The effectiveness of walking in preventing cardiovascular disease in women: a review of the current literature

This paper summarizes research examining the effects of walking on the prevention of cardiovascular disease (CVD) and treatment of CVD risk factors in women. Epidemiological evidence indicates that walking reduces a woman's risk for developing CVD. Walking may lower CVD risk by having beneficial effects on risk factors associated with CVD development. Obesity, dyslipidemia, hypertension, and diabetes can all be positively affected by increased physical activity or, more specifically, increased daily walking in women. With a large number of people living a sedentary lifestyle, it is important to focus on the effects of physical activity options that are both physiologically beneficial and personally appealing and available to the majority of individuals. With studies showing positive results using pedometer- monitored walking to decrease CVD risk, accumulated daily walking as opposed to structured walking activity should also be considered as a viable option in women.     

The effectiveness of workplace dietary modification interventions: A systematic review

Objective

To evaluate the effectiveness of workplace dietary modification interventions alone or in combination with nutrition education on employees' dietary behaviour, health status, self-efficacy, perceived health, determinants of food choice, nutrition knowledge, co-worker support, job satisfaction, economic cost and food-purchasing patterns.

Method

Data sources included PubMed, Medline, Embase, Psych Info., Web of Knowledge and Cochrane Library (November 2011). This review was guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Studies were randomised controlled trials and controlled studies. Interventions were implemented for at least three months. Cochrane Collaboration's risk of bias tool measured potential biases. Heterogeneity precluded meta-analysis. Results were presented in a narrative summary.

Results

Six studies conducted in Brazil, the USA, Netherlands and Belgium met the inclusion criteria. Four studies reported small increases in fruit and vegetable consumption (≤ half serving/day). These studies involved workplace dietary modifications and three incorporated nutrition education. Other outcomes reported included health status, co-worker support, job satisfaction, perceived health, self-efficacy and food-purchasing patterns. All studies had methodological limitations that weakened confidence in the results.

Conclusion

Limited evidence suggests that workplace dietary modification interventions alone and in combination with nutrition education increase fruit and vegetable intakes. These interventions should be developed with recommended guidelines, workplace characteristics, long-term follow-up and objective outcomes for diet, health and cost.     

Drug-eluting stents: a review of current evidence on clinical effectiveness and late complications

Drug-eluting stent (DES) use has increased greatly as a result of early trial evidence of a reduction in restenosis. However, thet are expensive and do not improve patient survival. Therefore their use has been rationed in some countries. There is a paucity of clinical evidence for some patient groups such as non-ST elevation myocardial infarction and multi-vessel disease. Recent studies suggest that the early benefits of drug-eluting stents may be offset by an increased risk in late stent thrombosis which is a potentially fatal complication. However, the absolute risk appears low and, as yet, there is no evidence of an increased risk of stent-thrombosis related myocardial infarction or death in patients studied in randomised clinical trials. Long-term use of anti-platelet therapy may protect against the risk of late stent thrombosis but the optimal treatment strategy is currently unclear. The aim of this paper is to provide an up-to-date review of the current evidence on DES; including clinical effectiveness, the limitations of existing trials, the emerging evidence on late stent thrombosis and the potential role of clopidogrel.     

The effectiveness of quality systems in nursing homes: a review

BACKGROUND: The need for quality improvement and increasing concern about the costs and appropriateness of health care has led to the implementation of quality systems in healthcare organisations. In addition, nursing homes have made significant investments in their development. The effects of the implementation of quality systems on health related outcomes are not yet clear. OBJECTIVE: To examine evidence in the literature on whether quality systems have an impact on the care process and the satisfaction and health outcomes of long term care residents. METHODS: Review of the literature. RESULTS: The 21 empirical studies identified concerned quality system activities such as the implementation of guidelines; providing feedback on outcomes; assessment of the needs of residents by means of care planning, internal audits and tuition; and an ombudsman for residents. Only four articles described controlled studies. The selected articles were grouped according to five focal areas of quality. The opinion of residents was seldom used to evaluate the effectiveness of quality systems. The effects on care processes and the health outcomes of long term care residents were inconsistent, but there was some evidence from the controlled studies that specific training and guidelines can influence the outcomes at the patient level. CONCLUSIONS:The design of most of the studies meant that it was not possible to attribute the results entirely to the newly implemented quality system. As it is difficult in practice to design a randomised controlled study, future research into the effectiveness of quality systems should not only focus on selected correlates of quality, but should also include a qualitative and quantitative (multivariate and multilevel) approach. The methods used to measure quality need to be improved.     

