Mediating role of rumination in the relationship between expectation gap of social support and postpartum depression in primiparae / 中国实用护理杂志

Objective:To investigate the mediating effect of rumination in primiparae on the expectation gap of social support and postpartum depression, so as to provide a reference basis for early detection and intervention in the regulation of meternal postpartum depression.Methods:In this cross-sectional study, questionnaires were administered from November 2021 to March 2022 using the general information questionnaire, the Ruminant Thinking Response Scale, the Postpartum Social Support Scale, and the Edinburgh Postpartum Depression Scale to 266 primiparae at three tertiary level A hospitals, the First Affiliated Hospital of Xi′an Jiaotong University, the Second Affiliated Hospital of Xi′an Jiaotong University, and the Northwest Women′s and Children′s Hospital, for postpartum review, and the relationship between ruminant thinking, social support expectation gap, and postpartum depression was analyzed using correlation analysis, structural equation modeling, and application of Bootsrap method.Results:The social support expectation gap, ruminative thinking, and postpartum depression average scores were (16.74 ± 12.77), (39.43 ± 4.14), (6.77 ± 2.77) points, respectively.There were positive correlations between social support expectation gap and ruminative thinking, postpartum depression, and ruminative thinking and postpartum depression ( r=0.62, 0.75, 0.70, all P<0.01). Primiparae ruminative thinking partially mediated the relationship between social support expectation gap and postpartum depression, with the mediating effect accounting for 22% of the total effect. Conclusions:Social support expectation gap can directly affect the occurrence of postpartum depression, but also indirectly through ruminative thinking, and postpartum depression can be prevented and intervened from the perspective of reducing ruminative thinking in clinical practice.

A summary on surveillance system of occupational disease under the framework of National Health Insurance Informatization Project / 中华劳动卫生职业病杂志

The surveillance of occupational disease has entered a new stage ofdevelopment, with the implementation of the national health informatization project. To improve the efficiency and quality of occupational disease monitoring information reporting in this paper, the system architecture and related management regulations, as long as the major changes and achievement of "surveillance system of occupational disease and health hazards information" under the framework of National Health Insurance Informatization Project were elaborated. The deficiencies existing in the system were analyzed, and expectation for the construction of the occupational disease surveillance system was addressed.

Head and Neck Cancer Survivors’ Perceptions of Cancer Treatment and Posttraumatic Growth

@#Introduction: Cancer patients’ perception on the treatment they received is vital to determine their adherence to cancer treatment, but important data on how this variable affects posttraumatic growth (PTG) experience by cancer patients is lacking. This cross-sectional study aimed to evaluate the degree of PTG among a cohort of head and neck cancer (HNC) survivors who were within first year of diagnosis and determined the association between perception of cancer treatment received (expectation and satisfaction with cancer treatment received and the feeling about the adverse effects) and PTG controlling for socio-demographic and clinical characteristics. Methods: HNC survivors were recruited from two oncology referral centres, and they were administered socio-demographic and clinical characteristics questionnaire, the Malay version of the Cancer Therapy Satisfaction Questionnaire (CTSQ) (to assess the satisfaction, expectation and feeling about the adverse effects of cancer treatment received) and the Malay version of the Posttraumatic Growth Inventory-Short Form (PTGi-SF) (to measure the degree of PTG). Results: A total of 200 HNC survivors participated in the study. The mean total PTGI-SF score was 39.5 (standard deviation [SD] = 9.3). Greater degree of positive expectation of cancer treatment and satisfaction with cancer treatment received significantly contributed to higher level of PTG, whereas feeling about side effects of treatment was not associated with PTG, after controlling for socio-demographic and clinical characteristics. Conclusion: Incorporating psychosocial interventions (such as education on cancer treatment and counselling) into the treatment regimen may facilitate development of PTG and hence, safeguard the mental well-being of HNC patients.

Relacionamentos amorosos na contemporaneidade: um estudo exploratório sobre expectativas e experiências das mulheres / Loving relationships: an exploratory research on the expectations and life experiences of women / Relaciones amorosas contemporáneas: un estudio exploratorio sobre las expectativas y experiencias de las mujeres

