830 resultados para Estudo de revisão


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This paper aims to conduct a study to evaluate and measure the possible impact that the unavailability of spare parts can have on customer satisfaction for car dealerships in the post-sales. A theoretical-conceptual review on the subject of satisfaction and loyalty, on the backdrop of the reality of the automobile market, allowed the construction of a research tool dedicated to collect opinions of car owners, to allow an analysis empirical relationship between the availability of parts, repairs or scheduled service possible, and change or stay on the mark on the occasion of change of vehicle. 236 forms were applied to car owners in the city of Natal / RN. The results obtained in this survey allowed the identification of the unavailability of parts as a significant factor, among others, the motivation for the customer to switch brands. Collaterally, we could also conclude that the dynamics of change in marks, whatever its motivation, is reflected in the perceived positions of the different brands as the market share both in strictly quantitative terms and in terms of relative positioning, with significant changes in the ranking of consumer preferences for different brands available

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This Master of Science Thesis deals with the customer satisfaction and loyalty focusing on a private higher education institution in Belém city, Brazil. The literature review focuses on costumer satisfaction and loyalty concepts and theory, models of quality managing systems and methodologies of costumer satisfaction measurement. The research was a survey with a random stratified sample of 329 undergraduate students of Business Administration at the Faculdade do Pará , in the morning and the night periods. The data analysis was made through the descriptive statistics and multiple regression analysis. The main findings are that the model was satisfactory and the main factors affecting Satisfaction to the School were Best Professor Didatics (beta=0.297), Courses Contents (beta=0.280), Clerks Sympathy (beta=0.201), and Number of Students in Classroom (beta=0,187) with a adjusted R2 = 0,47. The main factors affecting School Loyalty with an adjusted R2 = 0,43 were School Image (beta=0.383), Affective Commitment (beta=0.255), and Satisfaction with Professors (beta=0,218). The findings suggest also that may be differences between the set of students and those that complain for something

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This research deals with the activity of text revision. It aims at understanding the work of the text reviewer, taking into consideration the professional experiences of the subjects who work in the area. It s theoretical basis comes from Bakhtin Circle, mainly the concept of verbal interaction formulated from reflections on language used in different spheres of human activities, which implies the notions of discourse genres, alterity, as well as exotopy. The methodology follows the tradition of the qualitative and interpretative research. The data is composed of the statements of text reviewers both in handbooks and interviews, as well as of the description of the researcher s own experience as text reviewer. The results indicate that the revision activity needs to be orientated by a dialogical conception of language, which takes into consideration the interaction between the reviewer and the author, aiming the text finalization

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A recuperação pós-exercício consiste em restaurar os sistemas do corpo a sua condição basal, proporcionando equilíbrio e prevenindo a instalação de lesões e, nesse sentido, torna-se aspecto importante de todo programa de condicionamento físico, em quaisquer níveis de desempenho, mas, sobretudo nos mais elevados. O objetivo desta revisão foi reunir informações e descrever as respostas proporcionadas por métodos recuperativos pós-exercício, como crioterapia, contraste, massagem e recuperação ativa, constituindo uma fonte de atualização do referido tema. Utilizaram-se os bancos de dados MedLine, Scielo e Lilacs, como lista de periódicos, o SportsDiscus. Foram incluídos no estudo somente ensaios clínicos randomizados controlados e não-controlados, além de artigos de revisão referentes ao tema proposto. Optou-se por procurar os termos: cryotherapy, massage, active recovery, thermotherapy, immersion e exercise, individualmente e em cruzamentos. Como achado, observou-se que alguns estudos relatam que a crioterapia é prejudicial em se tratando de recuperação pós-exercício, pois reduz o desempenho imediatamente após a aplicação da técnica. Por outro lado, estudos apontam como sendo benéfica, pois reduzem o nível de creatinaquinase após alta intensidade de esforço, evitando danos musculares. Para o contraste, embora apresente significância em se tratando de remoção de lactato sanguíneo, sua efetividade necessita ser mais bem discutida. Na massagem e na recuperação ativa, os principais vieses descritos dizem respeito à pressão exercida e à intensidade do exercício, respectivamente. Entre as técnicas, as que parecem ter efeitos semelhantes são o contraste e a recuperação ativa, no que tange à remoção de lactato e diminuição da creatinaquinase. Ressalta-se que o tempo de exposição é de fundamental importância para todos os métodos. Entretanto, diversos estudos não se propõem a identificar os reais efeitos fisiológicos promovidos pelas técnicas, utilizando-as de modo inipiente. Portanto, a inconsistência dos resultados encontrados sugere que a análise das variáveis utilizadas como método de recuperação deve ser mais bem controlada.

