Constructing theory model for medical quality and safety management based on grounded theory / 中华医院管理杂志

Objective:To construct future-oriented theoretical management model for medical quality and patient safety.Methods:Procedure grounded theory was applied to code data including 30 expert interview records from July 2021 to June 2022 and the qualitative analysis results of 71 core literatures in Chinese and English, and then the theoretical model was constructed.Results:After three-level coding, 555 reference points, 249 initial concepts, 41 categories, 27 main categories and 7 core categories related to medical quality and safety management were sorted out, and the theoretical model of SQ (I-SPORT) matrix for medical quality and safety management was constructed. This model extended the traditional dimension in quality and safety management.Conclusions:Regarding medical quality and safety management, on one hand, should focus on the systematic improvement of structure, process, results, reengineering, education and training in terms of management functions; on the other hand, it is necessary to improve the organization, employees, resources, technology and tools, and patient experience in terms of management elements.

Construction of a generalized structure-process-outcome theoretical model of medical quality and safety management in China / 中华医院管理杂志

Objective:To construct a theoretical model of medical quality and safety management based on the current situation of medical quality and safety management mode in China, providing reference for continuous improvement of medical quality and safety management.Methods:The CNKI database was used as the data source to search literature, with a high citation index H=38 as the judgment standard, the core literature related to the quality and safety management in China was selected. Based on the structure-process-outcome (SPO) model, Nvivo qualitative analysis software was used to code and analyze the included literature, sort out the relevant elements of China′s medical quality and safety management, and clarify the logical relationship between the elements, forming a generalized SPO model of China′s medical quality and safety management.Results:Through a systematic summary and review of relevant literature, a generalized SPO model for medical quality and safety management was proposed, including 5 structural elements (organizational structure, personnel management, resource management, informatization, management standards), 2 process elements (management methods, service processes), and 3 outcome elements (patient outcomes, employee outcomes, organizational results). The logical relationships between and within the three major elements were constructed.Conclusions:To improve the level of medical quality and safety management in China, the structural dimension should be focused on clarifying the responsibilities of the main body of quality management, establishing an independent and perfect quality control department, strengthening the investment and construction of information technology, and promoting the implementation of the medical quality management standard; the process dimension should be focused on promoting the rational application of quality management tools; and the outcome dimension should be focused on strengthening the management of patient safety and improving the individual satisfaction.

Construction of sports and medical integration intervention program in phase Ⅱ cardiac rehabilitation for patients with acute myocardial infarction / 中国实用护理杂志

Objective:To construct an intervention program of sports and medical integration for patients with acute myocardial infarction (AMI) in phase Ⅱ cardiac rehabilitation, so as to provide reference for the effective implementation of physical activity behavior change in AMI patients during phase Ⅱ cardiac rehabilitation.Methods:Before the research, we browsed relevant literature and guidelines published from July 2016 to June 2021, made a retrospective study on the influencing factors of cardiac rehabilitation behavior for AMI patients, and carried out a qualitative interview on cognitive and compliance motivations for AMI patients. Furthermore based on trans-theoretical model, the first draft of the intervention program was developed and and the expert consultation questionnaire was formed. From February to April 2022, Delphi method was used in 16 experts from 10 hospitals and 1 nursing college in 4 provinces. After 2 rounds of expert consultations on the importance and operability of items, the intervention program was finally determined.Results:The effective recovery rates of the 2 rounds of expert consultations questionnaires were both 16/16. The authority coefficient of expert consultation was 0.90, the judgment basis coefficient was 0.96, and the familiarity degree was 0.84. After the second round of expert consultation, the coefficient of variation of the importance of each item was (0.0-13.4)%, and the coefficient of variation of operability was (0.0-18.1)%. The final intervention program of sports and medical integration for patients with AMI in phase Ⅱ cardiac rehabilitation had 37 items, containing precontemplation stage (8 items), contemplation stage (7 items), preparation stage (5 items), action stage (9 items) and maintenance stage (8 items).Conclusions:The construction process of the intervention program of sports and medical integration for patients with AMI in phase Ⅱ cardiac rehabilitation is scientific and feasible. The content is focused on the patient-centred conception and the whole-process management for the exercise rehabilitation of AMI patients in phase Ⅱ cardiac rehabilitation. This intervention program may improve the safety, feasibility, participation and compliance in phase Ⅱ cardiac rehabilitation in patients with AMI. So it is recommended to be popularized and used in phase Ⅱ cardiac rehabilitation.