O presente artigo apresenta os resultados parciais de pesquisa realizada com 2778 mulheres, intitulada "Relacionamentos amorosos na contempo-raneidade: quais as expectativas das mulheres?" (Millan et al., 2019), que visou à compreensão das relações afetivo-sexuais na contemporaneidade a partir da visão das mulheres e o conhecimento da dinâmica das relações com seus pares, com vistas ao manejo de conflitos nos relacionamentos afetivos e familiares, em intervenções clínicas e sociais. Teve-se como objetivo destacar aspectos relativos às diferenças entre expectativas e experiências vividas nos relacionamentos, no que diz respeito aos papéis de gênero (desempenho das tarefas domésticas e cuidados com filhos), à vida profissional, à independência financeira, aos sonhos e projetos de vida. A metodologia utilizada foi de carac-terística quantitativa e qualitativa, com as respostas ao questionário tratadas como variáveis qualitativas ordinais e analisadas pelos testes estatísticos não paramétricos de Kruskal-Wallis ou de Mann-Whitney (1952), de acordo com o agrupamento das participantes, quanto à faixa etária, escolaridade e estado civil. As variáveis categóricas foram analisadas pelo Teste de Qui-quadrado ou pelo Teste Exato de Fisher, conforme a indicação. Na análise qualitativa, adotaram-se os referenciais psicanalítico e sistêmico. Os resultados obtidos mostram que as expectativas das mulheres nos relacionamentos amorosos são moduladas pela experiência vivida e passíveis de ajustes e reajustes durante o ciclo vital pessoal e familiar. As variáveis independentes (escolaridade, estado civil, faixa etária) influenciaram significativamente e de maneiras distintas as respostas analisadas neste artigo. Conclui-se que os relacionamentos amorosos expressam elementos próprios da contemporaneidade, na qual convivem tendências variadas de valores, condutas e pontos de vista dissonantes, em constante transformação.

This article reports partial results of the research "Loving relationships in contemporary times: what are women's expectations?" (Millan et al., 2019) carried out with 2,778 women, that aimed to comprehend affective-sexual rela-tionships in the contemporary era, from women's point of view and knowledge of the dynamics in their relationships with their peers, in order to develop clinical tools to manage conflicts in affective and familiar relationships, via clinical and social interventions. Its objective is to highlight aspects concerning differences between expectations and experiences in relationships, regarding gender roles (in the performance of household tasks and childcare), profes-sional life, financial independence, life dreams and projects. Quantitative and qualitative data were obtained, while answers to the questionnaire were labeled as qualitative ordinal variables and analyzed through Kruskal-Wallis or Mann-Whitney (1952) nonparametric statistical tests, according to the grouping of participants, by age, education and marital status. Categorical variables were analyzed through a Chi-squared Test or Fisher's exact test, as appropriate. In the qualitative analysis, psychoanalytic and systemic refe-rences were adopted. The obtained results show that women's expectations towards loving relationships are influenced by life experiences and prone to change throughout personal and familiar life cycles. The independent varia-bles (education, age, marital status) have significantly influenced the results in different ways. It is concluded that loving relationships express elements characteristic of contemporaneity, which presents several tendencies, diverse in values, conducts and dissonant points of view, in constant transformation.

Este artículo presenta los resultados parciales de una investigación realizada con una muestra de 2.778 mujeres, denominada "Relaciones amorosas en la actualidad: ¿cuáles son las expectativas de las mujeres?" (Millan et al., 2019), que tuvo como objetivo comprender las relaciones afectivo-sexuales en la contemporaneidad desde la perspectiva de las mujeres y el conocimiento de la dinámica de las relaciones con sus pares, con miras a gestionar los conflictos en las relaciones afectivas y familiares en intervenciones clínicas y sociales. El objetivo fue resaltar aspectos relacionados con las diferencias entre expec-tativas y experiencias vividas en las relaciones, en cuanto a roles de género (desempeño de las tareas del hogar y cuidado de los niños), vida profesional, independencia económica, sueños y proyectos de vida. La metodología utilizada fue cuantitativa y cualitativa, con las respuestas a las entrevistas tratadas como variables cualitativas ordinales y analizadas mediante las pruebas estadísticas no paramétricas de Kruskal-Wallis o Mann-Whitney (1952), agrupando las participantes en función del grupo etario, nivel de educación y estado civil. Las variables categóricas se analizaron mediante la prueba de Chi-cuadrado o la prueba exacta de Fisher, según se indica en cada caso. En el análisis cualitativo se adoptaron referencias psicoanalíticas y sistémicas. Los resultados obtenidos muestran que las expectativas de las mujeres en las relaciones amorosas están moduladas por la experiencia vivida y están sujetas a ajustes y reajustes durante el ciclo de vida personal y familiar. Las variables independientes (nivel de educación, estado civil, grupo etario) influyeron significativamente de diferentes formas en las respuestas analizadas en este artículo. Se concluye que las relaciones amorosas expresan elementos de contemporaneidad en los que conviven diferentes tendencias de valores, comportamientos y puntos de vista disonantes en constante transformación.

