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The purpose of this article is to develop a theoretical framework that identifies the intangible aspects that can be managed and contribute to the value creation for organizations. The theoretical framework was developed based on a systematic review performed according to a protocol that proposes steps to identify the intangible aspects present in the scientific literature. Mendeley software assisted in organizing and reading the 3152 articles identified by the systematic review. The results of the article propose a classification of intangible aspects identified in levels that collaborate with the value creation in organizations. The first and main group being called FPVs, encompassing: reputation, innovation, performance, legitimacy, and knowledge. Strategically, the FPVs are subdivided into 15 CSFs, that cover the other 35 intangibles perceived in the studies, called Indicators and that can be managed. The results of the article provide theoretical and managerial implications and can be used by the academic community and by managers of industrial organizations. The results present reflections on how intangible aspects are present in research and the management of organizations. Furthermore, the literature review proves the importance of analyzing and monitoring intangible aspects nowadays.
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Background: With increasing healthcare service utilization and the introduction of costly therapies, healthcare organizations are pressured to deliver cost-effective services within constrained budgets. Rising costs and the need for efficient healthcare delivery are major concerns for governments, insurers, and health plans. Objectives: It aims to understand the impact of these intangible assets on creating value and organizational resilience in healthcare, informing better practices and strategies for VBHC implementation. Methods: An applied research approach using the Work Breakdown Structure (WBS) methodology was adopted. The research was divided into seven interconnected Work Packages (WPs), each designed to investigate different aspects of the integration between VBHC and intangible assets, with a focus on enhancing organizational resilience through innovative health processes. Key methodologies included literature reviews and qualitative analyses, employing Open Innovation and Design Thinking. Results: The study revealed a dynamic interplay between VBHC, organizational resilience, and intangible assets. It showed that managerial effectiveness is influenced by direct patient outcomes and elements like intellectual capital and organizational reputation. Data integration from various Work Packages provided new insights into how intangible assets underpin VBHC strategies, proposing novel management approaches. Findings highlight the essential role of intangible assets in enhancing service delivery and fostering sustainable healthcare practices. Discussion: The study highlights a significant oversight in the integration of intangible assets within healthcare organizations, despite their crucial role in optimizing VBHC. It supports literature emphasizing the importance of intellectual capital and organizational culture in enhancing healthcare management efficiency and resilience. A paradigm shift in VBHC to include these assets is needed for building a more adaptable and sustainable healthcare system. This integration can lead to better clinical outcomes, patient satisfaction, and overall healthcare efficiency, aligning more closely with VBHC goals. Conclusion: Recognizing and effectively managing intangible assets are paramount for the successful implementation of VBHC and enhanced organizational resilience. Strategic integration of these assets into healthcare management practices can significantly improve patient outcomes and create a more sustainable, patient-centered, and resilient healthcare system. Future studies should develop methodologies for robust measurement and integration of these assets to fully realize the potential of VBHC.
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Background: Carbon dioxide (CO2), traditionally viewed as a mere byproduct of cellular respiration, plays a multifaceted role in human physiology beyond simple elimination through respiration. CO2 may regulate the tumor microenvironment by significantly affecting the release of oxygen (O2) to tissues through the Bohr effect and by modulating blood pH and vasodilation. Previous studies suggest hypercapnia (elevated CO2 levels) might trigger optimized cellular mechanisms with potential therapeutic benefits. The role of CO2 in cellular stress conditions within tumor environments and its impact on O2 utilization offers a new investigative area in oncology. Objectives: This study aims to explore CO2's role in the tumor environment, particularly how its physiological properties and adaptive responses can influence therapeutic strategies. Methods: By applying a structured translational approach using the Work Breakdown Structure method, the study divided the analysis into six interconnected work packages to comprehensively analyze the interactions between carbon dioxide and the tumor microenvironment. Methods included systematic literature reviews, data analyses, data integration for identifying critical success factors and exploring extracellular environment modulation. The research used SMART criteria for assessing innovation and the applicability of results. Results: The research revealed that the human body's adaptability to hypercapnic conditions could potentially inform innovative strategies for manipulating the tumor microenvironment. This could enhance O2 utilization efficiency and manage adaptive responses to cellular stress. The study proposed that carbon dioxide's hormetic potential could induce beneficial responses in the tumor microenvironment, prompting clinical protocols for experimental validation. The research underscored the importance of pH regulation, emphasizing CO2 and carbonic acid's role in modulating metabolic and signaling pathways related to cancer. Conclusion: The study underscores CO2 as vital to our physiology and suggests potential therapeutic uses within the tumor microenvironment. pH modulation and cellular oxygenation optimization via CO2 manipulation could offer innovative strategies to enhance existing cancer therapies. These findings encourage further exploration of CO2's therapeutic potential. Future research should focus on experimental validation and exploration of clinical applications, emphasizing the need for interdisciplinary and collaborative approaches to tackle current challenges in cancer treatment.