Progress in the Application of Various Theoretical Models in Advance Care Planning / 中国医学伦理学

Advance care planning (ACP) is an important part of hospice care, a core index of high-quality palliative care, and one of the effective indicators for improving the life quality of end-of-life patients. By reviewing the progress of various theoretical models and their applications in ACP, including planned behavior theory, behavioral change wheel theory, self-determination theory, prospect theory, change theory, and cultural suitability theory, this paper delved into the advantages and limitations of each theoretical model and analyzed its research prospects in future ACP clinical practice to promote researchers’ correct understanding of the role of different theoretical models in various types of studies, with a view to providing new ideas for clinical research on ACP.

Modelo teórico explicativo de la discapacidad moderada y grave por migraña

RESUMEN Introducción: la migraña es una enfermedad frecuente y discapacitante, sin embargo, existen pocas investigaciones sobre los factores predictivos de la discapacidad. Objetivo: crear un modelo teórico explicativo de la interrelación dinámica entre los factores asociados a la discapacidad por migraña y a su vez la relación individual de cada uno de estos factores con la discapacidad. Métodos: para la realización de esta investigación se asumió el enfoque racionalista-deductivo como postura epistemológica, y los métodos hipotético-deductivo y sistémico-estructural para su consecución. Resultados: se expusieron elementos teóricos reveladores de la compleja relación que existe entre la discapacidad por migraña y sus factores determinantes. Conclusiones: se creó un modelo explicativo de la interrelación dinámica entre los diferentes factores con influencia independiente sobre la discapacidad por migraña y a su vez la relación individual de cada uno de estos factores con la discapacidad.

ABSTRACT Introduction: migraine is a common and disabling disease, however, there is little research on the predictive factors of disability. Objective: to create an explanatory theoretical model of the dynamic interrelation between the factors associated with migraine disability and, in turn, the individual relationship of each of these factors with disability. Methods: to carry out this research, the rationalist-deductive approach was assumed as an epistemological position, and the hypothetical-deductive and systemic-structural methods were used to achieve it. Results: revealing theoretical elements of the complex relationship that exists between disability due to migraine and its determining factors were exposed. Conclusions: an explanatory model of the dynamic interrelation between the different factors with independent influence on migraine disability and, in turn, the individual relationship of each of these factors with disability was created.

RESUMO Introdução: a enxaqueca é uma doença comum e incapacitante, entretanto, há poucas pesquisas sobre os fatores preditivos de incapacidade. Objetivo: criar um modelo teórico explicativo da inter-relação dinâmica entre os fatores associados à incapacidade da enxaqueca e, por sua vez, a relação individual de cada um desses fatores com a incapacidade. Métodos: para a realização desta pesquisa, assumiu-se como posição epistemológica a abordagem racionalista-dedutiva, e para alcançá-la foram utilizados os métodos hipotético-dedutivo e sistêmico-estrutural. Resultados: foram expostos elementos teóricos reveladores da complexa relação que existe entre a incapacidade por enxaqueca e seus fatores determinantes. Conclusões: foi criado um modelo explicativo da inter-relação dinâmica entre os diferentes fatores com influência independente na incapacidade da enxaqueca e, por sua vez, a relação individual de cada um desses fatores com a incapacidade.