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The new technique for automatic search of the order parameters and critical properties is applied to several well-know physical systems, testing the efficiency of such a procedure, in order to apply it for complex systems in general. The automatic-search method is combined with Monte Carlo simulations, which makes use of a given dynamical rule for the time evolution of the system. In the problems inves¬tigated, the Metropolis and Glauber dynamics produced essentially equivalent results. We present a brief introduction to critical phenomena and phase transitions. We describe the automatic-search method and discuss some previous works, where the method has been applied successfully. We apply the method for the ferromagnetic fsing model, computing the critical fron¬tiers and the magnetization exponent (3 for several geometric lattices. We also apply the method for the site-diluted ferromagnetic Ising model on a square lattice, computing its critical frontier, as well as the magnetization exponent f3 and the susceptibility exponent 7. We verify that the universality class of the system remains unchanged when the site dilution is introduced. We study the problem of long-range bond percolation in a diluted linear chain and discuss the non-extensivity questions inherent to long-range-interaction systems. Finally we present our conclusions and possible extensions of this work

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In asthmatic, the lung hyperinflation leaves the inspiratory muscle at a suboptimal position in length-tension relationship, reducing the capacity of to generate tension. The increase in transversal section area of the inspiratory muscles could reverse or delay the deterioration of inspiratory muscle function. Objective: To evaluate the evidence for the efficacy of inspiratory muscle training (IMT) with an external resistive device in patients with asthma. Methods: A systematic review with meta-analysis was carried out. The sources researched were the Cochrane Airways Group Specialised Register of trials, Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 11 of 12, 2012), MEDLINE, EMBASE, PsycINFO, CINAHL, AMED, ClinicalTrials.gov and reference lists of articles. All databases were searched from their inception up to November 2012 and there was no restriction on the language of publication. Randomised controlled trials that involved the use of an external inspiratory muscle training device versus a control (sham or no inspiratory training device) were considered for inclusion. Two reviewers independently selected articles for inclusion, evaluated risk of bias in studies and extracted data. Results: A total of five studies involving 113 asthmatic patients were included. Three clinical trials were produced by the same group. The included studies showed a significant increase in maximal inspiratory pressure (MD 13.34 cmH2O, 95% CI 4.70 to 21.98), although the confidence intervals were wide. There was no statistically significant difference between the IMT group and the control group for maximal expiratory pressure, peak expiratory flow rate, forced expiratory volume in one second, forced vital capacity, sensation of dyspnea and use of beta2-agonist. There were no studies describing exacerbation events that required a course of oral and inhaled corticosteroids or emergency department visits, inspiratory muscle endurance, hospital admissions and days of work or school. Conclusions: There is no conclusive evidence in this review to support or refute inspiratory muscle training for asthma, once the evidence was limited by the small number of studies included, number of participants in them together with the risk of bias. More well conducted randomized controlled trials are needed, such trials should investigate respiratory muscle strength, exacerbation rate, lung function, symptoms, hospital admissions, use of medications and days off work or school. IMT should also be assessed in the context of more severe asthma