Exploration and development of fragility fracture nursing practice / 中国实用护理杂志

With the intensification of population aging, the world is facing the challenges of medical care brought by fragility fractures. From the current situation of fragility fractures, this paper summarizes the current nursing practice hotspots of fragility fractures, expounds the prevention strategies for secondary fractures, and propose promoting the effective management of fragility fractures through a multidisciplinary cooperative nursing model, and provide reference for improving the nursing quality of patients with fragility fractures

Modelos de medición de la calidad de atención en salud / Health care quality measurement models

Una aproximación para medir el nivel de atención expresada en la calidad de servicio que se presta al paciente en los establecimientos de salud está referida al uso de modelos de medición, que en este artículo se describen desde la propuesta por Donabedian basado en la teoría general de sistemas evaluando estructura, proceso y resultado, pasando a segundo plano la percepción del paciente. Este modelo contrasta con el modelo Nórdico que enfatiza la imagen corporativa, con un balance entre el servicio esperado y la percepción del servicio, basado en el paradigma de la desconfirmación al igual que el modelo presentado por Nguyen. En esta última línea paradigmática se encuentra el modelo más notorio, SERVQUAL que contrasta las expectativas y la precepción del usuario de un servicio identificando brechas en base a las 5 dimensiones propuestas fiabilidad, seguridad, elementos tangibles, capacidad de respuesta, y la empatía, posteriormente basado en este modelo se propone el modelo SERVPERF, basada exclusivamente en la valoración de las percepciones. Posteriormente, se describen el modelo de Desempeño Evaluado que surge como un modelo alternativo al SERVQUAL sustituyendo las expectativas por el concepto de punto ideal; el Modelo Jerárquico Multidimensional que desarrolla una solución tridimensional para completar la modelización de la calidad de servicio. De igual manera el modelo multietapa de valoraciones de la calidad que identifica la disconformidad que existe las expectativas del cliente en relación al servicio y las percepciones de las características por niveles de componente

One approach to measuring the level of care expressed in the quality of service provided to the patient in health facilities is referred to as the use of measurement models described in this paperstarting with the one proposed by Donabedian based on the general theory of systems evaluating structure, process and outcome, with the patient's perception taking second place. In contrast, the Nordic model emphasizes the corporate image, with a balance between the expected service and the perception of the service, based on the paradigm of disconfirmation as well as the model presented by Nguyen. In this paradigmatic line the most notorious model, SERVQUAL, contrasts the expectations and the user's perception of a service identifying gaps based on the 5 proposed dimensions reliability, security, tangible elements, responsiveness, and empathy, later based on this model the SERVPERF model is proposed, based exclusively on the valuation of perceptions. In addition, the Evaluated Performance model, which emerges as an alternative model to SERVQUAL, replaces expectations with the concept of ideal point. And the Multidimensional Hierarchical Model develops a three-dimensional solution to complete the modeling of service quality, as well as the multi-stage model of quality assessments that identifies the non-conformity that exists between customer expectations in relation to the service and the perceptions of the characteristics by component levels

Expectations and their influencing factors of gynecological examination among female physical examination population / 中华健康管理学杂志

Objective:To analyze the expectations and their influencing factors of gynecological examination among female physical examination population.Methods:Convenience sampling method was used to select women undergoing gynecological examinations in the health management center of the Shandong Provincial Hospital Affiliated to Shandong First Medical University between April to June 2021. A face to face interview was conducted with a 20-item structured questionnaire including general information, the women?s feelings about a gynecological examination, expectations of doctors, preferences for the doctor ?s gender, and the presence of chaperones in male doctor examination scenarios. Of the 1 600 questionnaires distributed, 1 583 were valid, with a recovery rate of 98.93%. To compare the preferences for a doctor ?s gender and chaperones with different demographic characteristics, an χ2 test was used. Logistic regression was used to analyze the influencing factors of preferences for doctors ?gender and for chaperones. Results:For a gynecological examination, women were mainly worried about the possibility of bad results (77.4%), while the main expectation to doctors was communication before the examination (49.2%); most women wanted to be examined by a female doctor (85.5%), mainly because they felt relaxed (76.0%); most women did not want chaperones when examined by a female doctor (56.5%), while most of them preferred to be accompanied by a nurse when examined by a male doctor (50.1%). Women whose family income was lower than expenditure and had gynecological examination experiences with male doctors tended to have no preference for a doctor ?s gender. Additionally, there was a strong inverse association between the education level and likelihood of no preference for a doctor ?s gender, that is, the lower the education level, the more likely they were to have no preference for the doctor ?s gender ( P<0.05), when examined by a male doctor. Furthermore, women older than 55 years and who had a gynecological examination more than twice a year, was less likely to need chaperones, while women who had gynecological examination experience with male doctors tended to have no preference for chaperones. Conclusions:Women preferred gynecological examinations to be performed by female doctors who provide gentle and companion staff support during the examinations. Education level, family income, and examination experience of male doctors are the influencing factors for gender preferences of a doctor. Age, examination frequency, and examination experience of male doctors are the influencing factors affecting the preferences of choosing an accompanying person.