Application of Internet nursing based on transtheoretical model in diet management of patients with chronic kidney disease / 中国实用护理杂志

Objective:To explore the effect of Internet nursing based on transtheoretical model (TTM) in dietary management of patients with chronic kidney disease (CKD).Methods:A total of 160 CKD patients in the Nephrology Clinic of Tianjin First Central Hospital were selected and divided into the control group and the observation group by convenience sampling and simple randomization, with 80 cases in each group. Quantitative diet management were given in the control group and Internet nursing intervention with TTM as the framework in the observation group for 6 months. The distribution of behavioral stages, dietary compliance and changes in clinical laboratory parameters before and after intervention were investigated in the two groups.Results:After intervention for 3 and 6 months, the distribution of behavioral phase in the observation group was better than that in the control group, and the difference was statistical significant ( χ2=28.48, 48.49, all P<0.01); the daily sodium intake in the observation group was (2.86 ± 0.64), (2.58 ± 0.56) g, and the daily protein intake was (0.81 ± 0.18), (0.76 ± 0.13) g/kg, respectively; the daily sodium intake and daily protein intake in the control group were (3.76 ± 1.42), (4.11 ± 1.49) g and (1.00 ± 0.19), (1.04 ± 0.21) g/kg, respectively, and the differences between the two groups had statistical significance ( t values were 26.74 -105.11, all P<0.01). After intervention for 3 and 6 months, systolic blood pressure was (126.41 ± 9.12) and (124.96 ± 8.58) mmHg (1 mmHg=0.133 kPa), serum creatinine was (177.01 ± 89.04) and (183.24 ± 101.48) μmol/L in the observation group, while systolic blood pressure was (133.16 ± 14.28) and (133.18 ± 12.34) mmHg, serum creatinine was (213.29 ± 108.02) and (222.61 ± 117.33) μmol/L in the control group, and serum potassium and serum phosphorus were (4.37 ± 0.38) and (1.10 ± 0.16) mmol/L after intervention for 6 months in the observation group, while (4.60 ± 0.43) and (1.21 ± 0.21) mmol/L in control group, and the differences between the two groups had statistical significances ( t values were 5.16-23.89, all P<0.01). Using repeated measures analysis of variance, there were significant differences in daily sodium and protein intake, time effect, effect and interaction effect of systolic blood pressure, serum creatinine, serum potassium and serum phosphorus ( Ftime values were 8.97-61.66, Finterblock values were 3.96-32.28, Finteraction values were 3.15- 36.35, all P<0.05), diastolic blood pressure time effect and interaction effect ( Ftime=8.08, Finteraction=3.64, all P<0.05), and blood uric acid time effect ( Ftime=10.50, P<0.01). Conclusions:The Internet care model framed by TTM is beneficial for improving dietary behavior, improving dietary compliance, and improving clinical laboratory parameters in CKD patients in the long term.

Fruit and vegetable intake among overweight and obese school children: A cluster randomised control trial

@#Introduction: Adequate daily intake of fruits and vegetables is crucial for the prevention of chronic diseases. This study aimed to determine the effects of My Body is Fit and Fabulous at School (MyBFF@school) with nutrition education intervention (NEI) on the stages of change for fruit and vegetable intake among overweight and obese secondary school children based on the trans-theoretical model (TTM). Methods: This was a cluster randomised controlled trial involving 15 out of 415 eligible government secondary schools in central Peninsular Malaysia, which were randomly assigned into intervention (six schools; 579 school children) and control (nine schools; 462 school children). The intervention group was given NEI for 24 weeks, while the control group followed the existing school programme by the Ministry of Education. Results: There was no significant difference between the intervention and control groups for the stages of change, with majority at the maintenance stage after six months (intervention: 34.9%; control: 39.0%). The within group analysis showed a significant reduction after six months for those at the action stage (action and maintenance stage) from 68.0% to 60.4% in the intervention group and from 71.4% to 65.6% in the control group. However, there was a significant increase among those with adequate fruit and vegetable intake in the intervention group and no significant increase in the control group. Conclusion: MyBFF@school with NEI based on TTM provided acceptable changes in fruit and vegetable intake among overweight and obese secondary school children.

