982 resultados para Integrative review


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De Sousa′s comprehensive two-part review of a diversity of contemporary approaches to the study of consciousness is highly welcome. He makes us aware of a proliferation of theoretical and empirical approaches targeting a common theme, but diverging in many ways. He skilfully accomplishes a classification of kinds of approach, identification of the main representatives, their contributions, and respective limitations. However, he does not show how the desired integration could be accomplished. Besides summarising de Sousa′s efficient analytical work, I make critical comments and briefly report my contribution for the integration project.© MSM 2013.

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The literature indicates stress as a response of the organism to a stimulation that requires enormous efforts to adapt to the changes in the environment and the body. When an individual is subjected to stress, the autonomic nervous system is triggered, the sympathetic pathway is activated, and the parasympathetic system is suppressed, which exerts several effects on the cardiovascular system and affects heart rate variability. This research aimed to conduct a literature review to find and analyze the studies that address clearly the implications of stress on heart rate variability. The methodology employed was an active search in the databases SciELO, PubMed and Lilacs. The results were five articles, most of which suggest a relationship between stress and heart rate variability. We observed that the majority of the studies indicated a strong association between stress and cardiac autonomic activity. The stress is present in the daily activities of the population, especially in labor. The subject is vast, however, were observed in the references the effects of stress on the body making it vulnerable to diseases. Thus, this information may contribute to the aid of preventive strategies against stress and diseases of the cardiovascular system.

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Abstract Background Tobacco and cannabis use are strongly interrelated, but current national and international cessation programs typically focus on one substance, and address the other substance either only marginally or not at all. This study aimed to identify the demand for, and describe the development and content of, the first integrative group cessation program for co-smokers of cigarettes and cannabis. Methods First, a preliminary study using expert interviews, user focus groups with (ex-)smokers, and an online survey was conducted to investigate the demand for, and potential content of, an integrative smoking cessation program (ISCP) for tobacco and cannabis co-smokers. This study revealed that both experts and co-smokers considered an ISCP to be useful but expected only modest levels of readiness for participation.Based on the findings of the preliminary study, an interdisciplinary expert team developed a course concept and a recruitment strategy. The developed group cessation program is based on current treatment techniques (such as motivational interviewing, cognitive behavioural therapy, and self-control training) and structured into six course sessions.The program was evaluated regarding its acceptability among participants and course instructors. Results Both the participants and course instructors evaluated the course positively. Participants and instructors especially appreciated the group discussions and the modules that were aimed at developing personal strategies that could be applied during simultaneous cessation of tobacco and cannabis, such as dealing with craving, withdrawal, and high-risk situations. Conclusions There is a clear demand for a double cessation program for co-users of cigarettes and cannabis, and the first group cessation program tailored for these users has been developed and evaluated for acceptability. In the near future, the feasibility of the program will be evaluated. Trial registration Current Controlled Trials ISRCTN15248397

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Background. No comprehensive systematic review has been published since 1998 about the frequency with which cancer patients use complementary and alternative medicine (CAM). Methods. MEDLINE, AMED, and Embase databases were searched for surveys published until January 2009. Surveys conducted in Australia, Canada, Europe, New Zealand, and the United States with at least 100 adult cancer patients were included. Detailed information on methods and results was independently extracted by 2 reviewers. Methodological quality was assessed using a criteria list developed according to the STROBE guideline. Exploratory random effects metaanalysis and metaregression were applied. Results. Studies from 18 countries (152; >65 000 cancer patients) were included. Heterogeneity of CAM use was high and to some extent explained by differences in survey methods. The combined prevalence for “current use” of CAM across all studies was 40%. The highest was in the United States and the lowest in Italy and the Netherlands. Metaanalysis suggested an increase in CAM use from an estimated 25% in the 1970s and 1980s to more than 32% in the 1990s and to 49% after 2000. Conclusions. The overall prevalence of CAM use found was lower than often claimed. However, there was some evidence that the use has increased considerably over the past years. Therefore, the health care systems ought to implement clear strategies of how to deal with this. To improve the validity and reporting of future surveys, the authors suggest criteria for methodological quality that should be fulfilled and reporting standards that should be required.

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Introduction: Previous systematic reviews of the literature on the effects of Tai Chi Chuan(TCC)on balance have focussed either on determining the quality of the research design or have provided just a general description of the studies.To the best of our knowledge none have approached this topic by conducting an analysis from the point of view of the factors which affect balance.It is important to present this perspective as it will help to guide future research in this field. Methodology: Seven electronic data bases were searched for publications dated between 1996 and 2012.The inclusion criteria were;randomized controlled trials(RCT)written in English. Results: From a total of 397 articles identified, 27 randomized controlled trials were eligible for the analysis. Conclusions: Studies reviewed appear to confirm that TCC improves static and dynamic balance and in the functional factors which affect balance in persons of over 55 years of age.Only one study was identified on people affected with problems with the vestibular system. No studies on the influence of TCC on improvement in balance in individuals suffering from deteriorated brain function were identified.