Expectativas de la gestante sobre el acompañamiento de la pareja durante el trabajo de parto

RESUMEN Introducción: El acompañamiento en el parto representa una estrategia con diversos beneficios, por lo cual es necesario comprender las necesidades físicas y emocionales presentes en la mujer para prestar un servicio humanizado y de calidad, que satisfaga sus expectativas. Objetivo: Describir las expectativas de la gestante sobre el acompañamiento de la pareja durante el trabajo de parto en un hospital del tercer nivel de atención. Métodos: Estudio descriptivo y transversal, realizado en 120 gestantes atendidas en el Hospital Nacional "Sergio E. Bernales", que fueron seleccionadas de manera no probabilística. Se aplicó un cuestionario validado sobre la expectativa del acompañamiento de la pareja. Se estimaron frecuencias absolutas y relativas. Resultados: El 98,3 % prefería estar acompañada por su pareja en el parto. En los preparativos para el parto, 75 % prefería que su pareja se informe sobre su rol y 76,7 % que le brinde seguridad y confianza. Para el periodo de dilatación, 88,3 % esperaba que su pareja la comprenda y 6,7 % señaló que no quisiera recibir masajes por parte de su pareja. Para el periodo expulsivo, 96,7 % señaló que esperaba que su pareja esté atento al nacimiento del bebé; y para el alumbramiento, 95 % esperaba que su pareja muestre afecto a su hijo. Conclusiones: Las gestantes presentan altas expectativas sobre el acompañamiento previo y durante el proceso de trabajo de parto, especialmente en el aspecto emocional con ella y el recién nacido.

ABSTRACT Introduction: Accompaniment in childbirth represents a strategy with various benefits, which is why it is necessary to satisfy the physical and emotional needs present in women to provide a humanized and quality service that satisfies their expectations. Objective: To describe the expectations of the pregnant woman about the accompaniment of the couple during labor in a hospital of the tertiary care level. Methods: Descriptive and cross-sectional study, carried out in 120 pregnant women treated at the Sergio E. Bernales National Hospital, who were selected in a non-probabilistic way. A validated questionnaire was applied on the expectation of the accompaniment of the couple. Absolute and relative frequencies were estimated. Results: The 98,3 % preferred to be accompanied by their partner during childbirth. In preparing for childbirth, 75 % preferred that their partner be informed about her role and 76.7 % that they provide security and confidence. For the period of dilation, 88,3 % expected their partner to understand and 6,7 % indicated that they did not want to receive messages from their partner. For the second stage, 96,7 % indicated that they expected their partner to be attentive to the birth of the baby; and for delivery, 95 % expected their partner to show affection to their child. Conclusions: Pregnant women have high expectations about the accompaniment before and during the labor process, especially in the emotional aspect with her and the newborn.

Research on the mediation effect of expectation gap of postpartum support between perceived stress and postpartum depression / 中国实用护理杂志

Objective:To investigate the relationships of expectation gap of postpartum support with perceived stress and postpartum depression, and the mediating role of the former in the association between the latter two.Methods:A total of 278 convenient sample of puerperas at 6-8 weeks after delivery from June to August in 2019 in Shenzhen Hospital of Southern Medical University were investigated with the Perceived Stress Scale, the Chinese version of the Postpartum Social Support Questionnaire, and the Edinburgh Postnatal Depression Scale. Structure equation model was established and Bootstrap method was used to explore the direct and indirect effects of these variables.Results:The perceived stress score, and expectation gap of postpartum support score were (26.50±2.50), (25.30±5.79), respectively; and the postpartum depression score was (14.60±2.10). The incidence of postpartum depression(defined as postpartum depression score ≥10) was 37.4%(104/278). Path analysis showed that the model was well fitted (χ 2/ df was 0.265, Tucker-Lewis index was 1.0, comparative fit index was 1.0,root mean square of approximate error was 0, root mean square of standard deviation and residual error was 0.04). Perceived stress positively correlated with expectation gap of postpartum support, and postpartum depression ( P<0.05). Expectation gap of postpartum support positively correlated with postpartum depression ( P<0.05). The effect of perceived stress on postpartum depression was partially mediated by expectation gap of postpartum support (Estimate was 0.285, 95% CI 0.197-0.352). Conclusions:Perceived stress had direct or indirect effect via expectation gap of postpartum support on postpartum depression. This indicated that the medical staff can build a comprehensive support system, reduce the experience of perceived stress among puerperas, improve social support satisfaction, and thus reduce the incidence of postpartum depression.