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Introduction: Pneumonia is an inflammatory lung disease and it is the greatest cause of deaths in children younger than five years of age worldwide. Chest physiotherapy is widely used in the treatment of pneumonia because it can help to eliminate inflammatory exudates and tracheobronchial secretions, remove airway obstructions, reduce airway resistance, enhance gas exchange and reduce the work of breathing. Thus, chest physiotherapy may contribute to patient recovery as an adjuvant treatment even though its indication remains controversial. Objectives: To assess the effectiveness of chest physiotherapy in relation to time until clinical resolution in children (from birth up to 18 years old) of either gender with any type of pneumonia. Methods: We searched CENTRAL 2013, Issue 4; MEDLINE (1946 to May week 4, 2013); EMBASE (1974 to May 2013); CINAHL (1981 to May 2013); LILACS (1982 to May 2013); Web of Science (1950 to May 2013); and PEDro (1950 to May 2013). We consulted the ClinicalTrials.gov and the WHO ICTRP registers to identify planned, ongoing and unpublished trials. We consulted the reference lists of relevant articles found by the electronic searches for additional studies. We included randomised controlled trials (RCTs) that compared chest physiotherapy of any type with no chest physiotherapy in children with pneumonia. Two review authors independently selected the studies to be included in the review, assessed trial quality and extracted data. Results: Three RCTs involving 255 inpatient children are included in the review. They addressed conventional chest physiotherapy, positive expiratory pressure and continuous positive airway pressure. The following outcomes were measured: duration of hospital stay, time to clinical resolution (observing the following parameters: fever, chest indrawing, nasal flaring, tachypnoea and peripheral oxygen saturation levels), change in adventitious sounds, change in chest X-ray and duration of cough in days. Two of the included studies found a significant improvement in respiratory rate and oxygen saturation whereas the other included study failed to show that standardised respiratory physiotherapy and positive expiratory pressure decrease the time to clinical resolution and the duration of hospital stay. No adverse effects related to the interventions were xvi described. Due to the different characteristics of the trials, such as the duration of treatment, levels of severity, types of pneumonia and the techniques used in children with pneumonia, as well as differences in their statistical presentation, we were not able to pool data. Two included studies had an overall low risk of bias whereas one included study had an overall unclear risk of bias. Conclusion: Our review does not provide conclusive evidence to justify the use of chest physiotherapy in children with pneumonia due to a lack of data. The number of included studies is small and they differed in their statistical presentation

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Chronic venous disease (CVD) is evident among the chronic diseases and affects the elderly population and primarily is responsible for leg ulcers in this population. The use of dressings in the care of a venous ulcer is a fundamental part of the treatment for healing, however, evidence to assist in choosing the best dressing is scarce. The main objective of this study was to evaluate the effectiveness of treatment with hydrogel in the healing of venous ulcers using search methods, synthesis of information and statistical research through a systematic review and meta-analysis. Randomized controlled trials were selected in the following databases: CENTRAL; DARE; NHS EED; MEDLINE; EMBASE; CINAHL. Beyond these databases three websites were consulted to identify ongoing studies: ClinicalTrials.gov, OMS ICTRP e ISRCTN. The primary outcomes were analyzed: complete wound healing, incidence of wound infection and the secondary were: changes in ulcer size, time to ulcer healing, recurrence of ulcer, quality of life of participants, pain and costs of treatment. Four studies are currently included in the review with a total of 250 participants. The use of hydrogel appears to be superior to conventional dressing, gauze soaked in saline, for the healing of venous leg ulcers; 16/30 patients showed complete healing of ulcers (RR 5,33, 95%CI [1,73,16,42]). The alginate gel was shown to be more effective when compared to the hydrogel dressing in reduction of the wound area; 61,2% (± 26,2%) with alginate e 19,4% (± 24,3%) with hydrogel at the end of four weeks of treatment. Manuka honey has shown to be similar to the hydrogel dressings in percentage of area reduction. This review demonstrated that there is no evidence available about the effectiveness of the hydrogel compared to other types of dressings on the healing of venous leg ulcers of the lower limbs, thus demonstrating the need of future studies to assist health professionals in choosing the correct dressing.