Occupational voice disorders due to workplace exposure to irritants--a review of the literature

The medical literature contains relatively few examples of reports of voice disorders that could be attributed to chemical exposure at work. General medical conditions such as gastro-oesophageal reflux and the use of medication such as inhaled steroids are well-recognized causes of laryngitis, but the occupational causes are less well documented. This paper describes the results of a literature review looking at the reporting of cases of occupationally acquired voice disorders due to exposure to irritants in the workplace.     

The teaching of biosafety in undergraduate nursing: a literature review

It's a study that made a scientific production survey in nursing regarding to biosafety teaching aiming to investigate its context and discover the content of publishing on biosafety teaching in the nursing undergraduation. It was analyzed the journal articles found consulting LILACS, SciELO, MEDLINE, BDENF, DEDALUS and PERIENF databases, identifying 26 articles. The results found provided the creation and discussion of these categories: "Ideological and theoretical bases", "Historic approach of biosafety", "Occupational risks and AIDS" and "Biosafety education in graduation". It was concluded that the number of articles is small, mainly the ones focusing on biosafety teaching, but there was an evolution of this content in the last years.     

Medical management of radiation injuries: current approaches

The current approach to medical management of irradiated patients begins with early diagnosis of radiation injury. Medical assessment of radiation dose is based on event history, symptomatology and laboratory results, with emphasis on time to emesis and lymphocyte depletion kinetics. Dose assessment provides a basis for early use of haematopoietic growth factors that can shorten the period of neutropaenia for patients with acute radiation syndrome. Assessments of haematopoietic, gastrointestinal and cutaneous syndromes have improved in recent years, but treatment options remain limited. Selected examples of current developments are presented.     

Nutritional management of stroke: from current evidence to conjecture

Summary   Stroke is a leading cause of death and adult disability in the Western world. Diet is an important consideration as there is evidence that around half of stroke patients are undernourished on admission to hospital and their nutritional status often declines during the hospital stay. Undernutrition is associated with both increased morbidity and mortality. There have been many studies that have looked at various aspects of feeding in stroke patients, and guidelines are available for clinicians and healthcare workers involved in the care of stroke patients. The present paper aims to review current evidence underpinning guidelines on nutritional management of stroke patients, identify potential barriers to implementation and highlight areas for future research.     

Low back pain interventions at the workplace: a systematic literature review

OBJECTIVE: To assess the effect of controlled workplace interventions on low back pain (LBP) through a review of controlled studies. The rising costs of employees with LBP have resulted in an abundance of offers to society and organizations of interventions to prevent and/or treat the problem. Little is known of the effect of the different interventions. METHODS: A systematic literature search based on the inclusion criteria: controlled trial, work setting and assessment of at least one of the four main outcome measures: sick leave; costs; new episodes of LBP; and pain. Effect of the interventions was reported for the four main outcome measures. RESULTS: Thirty-one publications from 28 interventions were found to comply with the inclusion criteria. Exercise interventions to prevent LBP among employees and interventions to treat employees with LBP have documented an effect on sick leave, costs and new episodes of LBP. Multidisciplinary interventions have documented an effect on the level of pain. CONCLUSIONS: The results show that there is good reason to be careful when considering interventions aiming to prevent LBP among employees. Of all the workplace interventions only exercise and the comprehensive multidisciplinary and treatment interventions have a documented effect on LBP. There is a need for studies employing good methodology.     

A systematic review of the effectiveness of health promotion interventions in the workplace

The aim of this study was to identify and critically review evaluations of the effectiveness of health promotion programmes in the workplace. In line with guidelines for 'good practice' within the literature on workplace health promotion, this study aimed to assess the extent to which evaluated interventions considered employees' expressed needs or involved employee-employer partnerships. Overall, 110 outcome evaluations were located. Only a quarter of these reported that interventions were implemented in response to the explicit needs and/or views of the employees and very few involved partnerships. Most of the programmes targeted individual behaviour and supportive organizational change was limited. The majority of the outcome evaluations were not sufficiently rigorous to make a strong case for the effectiveness of workplace health promotion. However, some pointers to success were identified. It was concluded that there seems to be a wide disparity between what counts as 'good practice' within workplace health promotion and what is reported in the evaluation of effectiveness literature. This is not to say that 'good practice' does not exist, but that either such programmes are not rigorously evaluated for their effectiveness and/or that many of the evaluation findings remain outside the public domain.     

Team work in nursing: systematic literature review

The comprehension of the real meaning of team is fundamental, and even necessary for a good and efficient quality in healthcare with, requiring collective involvement of the nursing team. The present article aims to identify and to analyze the national scientific production in Nursing area about team work over the period from 1992 to 2002. It is a literature review proceeded using seven nursing journals. Twenty-four articles concerning the subject were identified and analyzed, with major occurrence in the year of 1997. In the remaining years production is linear and less expressive regarding to publication by year. The issue most emphazised by authors as an estrategic tool and essential in team interaction, was communication.