Modelo Teórico Sistema de Créditos Académicos para la carrera de medicina en Cuba / Theoretical Model for the Academic Credit System for medical studies in Cuba

Introducción: La formación de médicos en Cuba posee reconocido prestigio nacional e internacional, lo que ha favorecido el aumento de la cooperación internacional, tanto en el posgrado como en el pregrado; sin embargo, el plan de estudios de la carrera de medicina no contempla los créditos académicos que faciliten los procesos de homologación y convalidación para la incorporación al mercado laboral. Objetivo: Diseñar un Modelo Teórico del Sistema de Créditos Académicos para la carrera de medicina en Cuba que favorezca la homologación y convalidación en el contexto de la internacionalización. Métodos: Se efectuó una investigación de desarrollo en el campo pedagógico con enfoque mixto, mediante la aplicación de métodos y procedimientos cualitativos y cuantitativos para la obtención de la información por diferentes vías o fuentes. Se aplicó la triangulación metodológica para la integración de los resultados. Resultados: El diseño del modelo teórico tuvo una concepción integral y participativa en respuesta a las necesidades de la homologación y convalidación. Este modelo teórico se estructuró en los niveles teórico normativo -comprende los referentes teóricos, las dimensiones y los indicadores- y teórico conceptual -abarca sus propios componentes y su interrelación para lograr el propósito deseado. Conclusiones: La modelación como método científico permitió la elaboración del Modelo Teórico del Sistema de Créditos Académicos en Cuba, para favorecer los procesos de homologación y convalidación en el contexto de la internacionalización(AU)

Introduction: The Cuban doctor training program has national and international prestige, which has favored the increase of international cooperation, both in postgraduate and undergraduate degrees. However, the syllabus for the medical studies does not include academic credits that facilitate homologation and validation processes allowing insertion into the labor market. Objective: To design a theoretical model of the academic credit system for medical studies in Cuba that favors homologation and validation in the international context. Methods: A development research was carried out in the pedagogical field with a mixed approach, using qualitative and quantitative methods and procedures to obtain information through different routes or sources. Methodological triangulation was used to integrate the results. Results: The design of the theoretical model had comprehensive and participatory conception in response to the needs of homologation and validation. This theoretical model was structured at theoretical-normative levels -including theoretical referents, dimensions and indicators and theoretical conceptual. It encompasses its own components and their interrelation to achieve the desired purpose. Conclusions: The modeling as a scientific method allowed preparing the theoretical model of the academic credit system in Cuba, to favor the homologation and validation processes in the international context(AU)

Research advancements of motor imagery for motor function recovery after stroke / 生物医学工程学杂志

Neurological damage caused by stroke is one of the main causes of motor dysfunction in patients, which brings great spiritual and economic burdens for society and families. Motor imagery is an important assisting method for the rehabilitation of patients after stroke, which is easy to learn with low cost and has great significance in improving the motor function and the quality of patient's life. This paper mainly summarizes the positive effects of motor imagery on post-stroke rehabilitation, outlines the physiological performance and theoretical model of motor imagery, the influencing factors of motor imagery, the scoring criteria of motor imagery and analyzes the shortcomings such as the few kinds of experimental subject, the subjective evaluation method and the low resolution of the experimental equipment in the process of rehabilitation of motor function in post-stroke patients. It is hopeful that patients with stroke will be more scientifically and effectively using motor imagery therapy.

Homeopatia no serviço público de saúde: pré-avaliação das ações no município do Recife (PE) / Homeopathy in the public health service: pre-assessment of activities in Recife, Pernambuco

Resumo Trata-se de um estudo de pré-avaliação das ações de homeopatia no município do Recife (PE). Por meio de revisão de documentos oficiais e técnicos foi elaborado um modelo teórico lógico (ML) preliminar da intervenção, no qual se baseou a formulação de uma matriz de critérios e indicadores para avaliação. O ML e a matriz foram submetidos a informantes-chave com expertise na área. Os dados foram coletados de seis entrevistas realizadas em 2016. Os componentes pactuados para ambas as ferramentas foram: gestão e coordenação conjunta; atenção homeopática; e educação, comunicação e mobilização social. Espera-se que o ML e a matriz de critérios e indicadores elaborados e validados sirvam como referência na instituição de processos de monitoramento e avaliação de intervenções semelhantes.