Influence of 3D mean-median filter parameters on 3D ordered subsets expectation maximization reconstructed images / 中国医学影像技术

Objective: To quantitatively analyze the influence of 3D mean-median filter parameter on ordered subsets expectation maximization (OSEM) reconstruction images through applying 3D mean-median filter to process the projection data before reconstruction and adjusting the parameter. Methods: 3D mean-median filter was applied to process 3D phantom projection data simulated by the Analytical Simulator (ASIM). OSEM algorithm of open source tomographic image reconstruction (STIR) was used to reconstruct the projection data before and after filtering. Finally, the reconstructed image was visually and quantitatively evaluated. Results: The filter parameter K was closely related to image quality. If the Kvalue was too large, the edge preservation capability of image was poor, and the image was too smooth. If the Kvalue was too small to suppress noise, the details of image were blurred. Conclusion: The noise level and edge preservation effect of the image are very sensitive to the selection of filtering parameter K. The range of filtering parameter can be selected according to the distribution of gradient histogram. The appropriate parameter can be chosen by combining with the gradient distribution ratio, so as to remove noise and retain edge characteristic.

Patients’ Expectations and Perceptions of Services Provided by Primary Health Clinics in Kota Bharu, Kelantan, Malaysia

@#Introduction: Primary health care plays an important role in healthcare systems. In Malaysia, One (1) Malaysia Clinic (now known as Community Clinic since 2018) was established in 2010 aims to increase healthcare services accessibility within the poor urban population. The aim was to look at the effectiveness of One (1) Malaysia Clinic as a new form of public primary health clinic by looking at expectations and perceptions of the quality of the provided services by the patients. Method: It applied a cross sectional study involving nine clinics in of the busiest district in Kelantan namely, Kota Bharu district. 386 respondents which were Malaysian citizen, 18 years old and above were involved in this study. The survey used Malay validated SERVQUAL questionnaire. The Service Quality (SQ) gap was calculated. Result: The empathy dimension obtained the highest expectation and perception score, while the tangible dimension has the lowest expectation and perception score. In all SERVQUAL dimension, the expectations and perceptions of the service provided was significantly different with P < 0.001. The most critical dimension identified was tangible dimension as it has the largest negative SQ gap score. Conclusion: Negative gaps for all SERVQUAL dimensions and individual items indicated that provided services at One (1) Malaysia Clinic still could not fulfilled the patient’s expectation. A continuous improvement program is needed especially on tangible dimension in delivering a quality healthcare services.

Elaboración artesanal de un muffin de zapallo-brócoli y su evaluación de la expectativa y aceptabilidad en el hogar / Homemade cooking of a pumpkin-broccoli muffin and analysis of sensory expectation and acceptability in home use test

Introducción: considerando la importancia de la alimentación saludable, la tendencia de la población de ingerir alimentos prácticos y la oportunidad de incorporar hortalizas a productos alimenticios, surge la propuesta de desarrollar un muffin diferente. Objetivos: desarrollar un muffin de zapallo-brócoli artesanal. Evaluar expectativa y aceptabilidad sensorial en el hogar. Determinar el orden de preferencia del color del plato para servirlo. Materiales y método: se desarrolló el producto alimenticio.124 participantes evaluaron expectativa sensorial (apariencia, suavidad bucal y sabor), percepción de producto saludable e intención de consumo en escala de 1(me disgusta mucho) a 10(me gusta mucho) y orden de preferencia para servir el Muffin, según el color de plato (blanco, verde, azul y rojo). En aceptabilidad en el hogar, 41 personas de las 124 que evaluaron expectativa, realizaron el Muffin según la receta entregada. Evaluaron apariencia, suavidad bucal, sabor, intención de consumo y percepción de producto saludable en escala de 1(me disgusta mucho) a 10(me gusta mucho), disposición a consumir nuevamente este producto y en qué momento del día. Resultados: el producto desarrollado vehiculiza 26,5% de la recomendación de hortalizas por porción. En la expectativa sensorial se obtuvieron muy buenos puntajes promedios, superiores a 7,27. El orden de preferencia del color de los platos para el servicio fue: blanco-verde-rojo-azul; sin diferencias entre rojo-azul. Para la aceptabilidad en el hogar, los atributos evaluados tuvieron valores promedio superiores a 8,5 puntos. El 92,7% de los encuestados consumiría nuevamente el producto, el almuerzo fue el momento del día más elegido. Al comparar las respuestas de expectativa y aceptabilidad (n=41) se encontraron diferencias significativas para suavidad bucal y sabor (valores mayores en aceptabilidad en el hogar). Conclusiones: el muffin de zapallo-brócoli obtuvo muy buenos valores de expectativa y aceptabilidad en el hogar, y contribuiría a alcanzar la recomendación diaria de hortalizas(AU).

