-course insecurity, i.e. worrisome feelings with regard to one's own future, and young adults' employment status using a newly developed measurement instrument. Furthermore, we examine whether, in terms of life-course insecurity, specific groups of young people are more affected by insecure employment conditions based on their structural position. Survey data (n = 1087) were collected within a Dutch representative panel among those aged 18-35. Structural equation modelling is used to construct latent dependent variables for experienced insecurity in four life domains, namely 'work', 'finances', 'partner and family' and 'leisure and personal development'. Results show that, while controlling for gender, life phase, education level and level of neuroticism, lack of employment is associated with higher insecurity in all four domains of life. Precarious employment based on a flexible contract is associated with higher insecurity regarding 'work', 'finances' and 'partner and family'. Moreover, we find the relationship between lack of employment and life-course insecurity to be stronger for young people in the 26-35 age bracket. However, higher educational attainment does not attenuate the positive relationship between precarious employment and life-course insecurity. The findings of this study inform our theoretical understanding of agency within the life course of young adults by signaling insecure labour market attachment as a potential constraint to formulating plans for the future.


Assuntos
Emprego , Acontecimentos que Mudam a Vida , Humanos , Adulto Jovem , Adolescente , Escolaridade , Emoções , Etnicidade
19.
Sustain Energy Res ; 10(1): 17, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38037615

RESUMO

Wood pellets have gained global attention due to their economic availability and increasing demand for bioenergy as part of sustainable energy solutions. Management of the wood pellet supply chains, from feedstock harvesting to bioenergy conversion, is critical to ensure competitiveness in the energy markets. In this regard, wood pellets supply chain coordination can play a strategic role in enhancing the efficiency and reliability of bioenergy generation. This study proposes a contract-based coordination mechanism for wood pellet supply chains and compares its performance in alternative centralized and decentralized decision-making structures. A bi-level nonlinear game-theoretic approach with two economic and environmental objective functions is developed. It utilizes the concept of life cycle assessment in a Stackelberg leader-follower game to obtain the bioenergy equilibrium solutions. Further, this study examines the case of wood pellet supply chains in three remote Canadian communities. The aim is to showcase the practicality and significance of the proposed approach and interpret the findings. By focusing on these communities, the crucial role of supply chain coordination in fostering sustainable development, particularly, in the context of bioenergy generation is emphasized. The study colludes by advocating a number of avenues for future research.

20.
Front Public Health ; 11: 1208994, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37927883

RESUMO

To implement state policies of zero-markup drug policy and medical service fee adjustment for public hospitals, this study constructed game models of the pharmaceutical supply chain, consisting of a drug supplier and a public hospital. The study obtained the optimal medical service level and pricing under the new state drug policies. In addition, it analyzed the impacts of the degree of public benefit of hospitals on the medical service level, the medical service price, and the drug price. Finally, from the perspective of cooperation between drug suppliers and public hospitals, the specialized coordination contract was designed to maximize overall social welfare. This study found an anomalous but meaningful conclusion: in the background of the zero-markup drug policy, a higher public benefit of hospitals could increase the drug prices, but it could reduce the medical service prices further to cut down on the overall treatment fees for the patients. The novel coordination contract can optimize the pharmaceutical supply chain and achieve a win-win situation for the drug suppliers, public hospitals, and patients. When the public benefit of hospitals is higher, the profit of a decentralized decision-making supply chain is greater than a centralized one, while the pharmaceutical supply chain will not coordinate itself.


Assuntos
Hospitais Públicos , Política Pública , Humanos , Custos e Análise de Custo , Preparações Farmacêuticas
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