Abstract This study is a pre-assessment of homeopathy activities in the municipality of Recife, Pernambuco. Review of official and technical documentation produced a preliminary logical theoretical model for this intervention, based on a matrix of criteria and indicators for evaluation. The model and matrix were submitted to key informants with expertise in the area, and the data were collected from six interviews in 2016. Three major components were seen to be needed for both tools: joint management and coordination; homeopathic care; and education, communication, and social mobilization. We expect the theoretical model and matrix of criteria and indicators which were developed and validated to serve as a reference to establish procedures for monitoring and assessing similar interventions.

Modelo de formación pedagógica para profesores de la Universidad Metropolitana del Ecuador / Pedagogical training model for professors of the Metropolitan University of Ecuador

Introducción: La formación pedagógica de los profesores universitarios constituye una prioridad para las instituciones universitarias. Los docentes que imparten clases a los estudiantes de las carreras de perfiles de la salud carecen de esta para el desempeño de la función docente educativa. Objetivo: Elaborar un modelo para la formación pedagógica de los profesores de la Universidad Metropolitana de Ecuador. Métodos: Se realizó un estudio cualitativo y análisis documental. Se seleccionó una muestra de docentes y estudiantes de la Universidad Metropolitana del Ecuador; se realizaron entrevistas no estructuradas y observaciones a clases. Fueron analizados documentos sobre la preparación de los docentes y las publicaciones sobre el tema. Se concibió un plan de acciones de formación. Resultados: El modelo elaborado asumió las características, como cualidades que operan en su funcionamiento: participación protagónica de los profesores, flexibilidad y reflexión crítica. Contó con tres etapas para su implementación: diagnóstico de potencialidades y necesidades de aprendizaje, desarrollo del plan de acciones e impacto de la evaluación. Conclusiones: La formación pedagógica ejerció una significativa influencia sobre el desempeño docente, permitió la reflexión sobre la práctica pedagógica, provocó cambios en los modos de actuación de los profesores e influyó en su preparación científica, metodológica y didáctica(AU)

Introduction: Pedagogical training of professors is a priority for university institutions. The professors who teach classes to the students of the careers of health profiles lack this training for the performance of the educational teaching function. Objective: to design a model for the pedagogical formation of the professors of the Metropolitan University of Ecuador. Methods: A qualitative study and documentary analysis was carried out. A sample of professors and students from the Metropolitan University of Ecuador was selected; unstructured interviews and lessons observations were conducted. Documents on the preparation of professors and publications on the subject were analyzed. A plan of training actions was conceived. Results: the elaborated model assumed the characteristics as qualities that operate in its operation: protagonist participation of the professors, flexibility and critical reflection. It had three stages for its implementation: diagnosis of potentialities and learning needs, development of the action plan and impact of the evaluation. Conclusions: the pedagogical training exerted a significant influence on the teaching performance, allowed the reflection on the pedagogical practice, provoked changes in the modes of action of the professors and influenced in their scientific, methodological and didactic preparation(AU)

Comparison and theoretical modeling of capillary electrophoresis analysis for the interaction between caffeine and serum proteins / 药学学报

The method for analyzing the interaction between caffeine and human serum albumin (HSA) was established by capillary electrophoresis. Under physiological conditions, the interaction between ligand (caffeine)-receptor (HSA) was studied with frontier-analysis (FA) method, Hummel-Dreyer (HD) method and plug-plug kinetic (PPK) method. The interaction parameters of caffeine-HSA system were obtained using non-linear equation, Scatchard equation and Klotz equation. The results showed that FA, HD and PPK methods were suitable for caffeine-HSA system, among them, HD method was the best, and the Non-linear equation was the best theoretical model to caffeine-HSA system. Interaction parameter tests showed that caffeine-HSA interaction was a single site interaction and the binding stability was moderate. The mechanism of caffeine-HSA interaction has been elucidated, which can provide valuable information for further research of alkaloids.