Introduction: taking into consideration the importance of healthy eating, the general trend towards easy-to-eat food, and the opportunity to include vegetables in food products triggered off the idea of developing a different, original muffin recipe. Objectives: develop a recipe for a homemade pumpkin & broccoli muffin. Analyze sensory expectation and acceptability in home use test. Determine the order of preference for the color of the plate on which the muffin is served. Materials and Methods: the recipe was formulated, and the food product was prepared. 124 participants provided their input on sensory expectation (appearance, smoothness and flavor), product healthiness perception and intention to eat the muffin, using a 10-point scale (1=dislike extremely and 10=like extremely). They also ranked the colors (white, green, blue and red) of the plate on which the muffin was served in order of preference. 41 of the 124 people that participated in the sensory expectation evaluation homebaked the muffin following the recipe provided and measured acceptability. They assessed appearance, smoothness, flavor, product healthiness perception and intention to eat the muffin using a10-point scale (1=dislike extremely and 10=like extremely). Furthermore, the participants specified their degree of willingness to consume the food product again and what meal they would eat the muffin in. Results: this food product offers 26.5% of the recommended vegetables serving size. Scale scores for sensory expectation were very good, averaging over 7.27. The order of preference for the color of the plate on which the muffin is served was: white-green-red-blue; with no statistical differences between red and blue. The mean scores for the food attributes (acceptability in home used test) were over 8.5. Also, 92.7% of the participants said they would consume the food product again, lunch being the preferred meal for doing so. When comparing answers for sensory expectation and acceptability (n=41), significant differences were found for smoothness and flavor (scores were higher in acceptability for home use test). Conclusions: the pumpkin & broccoli muffin rated very well in sensory expectation and acceptability in home use test and would contribute to reaching the recommended daily intake of vegetables(AU).

Percepções sobre as Paralimpíadas Escolares: Um estudo com atletas / Perceptions on School Paralypics: a study with athletes / Percepciones acerca de las Paralimpiadas Escolares: un estudiocon atletas

O paradesporto no Brasil vem se fomentando devido a um conjunto de motivos, como o fato de termos sediado as Paralimpíadas Mundiais 2016, maior interesse do público/mídia, aumento no número de adeptos das modalidades e construção do centro de treinamento. Além disso, o legado deixado pelo eventose constituiutambém no aumento das expectativas de todosos envolvidos nessemovimento. Sendo assim, buscou-se analisar as expectativas de paratletas em nível escolar. Entrevistou-se 114 atletas brasileiros de ambos os sexos, com idade média de±15,45 anos, participantes das Paralimpíadas Escolares. Identificou-se a relevância da participação nessacompetição na modificação da percepção dos jovensem relação aos seusprojetos futuros e a oportunidade de serem valorizados e vistos com orgulho pelo meio social.

The paradesport in Brazil is being promoted due to a number of reasons, such as the fact that we have hosted the World Paralympics, greater public/media interest, increase in the number of fans of the modalities and construction of the training center. In addition, the legacy left is also an increase in the expectations of all those involved in this movement. Thus, we sought to analyze the expectations of paratletas at school level. We interviewed 114 Brazilian athletes, of both sexes, of age ±15.45 years, participating in School Paralympic Games. It was identified the relevance of participation in this competition in the modification of the perception in relation to future projects and as an opportunity to be seen as an object of valorization and pride in the social environment.

