Effect of Tort Reform on Diagnostic Imaging Rates

Introduction: Defensive medicine, is defined as “order[ing] tests, procedures, or visits, or avoid certain high-risk patients or procedures, primarily (but not solely) because of concern about malpractice liability.” Nearly all physician who fear malpractice litigation have admitted to practicing some degree of defensive medicine. In response, many states have enacted policy reforms to lighten the threat of malpractice on physicians. Objective: The most common defensive medicine behavior is ordering diagnostic imaging tests when it is potentially unwarranted. Many states have enacted non-economic damage caps from 2000-2010. We explored if these laws had an impact on the rates of diagnostic imaging in states that enacted the laws compared to those that did not. Methods: We used a retrospective time series analysis on our data from 2002-2016 to compare experimental states with controls, with threshold matching at p \u3c 0.20 based on age distribution, sex, and race. We then calculated if the diagnostic imaging was inappropriate, as derived from the HEDIS measure for inappropriate low back pain imaging. This yielded North Carolina and Tennessee (354,917 episodes) as the only experimental states and Arkansas as the control (58,100 episodes). Results: The experimental groups saw a 0.7% drop in inappropriate diagnostic imaging compared to 0.33% to the control (p \u3c 0.0001). Conclusion: The experimental groups saw a significant reduction in potentially defensive diagnostic imaging compared to the matched control. We hope to adjust our rates period to include more states in the next set of calculations in order to make the results more applicable

Developing a Grounded Theory Model on Collaboration in Learning

The purpose of this research is to develop a grounded theory model to explain the factors influencing collaborative learning in higher education, the role of technology in facilitating collaboration, and the outcome of collaboration. We assigned 28 participants to small groups to work on course-related questions; half of the groups were face-to-face groups and the other half groups were collaborating in a simulated virtual environment with the aid of information technology. Interview data was collected and analyzed following the grounded theory approach. Congruent with distributed cognition theories, the results of our study suggest that both social and technological factors were important and interlocking. We also discussed the importance of designing learning technologies that have strong social and communications features

Spatial Distribution Characteristics and Evolution Pattern of Air Quality in Henan Province

Urban air pollution is an urgent problem to be solved in the process of rapid urbanization and economic development in China. Based on the daily average data of urban air quality index of Henan province from 2015.1 to 2018.12, this paper utilizes cluster analysis, trend surface analysis and centralizing evolution analysis methods to study the spatial distribution characteristics and evolution pattern of urban air quality in the province. The results show that the air quality in the province presents five air quality systems, which seriously relate to the terrain, the air quality index of the northern cities has always been higher than that of the southern cities, with the latitude increases, the air quality index gradually increases, and the increase rate in the middle region is significantly higher than that in both sides. The province weathers, in the study period, shows 4 grades as good & moderate, lightly polluted, moderately polluted and heavily polluted. Lightly polluted weathers first appear in central and southern cities, moderately polluted and heavily polluted weather first appear in the northern cities, and then spread to the rest cities of the province

Correlation Analysis of Main Pollutant Concentration-A Case Study of Zhengzhou

Air pollution is one of the main problems to be solved in the sustainable development of China's economy, its main pollution components include PM2.5, PM10, SO2, NO2, CO and O3, the pollution component governance is an effective means of atmospheric environmental management. Based on the monitor data of six main pollutant concentrations in Zhengzhou from 2015 to 2018, this paper analyzes the correlation characteristics between their concentrations by using correlation analysis, the multiple correlation characteristics of the one pollutant concentration with the other five pollutant concentrations by using multiple correlation analysis, the independent linear interpretation ratio between the six pollutant concentrations by using partial correlation analysis, at last, a pollutant independent emission index is defined to describe the independent emission level of one pollutant, then utilize the index to study the distribution characteristics of six main pollution concentrations in the study period in Zhengzhou. The results show that there is a significant correlation between the six pollutant concentrations. PM2.5, O3 and PM10 are the primary pollutants in Zhengzhou, the PM2.5 concentration is controlled by PM10 concentration and CO concentration, similarly, the PM10 concentration is controlled by PM2.5 concentration. In the polluted weather, O3 has the highest level of independent emissions. The main task of Zhengzhou in pollutant composition governance is to control the emission of PM2.5 and O3