Construction of theoretical model of traditional Chinese medicine intelligent manufacturing / 中国中药杂志

In the process of transforming and upgrading of traditional Chinese medicine( TCM) intelligent manufacturing,the TCM enterprises lack systematic and in-depth research on intelligent manufacturing of TCM,leading to insufficient understanding of relevant concepts,development direction,development content and other aspects,to some extent,causing fuzzy and chaotic phenomena. The theoretical model,as a higher expression level of scientific thinking,has the function of interpretation and prediction,and can provide theoretical basis as well as guide for scientific research. Therefore,this article aims to construct a theoretical model of TCM intelligent manufacturing based on the concept of flexible production and intelligent equipment for some unhealthy phenomena in the development process of TCM intelligent manufacturing. In the TCM intelligent manufacturing system,with theory model as the core,the new-generation information technology was integrated with the TCM manufacturing technology to realize the integration of informationization and industrilization as well as the landing of theoretical model. Then,a 3 D simulation model was established to provide a visual environment for intelligent manufacturing of TCM and simulate the virtual reality throughout the TCM intelligent manufacturing process. The new theoretical model in this paper,to a certain extent,can play a guiding role in the development of TCM intelligent manufacturing,and can also provide reference for the realization of TCM intelligent manufacturing.

Review of high-risk sexual behaviors in men who have sex with men: influencing factors and theoretical models / 上海交通大学学报（医学版）

The disproportionately high prevalence of HIV among men who have sex with men (MSM) is associated with the prevalence of unprotected anal intercourse (UAI), which has been the predominant high-risk behavior of HIV acquisition and transmission. MSM have become a target population for HIV prevention. The aspects affecting the high-risk sexual behaviors of MSM mainly include personal factors, environmental factors, and social psychological factors. Currently widely applied models of acquired immunodeficiency syndrome (AIDS) behavioral intervention include KABP (knowledge, attitude, belief, and practice) model, health belief model, theory of reasoned action, social network theory, and so on. These theories provide a reference for studying various influential factors and elaborating the occurrence of high-risk sexual behaviors of MSM. Exploring and building the comprehensive model and integrating the influencing factors of high-risk sexual behaviors of MSM can help us to predict their ultimate actions in the future. Similarly, it will also provide ideas for the further preventions and interventions in MSM.

Envolvimento paterno: construção de um modelo teórico baseado em uma revisão da literatura / Envolvimiento paterno: construcción de un modelo teórico basado en una revisión de la literatura / Father involvement: construction of a theoretical model based on a literature review

Um corpo amplo de evidências científicas já existente documenta a importância da relação pai-filho. O objetivo deste estudo foi desenvolver um modelo teórico de envolvimento paterno, organizado de acordo com princípios de Análise de Equações Estruturais, que requerem especificar as variáveis associadas ao construto central, com base em dados empíricos. Em 2015, foi realizada uma busca sistemática nas bases de dados eletrônicas APA PsycNET, Bireme, PEPSIC, Web of Science e IndexPsi Periódicos, usando os descritores "envolvimento" e "paterno", cruzados com "avaliação" ou "instrumento", nos idiomas inglês e português. Não foram impostas restrições em relação ao ano de publicação. foram encontrados 39 textos completos que incluíam dados empíricos sobre o envolvimento paterno. As informações encontradas foram agrupadas em três categorias: (a) dimensões do envolvimento paterno, (b) fatores que afetam o envolvimento paterno e (c) impactos deste envolvimento sobre outras variáveis. O modelo apresentado sintetiza os resultados dos estudos e representa um avanço no desenvolvimento teórico na área. Este modelo aumenta a visibilidade de questões conceituais sobre o envolvimento paterno e seus correlatos, e, depois da sua testagem empírica, poderá contribuir para o aprimoramento de programas de intervenção para pais.

Un cuerpo de evidencia científica ya existente documenta la importancia de la relación padre-hijo. El objetivo de este estudio fue desarrollar un modelo teórico de envolvimiento paterno, organizados de acuerdo con los principios de la Análisis de Ecuaciones Estructurales, que requieren especificar las variables asociadas con el constructo central, basada en datos empíricos. En 2015, se realizó una búsqueda sistemática en las bases de datos electrónicas APA PsycNET, Bireme, PEPSIC, Web of Science e IndexPsi Periódicos, utilizando los descriptores "envolvimento" y "paterno", cruzados con "avaliação" o "instrumento", en Inglés y Portugués. No hubo restricciones en el año de publicación. Se encontraron 39 textos completos que incluían datos empíricos sobre el envolvimiento paterno. Estos resultados se agruparon en tres categorías: (a) las dimensiones del envolvimiento paterno, (b) factores que afectan el envolvimiento paterno y (c) el impacto de este envolvimiento en otras variables. El modelo sintetiza los resultados de los estúdios y representa un avance en el desarrollo teórico del área. Este modelo aumenta la visibilidad de las cuestiones conceptuales sobre el envolvimiento paterno y sus correlatos, y, después de su comprobación empírica, puede contribuir a la mejora de los programas de intervención para los padres.