El paradesporto en Brasil se viene fomentando debido diversos motivos, como el hecho de tener ubicadas las Paralimpíadas Mundiales 2016, mayor interés del público/imprenta, mayor número de adeptos de modalidades y construcción del centro de entrenamiento. Además, el legado dejado se constituye también en el aumento de expectativas de todos involucrados en el movimiento. Siendo así, se buscó analizar las expectativas de paratletas a nivel escolar. Entrevistó 114 atletas brasileños, de ambos sexos, de edad ±15,45 años, participantes de las Paralimpíadas Escolares. Se identificó la relevancia de la participación en esta competición en la modificación de la percepción de los proyectos futuros y como oportunidad de ser vistos como objeto de valorización y orgullo por el medio social.

A survey of expectations and perceptions of nursing service quality in nurses and patients in ICU / 中国实用护理杂志

Objective@#To investigate the expectations and perceptions of nurses and patients in the intensive care unit (ICU) on the quality of nursing services, and to compare and analyze the differences and similarities between the two groups.@*Methods@#97 nurses and 184 patients from three ICU of three hospitals in our city were selected by convenient sampling, and their nursing service quality expectation and perception questionnaire were used to investigate.@*Results@#The expectation scores of ICU nurses and patients on the quality of nursing service were (4.31 ± 0.63) and (4.22 ± 0.62) respectively. The scores of perception were (4.05 ± 0.58) and (3.96 ± 0.70) respectively. The difference of perception expectation score between nurses and patients is negative. The score difference between nurses in Item 3, 9~12 and responsiveness was significantly higher than that of the patients. The score difference between the entry 4~7 and the reliability dimension was significantly lower than that of the patients, and the difference was statistically significant (P<0.05).@*Conclusions@#The quality of nursing service perceived by ICU patients and nurses is relatively poor, and there are differences in reliability and responsiveness between the two patients.

A survey of expectations and perceptions of nursing service quality in nurses and patients in ICU / 中国实用护理杂志

Objective To investigate the expectations and perceptions of nurses and patients in the intensive care unit (ICU) on the quality of nursing services, and to compare and analyze the differences and similarities between the two groups. Methods 97 nurses and 184 patients from three ICU of three hospitals in our city were selected by convenient sampling, and their nursing service quality expectation and perception questionnaire were used to investigate. Results The expectation scores of ICU nurses and patients on the quality of nursing service were (4.31 ± 0.63) and (4.22 ± 0.62) respectively. The scores of perception were (4.05 ± 0.58) and (3.96 ± 0.70) respectively. The difference of perception expectation score between nurses and patients is negative. The score difference between nurses in Item 3, 9~12 and responsiveness was significantly higher than that of the patients. The score difference between the entry 4~7 and the reliability dimension was significantly lower than that of the patients, and the difference was statistically significant (P<0.05). Conclusions The quality of nursing service perceived by ICU patients and nurses is relatively poor, and there are differences in reliability and responsiveness between the two patients.

Effects of Early Rehabilitation on Expectation and Perception for Inpatients with Work Injury / 中国康复理论与实践

Objective:To compare the expectation and perception of rehabilitation services for patients with work injury with or without early intervention. Methods:From August, 2017 to February, 2018, 350 inpatients with work injury accepted early intervention and non-early intervention were investigated with the modified ServQual scale. Results:There was no significant difference in the expectation between the inpatients accepted early intervention and non-early intervention (t < 1.904, P > 0.05). In both groups, expectation was the highest in assurance and responsiveness dimension, and the lowest in reliability dimension. The perception was higher in the early intervention group than in the non-early intervention group. In both groups, perception was the highest in tangibility, and the lowest in empathy. Conclusion:Early intervention of rehabilitation may improve the perception of services.

La psiquiatría militar alemana en la Segunda Guerra Mundial. Artículo histórico / German military psychiatry in the Second World War. Historical article

Resumen Introducción La reacción de estrés de combate (REC), que hoy en día podría ser denominada «reacción a estrés agudo¼ (ICD-10), se refiere a una reacción de ansiedad transitoria en el soldado, la cual históricamente llevó a una incapacidad para afrontar la lucha de la guerra. La mayoría de los análisis militares, históricos y médicos de la actividad realizada por la Wehrmacht § en la Segunda Guerra Mundial reportan que no se presentaron serios problemas debido al «quiebre¼ por estrés. Las razones se fundamentan en la calidad excepcional y el liderazgo de las pequeñas unidades militares del ejército alemán. Sin embargo, con el paso de los años, ya no fue posible evitar el reporte de un elevado número de bajas secundarias a la REC, lo que ha puesto en duda el mito de la inmunidad del soldado alemán al estrés de la guerra. Conclusiones Al final de la WWII, la reacción de estrés de combate fue un tópico común en las guías oficiales. Los psiquiatras fueron quienes subestimaron de forma continua el papel de este trastorno en la Wehrmacht. La percepción generalizada de que la Wehrmacht no sufría los serios problemas del quiebre emocional en los soldados puede ser modificada hasta cierto punto.