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Currently, debate in the area of cross-national human resource management (HRM) suggests that both “culture-bound” and “culture-free” factors and variables are important determinants of HRM policies and practices. HRM is presented as being context-specific and it is argued that with the growth of new markets world-wide, and increased levels of competition and globalization of business, there is a strong need for more cross-national HRM studies. However, the literature shows the absence of an integrated framework, which can help to highlight the different role that context-specific facets of HRM practices play. The nature of different determinants in different national and regional settings is rarely analyzed. This paper develops an integrated framework. It delineates the main distinctive facets associated with national factors, contingent variables, and organizational and human resource (HR) strategies and policies, that may be used to evaluate cross-national comparative HRM policies and practices.

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Purpose: The servitization of manufacturing is a diverse and complex field of research interest. The purpose of this paper is to provide an integrative and organising lens for viewing the various contributions to knowledge production from those research communities addressing servitization. To achieve this, the paper aims to set out to address two principal questions, namely where are the knowledge stocks and flows amongst the research communities? And what are generic research concerns being addressed by these communities? Design/methodology/approach: Using an evidenced-based approach, the authors have performed a systematic review of the research literature associated with the servitization of manufacturing. This investigation incorporates a descriptive and thematic analysis of 148 academic and scholarly papers from 103 different lead authors in 68 international peer-reviewed journals. Findings: The work proposes support for the existence of distinct researcher communities, namely services marketing, service management, operations management, product-service systems and service science management and engineering, which are contributing to knowledge production in the servitization of manufacturing. Knowledge stocks within all communities associated with research in the servitization of manufacturing have dramatically increased since the mid-1990s. The trends clearly reveal that the operations community is in receipt of the majority of citations relating to the servitization of manufacturing. In terms of knowledge flows, it is apparent that the more mature communities are drawing on more locally produced knowledge stocks, whereas the emergent communities are drawing on a knowledge base more evenly distributed across all the communities. The results are indicative of varying degrees of interdependency amongst the communities. The generic research concerns being addressed within the communities are associated with the concepts of product-service differentiation, competitive strategy, customer value, customer relationships and product-service configuration. Originality/value: This research has further developed and articulated the identities of distinct researcher communities actively contributing to knowledge production in the servitization of manufacturing, and to what extent they are pursuing common research agendas. This study provides an improved descriptive and thematic awareness of the resulting body of knowledge, allowing the field of servitization to progress in a more informed and multidisciplinary fashion. © Emerald Group Publishing Limited.

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G protein-coupled receptors (GPCR) are amongst the best studied and most functionally diverse types of cell-surface protein. The importance of GPCRs as mediates or cell function and organismal developmental underlies their involvement in key physiological roles and their prominence as targets for pharmacological therapeutics. In this review, we highlight the requirement for integrated protocols which underline the different perspectives offered by different sequence analysis methods. BLAST and FastA offer broad brush strokes. Motif-based search methods add the fine detail. Structural modelling offers another perspective which allows us to elucidate the physicochemical properties that underlie ligand binding. Together, these different views provide a more informative and a more detailed picture of GPCR structure and function. Many GPCRs remain orphan receptors with no identified ligand, yet as computer-driven functional genomics starts to elaborate their functions, a new understanding of their roles in cell and developmental biology will follow.

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The commodification of natural resources and the pursuit of continuous growth has resulted in environmental degradation, depletion, and disparity in access to these life-sustaining resources, including water. Utility-based objectification and exploitation of water in some societies has brought us to the brink of crisis through an apathetic disregard for present and future generations. The ongoing depletion and degradation of the world’s water sources, coupled with a reliance on Western knowledge and the continued omission of Indigenous knowledge to manage our relationship with water has unduly burdened many, but particularly so for Indigenous communities. The goal of my thesis research is to call attention to and advance the value and validity of using both Indigenous and Western knowledge systems (also known as Two-Eyed Seeing) in water research and management to better care for water. To achieve this goal, I used a combined systematic and realist review method to identify and synthesize the peer-reviewed, integrative water literature, followed by semi-structured interviews with first authors of the exemplars from the included literature to identify the challenges and insights that researchers have experienced in conducting integrative water research. Findings suggest that these authors recognize that many previous attempts to integrate Indigenous knowledges have been tokenistic rather than meaningful, and that new methods for knowledge implementation are needed. Community-based participatory research methods, and the associated tenets of balancing power, fostering trust, and community ownership over the research process, emerged as a pathway towards the meaningful implementation of Indigenous and Western knowledge systems. Data also indicate that engagement and collaborative governance structures developed from a position of mutual respect are integral to the realization of a given project. The recommendations generated from these findings offer support for future Indigenous-led research and partnerships through the identification and examination of approaches that facilitate the meaningful implementation of Indigenous and Western knowledge systems in water research and management. Asking Western science questions and seeking Indigenous science solutions does not appear to be working; instead, the co-design of research projects and asking questions directed at the problem rather than the solution better lends itself to the strengths of Indigenous science.