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Uma das principais limitações relacionadas ao processo de retificação de cerâmica é a confiabilidade do material devido aos defeitos introduzidos no processamento. A compreensão dos mecanismos envolvidos na remoção de material durante a retificação e a interação com os parâmetros de processo e microestrutura é fundamental para minimizar estes defeitos. A proposta desta revisão é apresentar os modelos de remoção de material e a forma como afetam as propriedades mecânicas da peça final.

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Circadian rhythms are variations in physiological processes that help living beings to adapt to environmental cycles. These rhythms are generated and are synchronized to the dark light cycle through the suprachiasmatic nucleus. The integrity of circadian rhythmicity has great implication on human health. Currently it is known that disturbances in circadian rhythms are related to some problems of today such as obesity, propensity for certain types of cancer and mental disorders for example. The circadian rhythmicity can be studied through experiments with animal models and in humans directly. In this work we use computational models to gather experimental results from the literature and explain the results of our laboratory. Another focus of this study was to analyze data rhythms of activity and rest obtained experimentally. Here we made a review on the use of variables used to analyze these data and finally propose an update on how to calculate these variables. Our models were able to reproduce the main experimental results in the literature and provided explanations for the results of experiments performed in our laboratory. The new variables used to analyze the rhythm of activity and rest in humans were more efficient to describe the fragmentation and synchronization of this rhythm. Therefore, the work contributed improving existing tools for the study of circadian rhythms in mammals

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This paper is a case study that aims to discuss the effects of drug abuse by a person with psychotic structure from a psychoanalytical perspective. The interest in this subject was born from an internship experience in the Mental Health area in which a psychotic patient had a drug abuse problem and the service treating him had difficulties dealing with this. In order to accomplish the objective of this work four theoretical chapters were written and the case is discussed throughout them articulating the theoretical issues with clinical practice. A literature review revealed that Freud and Lacan did not dedicate themselves to the study of the effect of drug use by psychotic patients but they made important contributions unfolding the theoretical and clinical psychoanalytical practice. Contemporary psychoanalytic authors suggest that the drug use made by psychotics differs from the use by neurotics, because of the particularity of the psychotic structure. It was found that drug use in psychosis can operate in three different ways: the first refers to drug use as substitute of a missing signifier helping the psychotic patient building a social bond. The second function is to intensify psychotic phenomena and the third function is to operate as an attempt to diminish those same phenomena. We conclude that, while the use of drugs in neurosis provides an individualist way of satisfaction, that excludes social aspects. For psychosis such use may operate differently and may play a role in social integration, among others effects. Such discussion can help move forward the direction of treatment of psychosis when the case involves drug use

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Precarization of work, process situated historically after the third Industrial Revolution, express itself as one of the faces of changes in production modus and working conditions. The present study aims to identify the process of work precarization in supermarket sector in Natal municipality. The choice for this sector and professional category is based on low investment in studies on the commercial sector and on technological and administrative transformations that supermarkets have implemented. After a bibliographical review, ten indicators of precarization were chosen which permitted to set up a schedule to interviews and its application to employees of two supermarkets (local companies) in Natal area. The following working functions were chosen to participate in the survey: cashier, display assistant (shelf-stacker) and attendants (N=6). From the interviews we developed an analysis of categorical contents in order to identify the presence of precarization indicators. Categorizations allowed us to identify five major themes: work categorization; work meaning: its attributes; work meaning: work centrality; comments on the employment of apprentices or trainees; and transversal work contents. Such themes contents express or not the presence of precarization process at supermarket sector in Natal area. Precarious work is identified in participants speech when they refer to the employees decreasing power in salaries negotiation between them and employers that institute the precarious work conditions