An ample body of scientific evidence exists, documenting the importance of the father-child relationship. The objective of this study was to develop a theoretical model of father involvement, organized according to the principles of Structural Equation Modeling, which require specification of the variables associated with the central construct, based on empirical data. In 2015, a systematic search was conducted in the databases APA PsycNET, Bireme, PEPSIC, Web of Science and IndexPsi Periódicos, using the descriptors "involvement" and "father", crossed with "measure", "scale", "tool" or "instrument", in both the English and Portuguese languages. There were no restrictions on the year of publication. In total, 39 complete texts were located, that included data on father involvement. The information in these texts was grouped into three categories: (a) dimensions of father involvement, (b) factors affecting father involvement and (c) impacts of father involvement on other variables. The model presented synthesizes the results of these studies, representing an advance in theory development in this area. This model increases the visibility of conceptual issues about father involvement and its correlates, and, following empirical testing, may contribute to the improvement of intervention programs for fathers.

Modelo teórico de la endodoncia actual / Theoretical model of the current endodontics

Para comprender en profundidad cada una de las técnicas endodónticas de aplicación clínica, propuestas en la actualidad por los autores de diferentesescuelas de endodoncia, debemos previamente conocer el modelo teórico o paradigma preconizado por cada una de ellas. Ello nos permitirá discernir yseleccionar la más adecuada a las necesidades clínicas de nuestros pacientes, dirigiendo la investigacióny desarrollo de nuevas propuestas en el marco de determinado paradigma. La ciencia es multidisciplinaria y generadora de diferentes modelos teóricos aplicables en la endodoncia. Un modelo esencialmente técnico-quirúrgico busca el éxito apoyado enla limpieza, conformación y obturación tridimensional de los conductos radiculares. Eso es necesario pero no suficiente; por cuya razón, Maisto dio un salto cualitativo preconizando un nuevo paradigma endodóntico basado en la reparación apical. Este nuevo modelo teórico nos permite la formulación de nuevas conductas terapéuticas, desarrollar nuevosmateriales y proponer técnicas de instrumentación y obturación que engloben tanto al conducto radicular,como a su zona de influencia en el sistema de inserción dental y el hueso alveolar que lo rodea.

To understand in depth each of the endodontic techniques of clinical application, currently proposed by the authors of different schools of endodontics,we must first know the theoretical model orparadigm advocated by each of them.This will allow us to discern and select the mostappropriate of the clinical needs for our patients, directing research and developmentof new proposals within the framework of agiven paradigm. The science is multidisciplinary and generates different theoretical modelsapplicable to endodontics. An essentially technical-surgical model seekssuccess based on cleaning, shaping and three-dimensional obturation of the rootcanals. That is necessary but not enough, which leadMaisto to make a qualitative leap by advocating anew endodontic paradigm based on apical repair.This new theoretical model allows us to formulate new therapeutic behaviors, develop new materials and propose techniques of instrumentation and obturation that concerns both the root canal and its area of influence in the dental insertion system and the surrounding alveolar bone.