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Abstract Health institutions have an increased risk of occurrence of errors due to their diversity, specificity and volume of services, representing a great concern for health professionals whose main function is to protect the health and lives of their patients. We intend to identify a body of evidence, that shows what the most common adverse events are and what adverse events potentially arise from clinical miscommunications. An integrative literature review using the keywords "Adverse Events", "Patient Safety", "Communication". An inquiry was made on databases PubMed, Web of Science, Scielo and CINAHL, in articles published between January 2010 and March 2016, available in Portuguese and English. Of the 216 articles that emerged were selected eight articles that answered the research questions: what are the most common adverse events that have their origin in communication errors? Analyzing the selected studies, it appears that the most common adverse events arise in the context of obstetrics and pediatrics, in surgical contexts, in the continuity of care and related medication. Patient safety should be seen as a key component of quality in health care, with good management of the risk of fundamental error for the promotion of this security. The knowledge and understanding that communication failures are one of the main factors contributing to the occurrence of errors in the context of health care, allows the subsequent development of strategies to improve this process and thus ensure safer healthcare.

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Bisphosphonates (BPs) are a class of drugs used to treat osteoporosis and malignant bone metastasis. BPs show high binding capacity to the bone matrix, especially in sites of active bone metabolism. The American Society for Bone and Mineral Research defines BRONJ as an area of exposed bone in the maxillofacial region that has not healed within 8 weeks after identification by a healthcare provider in a patient who is receiving or has been exposed to a bisphosphonate and has not had radiation therapy to the craniofacial region. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) can adversely affect quality of life, as it may produce significant morbidity. The American Association of Oral and Maxillofacial Surgeons (AAOMS) considers as vitally important that information on BRONJ be disseminated to other dental and medical specialties. The purpose of this work is to offer a perspective on how dentists should manage patients on BPs, to show the benefits of accurately diagnosing BRONJ, and to present diagnostic aids and treatments strategies for the condition.

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Frailty is a syndrome that leads to practical harm in the lives of elders, since it is related to increased risk of dependency, falls, hospitalization, institutionalization, and death. The objective of this systematic review was to identify the socio-demographic, psycho-behavioral, health-related, nutritional, and lifestyle factors associated with frailty in the elderly. A total of 4,183 studies published from 2001 to 2013 were detected in the databases, and 182 complete articles were selected. After a comprehensive reading and application of selection criteria, 35 eligible articles remained for analysis. The main factors associated with frailty were: age, female gender, black race/color, schooling, income, cardiovascular diseases, number of comorbidities/diseases, functional incapacity, poor self-rated health, depressive symptoms, cognitive function, body mass index, smoking, and alcohol use. Knowledge of the complexity of determinants of frailty can assist the formulation of measures for prevention and early intervention, thereby contributing to better quality of life for the elderly.

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A literature review was conducted aiming to understand the interface between the Intellectual Disability and Mental Health fields and to contribute to mitigating the path of institutionalizing individuals with intellectual deficiencies. The so-called dual diagnosis phenomenon remains underestimated in Brazil but is the object of research and specific public policy internationally. This phenomenon alerts us to the prevalence of mental health problems in those with intellectual disabilities, limiting their social inclusion. The findings reinforce the importance of this theme and indicate possible diagnostic invisibility of the development of mental illness in those with intellectual disabilities in Brazil, which may contribute to sustaining psychiatric institutionalization of this population. 

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Rheumatoid arthritis (RA) is a systemic chronic inflammatory disorder that can compromise the cervical spine in up to 80% of the cases. The most common radiological presentations of cervical involvement are atlantoaxial subluxation (AAS), cranial settling and subaxial subluxation (SAS). We performed a systematic review in the PubMed Database of articles published later 2005 to evaluate the prevalence, progression and risk factors for cervical spine involvement in RA patients. Articles were classified according to their level of evidence. Our literature review reported a wide range in the prevalence of cervical spine disease, probably explained by the different studied populations and disease characteristics. Uncontrolled RA is probably the main risk factor for developing a spinal instability. Adequate treatment with DMARD and BA can prevent development of cervical instabilities but did not avoid progression of a pre-existing injury. MRI is the best radiological method for diagnosis cervical spine involvement. AAS is the most common form of RA. Long term radiological follow-up is necessary to diagnosis patients with late instabilities and monitoring progression of diagnosed injuries.