Abstract Introduction Combat stress reaction (CSR), now called «acute stress reaction¼ (ICD-10), refers to a transient anxiety reaction in the soldier, which has historically led to an inability to face the struggle of war. Most military, historical and medical analyzes of the activity carried out by the Wehrmacht in World War II reported no serious problems due to stress. The reasons are based on the exceptional quality of the small military units and the leadership of the German Army. However, over the years, it was no longer possible to avoid reporting the high number of casualties secondary to combat stress reactions, which has cast doubt on the myth of the German soldiers' immunity to the stress of war. Conclusions At the end of WWII, the CSR was a common topic in official reports, meetings and guides. The psychiatrists who had the opportunity to report it were those who continuously underestimated the role of this stress disorder in the Wehrmacht. Thus, the widespread perception that the Wehrmacht did not suffer serious problems of emotional breakdown in soldiers, typical of combat stress, can be modified to some extent.

Desarrollo de la Escala Expectativa de Comportamiento Ambiental de Otros con adultos jóvenes mexicanos / Development of the Expectation of other's Environmental Behavior Scale with a Sample of Mexican Young Adults

Resumen El propósito del estudio fue desarrollar una escala que mida la expectativa de comportamiento ambiental de otros y observar si hay relación con la conducta proambiental autorreportada. Se generaron 13 reactivos de respuesta tipo Likert, aplicados a una muestra de 218 adultos jóvenes mexicanos. El análisis factorial exploratorio muestra una estructura bifactorial, que distingue entre la expectativa de comportamiento proambiental y antiambiental, cuyos índices de consistencia interna fueron alfa = 0.77 y alfa = 0.79, que explican el 57.65% de la varianza. Se les aplicó también una escala de conductas proambientales. Mediante un modelo de ecuaciones estructurales se mostró que el factor de expectativa de comportamiento en estudio tuvo un efecto significativo sobre la conducta proambiental. Los resultados muestran evidencia de una escala bifactorial con propiedades psicométricas aceptables.

Abstract The purpose of this study was to develop an instrument to measure expectation of others' environmental behavior, and notice if there is a relationship between this variable and self-report of pro-environmental behaviors. Thirteen items Likert-type were development, and was applied to a sample of two hundred eighteen Mexican young adults. The exploratory factor analysis shows a bi-factorial structure distinguishes between, expectation of pro-environmental behavior, and expectation of anti-environmental behavior. Their Cronbach's alpha score was 0.77 and 0.79; both factors accounted for 57.65% of the variance. A scale of pro-environmental actions was applied too. A structural equation model showed that the factor expectation of pro-environmental behavior has a significant effect on pro-environmental actions. The result shows evidence for bi-factorial scale with acceptable psychometrics properties.

Patient Decision Making Process In A Dental Environment

An understanding of patient's decision making process helps a Dentist to present various treatment options in an appropriate and a legitimate way. The dynamics of today's practice is changing, where information search is made through various media. Patients pass through sequential steps comprising of, problem recognition, pre-purchase information search, evaluation of alternatives, purchase decision and post-purchase outcome and reaction before a choice is made. This paper provides an overview of how choices are made scientifically which helps the dentist to sustain an established practice and to successfully deliver the Dental treatment.

Empirical analysis of career cognition and development expectation of family doctors in Changning district , Shanghai / 中华医院管理杂志

Objective Under the linkage reform of family doctor service and medical insurance payment ,to study the family doctors′ career cognitive and expectations in order to improve the endogenous power of the family doctor system development ,and push forward the reform with sustainable effects .Methods All the family doctors in Changning were surveyed. There were 154 family doctors surveyed in the first phase of 2013 ,and 143 in the second phase of 2016 .The data were subject to descriptive statistics .Results About 80％ of the family doctors had a clear understanding of the family doctor system in 2016 ,with the proportion of family doctors clearly understanding their duties risen from 55.26％ (84/152)in 2013 to 61.27％ (87/142)in 2016 .Self-assessment of their work value and professional reputation were more positive significantly .70％ of them believed their social status as above average. The proportion of family doctors who were very confident/confident" in the development of community health services and family doctor system increased from 31.72％ (46/145) to 47.20％ (59/125)and from 31.72％ (46/145)to 52.42％ (65/124)respectively .Conclusions The occupational cognition and career expectations of family doctors in Changning district have been significantly improved ,which can guide their behavior towards reform objectives and propel the family doctor system progress smoothly .