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This research comprises a study about the social assessment performed by the Social Worker in the review process of the Benefit of Continued Installment. The Benefit of Continued Installment was implemented in 1996 and guarantees a minimum salary to the deficiency person and to an elder with sixty five years or more and that proves not to have ways to support neither himself/herself nor his/her own family. It is a demand to include in the BPC that the maximum income of a family does not exceed ¼ of minimum salary and that every two years this benefit to be revised to evaluate its continuity based in its original conditions. This study was carried out in the municipality of Natal/RN, with thirteen social workers, being the collection of data performed through interviews and social assessments of the users that count with the benefit. The results show that the users selected by the criterion of the income, present a profile of poverty and deprivations demonstrated through several situations survived in its daily life, indicative of vulnerability. It was demonstrated that the Social workers has relative autonomy in the evaluations along with the users and that it denotes the necessity of inclusion. However, by following the imposed criteria, it corroborates with the logic of exclusion. So, it is identified in the Municipality of Natal/RN, following the orientation given the politics of social work at national level, the implementation of revision of the BPC, for the social workers, from rigorous processes of selection and exclusions

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OBJETIVO: Analisar a concordância entre distintas escalas para grau de comprometimento em disfagia orofaríngea neurogênica. MÉTODOS: Foi realizado estudo clínico transversal. Participaram 200 indivíduos com disfagia orofaríngea neurogênica, 108 do gênero masculino e 92 do gênero feminino, com idades de 3 meses a 91 anos. Foram aplicadas quatro escalas para classificar o grau de comprometimento da disfagia orofaríngea, sendo duas escalas clínicas e duas videofluoroscópicas. Análises estatísticas foram realizadas para verificar a concordância entre as escalas clínicas e objetivas. RESULTADOS: Os resultados mostraram concordância muito boa entre as escalas clínicas estudadas (Kappa=0,92) e concordância moderada entre as escalas objetivas (Kappa=0,52). CONCLUSÃO: Embora a concordância entre as escalas clínicas tenha sido muito boa e entre as escalas objetivas tenha sido moderada, ainda é necessária ampla discussão e possível revisão dos parâmetros que definem o grau de comprometimento da disfagia orofaríngea em pacientes neurológicos.

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A disfonia espasmódica (DE) é um distúrbio vocal caracterizado por voz tensa-estrangulada, com quebras de sonoridade e que compromete a comunicação do indivíduo. O objetivo deste estudo é apresentar uma revisão bibliográfica dos tratamentos médico e fonoaudiológico proposto para a DE no período entre 2006 e 2010. Os tratamentos descritos foram: injeção de toxina botulínica (TB), miectomia, neurectomia, denervação e reinervação laríngea seletiva adutora, tireoplastia, miotermia tiroaritenóidea com radiofrequência, injeção de lidocaína, homeopatia e tratamento fonoaudiológico (fonoterapia). O uso de injeção de TB mostrou resultados que indicaram a satisfação dos pacientes tratados, embora alguns dos artigos apontassem a necessidade de reaplicação da toxina frequentemente, como desvantagem. Os procedimentos cirúrgicos foram considerados duradouros e indicados para os pacientes que não quiseram se submeter às aplicações de TB. Tais estudos, no entanto, apresentaram contingência de pacientes restrita e os resultados foram baseados, na maioria das investigações, no julgamento dos próprios pacientes sobre a sua qualidade vocal. Os tratamentos, com uso de lidocaína e homeopatia, mostraram resultados positivos em relação à qualidade vocal dos pacientes e foram sugeridos como uma opção, também, para aqueles que não gostariam de ser submetidos ao tratamento cirúrgico ou à aplicação de TB. Os poucos estudos que reportam fonoterapia assinalaram bons resultados quando a mesma foi associada à injeção de TB, mostrando a escassez de informações nesta área. Futuras pesquisas envolvendo a fonoterapia no tratamento da DE são necessárias.