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Os autores apresentam as correlações do estresse com a patogênese de várias doenças. Antes, expõem os aspectos fundamentais da Psiconeuroimunologia, para uma compreensão das interconexões no complexo microambiente onde ocorrem as influências do estresse. Concluem que, apesar de todas as implicações do estresse na desestruturação da homeostasia imunológica ainda não estarem completamente definidas, e das limitações metodológicas, há consenso de que fatores estressantes propiciam a vulnerabilidade do organismo a determinadas doenças.
The authors introduce the correlations between stress and the pathogenesis of various diseases. Previously, they expose the fundamental factors of Psychoneuroimmunology for the comprehension of the inter-connections in the complex microenvoironment where the influence of stress occurs. They conclude that despite all the implications of stress on the desestruturation of immunologic homeostasy are not already completely defined and despite metodologic limitations, there are a consensus that stressor factors provide vulnerability to the organism concerned to certain disorders.
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Humanos , Masculino , Feminino , Estresse Psicológico/complicações , Estresse Psicológico/fisiopatologia , Estresse Psicológico/imunologia , Transtornos Psicofisiológicos/fisiopatologia , Transtornos Psicofisiológicos/imunologia , Transtornos Psicofisiológicos/terapia , Depressão/imunologia , Depressão/psicologia , Neuroimunomodulação , Sistema Imunitário/fisiopatologia , Transtornos Somatoformes/classificaçãoRESUMO
Durante as duas últimas décadas, têm sido ressaltados os problemas somáticos, psíquicos e sociais de pacientes com câncer, bem como têm sido focalizadas, no âmbito do estudo oncológico, as teorias biopsicossociais e psiconeuroimunológicas. O presente trabalho apresenta consideraçöes clínicas sobre esses aspectos, ressaltando-se o impacto que o câncer provoca sobre os pacientes e seus familiares. O câncer e seus tratamentos constituem uma fonte de estresse, capaz de desencadear desordens de ajustamento nestes indivíduos. A mensuraçäo da qualidade de vida deve ser incorporada aos estudos clínicos, porque a sua inclusäo tende a melhorar as indicaçöes terapêuticas. Os relatos de pacientes sobre sintomas somáticos säo associados, principalmente, às suas preocupaçöes emocionais e sociais mais do que ao seu estado geral de saúde. A equipe responsável pelos pacientes deve compreender a dinâmica envolvida no binômio família-paciente e conhecer a influência que os fatores psicossociais exercem sobre ele. A falha do reconhecimento dessa influência e, conseqüentemente, o prejuízo provocado no suporte psicossocial da família iräo privar os pacientes do conforto, amor, suporte e companheirismo de que eles precisarÝo através do curso da sua doença. Os médicos devem ser capazes de identificar e estimular circunstâncias que facilitem o processo de adaptaçäo de seus pacientes. O tratamento psicológico, em pelo menos alguma extensäo, sempre é benéfico.
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Humanos , Masculino , Feminino , Pacientes , Qualidade de Vida , Família , Neoplasias/psicologia , Estresse Psicológico , Acontecimentos que Mudam a VidaRESUMO
Este artigo apresenta noçöes fundamentais sobre o background fisiológico para a compreensäo da interaçäo psiconeuroendocrinológica e enfoca os aspectos biopsicossociais existentes em distúrbios depressivos, respiratórios, reumatológicos e neoplásicos. Aborda de forma crítica as citaçöes bibliográficas, demosntrando os possíveis rumos do estudo da psiconeuroimunologia, que certamente potencializaräo a compreensäo dos aspectos epidemiológicos, clínicos, diagnósticos e neurobiológicos, bem como forneceräo noçöes para novas opçöes de tratamentos. Terapias alternativas (hipnose, relaxamento, condicionamentos clássicos, exercícios, exposiçöes a extressores fóbicos, autoconheciemnto e terapias cognitivo-comportamentais) säo um adjunto para a reduçäo da ansiedade e da depressäo. Existem personalidades com potenciais imunossupressores, os quais säo variáveis e dependentes do grau de adaptaçäo do indivíduo a certos impulsos e temores aos choques emocionais e às agressöes do mundo exterior, e que säo plausíveis de, sob intervençöes terapêuticas coadjuvantes, restabelecer a homeostasia psiconeuroimunológica