Ratcheting strain and theoretical prediction of articular cartilage under cyclic loading / 医用生物力学

Objective To obtain the ratcheting strain of articular cartilage under different loading conditions,and construct the theoretical model so as to predict the ratcheting strain of cartilage.Methods The fresh articular cartilage obtained from the trochlear of distal femur was used as experimental subject.The ratcheting strain of articular cartilage was tested under cyclic compressive loads by applying the non-contact digital image correlation technique.The theoretical model was constructed to predict the ratcheting strain of articular cartilage with different stress amplitudes and stress rates.The results from predictions were compared with the experimental results.Results The ratcheting strain of cartilage increased rapidly at initial stage and then showed the slower increase with cycles increasing.The ratcheting strain increased with stress amplitude increasing when the stress rate was constant.However,the ratcheting strain decreased with stress rate increasing when the stress amplitude was constant.When the stress rate increased,the ratcheting stain decreased.The prediction results of the established theoretical model were in good agreement with experimental results.Conclusions The ratcheting strain of articular cartilage is proportional to the stress amplitude,and inversely proportional to the stress rate.The established theoretical model can predict the ratcheting strain of articular cartilage and provide guidance for the construction of tissue engineered artificial cartilage.

Effect evaluation of intervene on healthy behavior of soldiers on platesu area to prevent hemorrhoids based on transtheoretical model / 中国实用护理杂志

Objective To explore the effect of trans theoretical model in changing on healthy behavior of soldiers on plateau area to prevent hemorrhoids. Methods Fifty-four soldiers respectively from the artillery troops and air defenses force troops were selected and divided into control group that received normal healthy education and treatment group that received the healthy behavior intervene based on transtheoretical model and the changes of the behavior at each stage of intervention were observed and contrasted between two groups. Results There was no statistically significant difference in the number of each stage between two groups at 1 and 3 months after intervention (χ2= 1.514, 6.554, P> 0.05). The number of former intention stage, intention stage, preparation stage, action stage, maintain stage at 6 months after intervention in treatment group were respectively 0, 0, 0, 15, 39 cases, and 2, 3, 6, 20, 23 cases in control group respectively, the difference was statistically significant (χ2=15.843, P0.05). The number of daily training of the levator ani less than 5, 6-15, 16-25, 26-35,>35 times at 3, 6 months after intervention respectively was 5, 6, 6, 17 cases and 20, 0, 0, 0, 14, 40 cases in treatment group respectively, 9, 13, 14, 10, 8 cases, and 3, 4, 6, 22, 19 cases in control group,the differences were statistically significant (χ2=13.459, 22.252, P<0.01). The incidence of bloody at 6 months after intervention was 3.70% (2/54) in treatment group and 16.67% (9/54) in control group, the difference was statistically significant (χ2 = 4.960, P < 0.05). Conclusions The intervene based on transtheoretical model can effectively promote the healthy behavior to prevent hemorrhoids and reduce the recurrence rate of hemorrhoids.

Theoretical discussion on the mode of government purchase of basic medical services / 中华医院管理杂志

Constructed in the paper is a theoretical model of the strategic procurement services by the government from macro, meso and micro level based on the concept of strategic procurement.The design comprised of a responsibility system, purchase mechanism and evaluation mechanism for the core operating mechanism of the government purchase of basic medical service.It aims to accelerate the reform of public hospitals in an effort to provide theoretical support and reference of the reform nationwide.

Ratcheting strain and theoretical prediction of articular cartilage under cyclic loading / 医用生物力学

Objective To obtain the ratcheting strain of articular cartilage under different loading conditions, and construct the theoretical model so as to predict the ratcheting strain of cartilage. Methods The fresh articular cartilage obtained from the trochlear of distal femur was used as experimental subject. The ratcheting strain of articular cartilage was tested under cyclic compressive loads by applying the non-contact digital image correlation technique. The theoretical model was constructed to predict the ratcheting strain of articular cartilage with different stress amplitudes and stress rates. The results from predictions were compared with the experimental results. Results The ratcheting strain of cartilage increased rapidly at initial stage and then showed the slower increase with cycles increasing. The ratcheting strain increased with stress amplitude increasing when the stress rate was constant. However, the ratcheting strain decreased with stress rate increasing when the stress amplitude was constant. When the stress rate increased, the ratcheting stain decreased. The prediction results of the established theoretical model were in good agreement with experimental results. Conclusions The ratcheting strain of articular cartilage is proportional to the stress amplitude, and inversely proportional to the stress rate. The established theoretical model can predict the ratcheting strain of articular cartilage and provide guidance for the construction of tissue engineered artificial cartilage.