Comprehensive Medication Management Services with a Holistic Point of View, a Scoping Review.

Implementing Comprehensive Medication Management (CMM) services uncovered the importance of the totality of the patient's perspective in this process. The holistic approach takes into account the physical, mental and emotional well-being of individuals, as well as their socioeconomic circumstances. The aim of this study was to characterize the scientific evidence associated with CMM services that included this holistic approach. A scoping review was conducted based on Arksey and O'Malley's method. Searches were performed in Google Scholar for papers published between 2010 and 2020 in English, Spanish and Portuguese. Study design, health contexts, sample of patients, results obtained, barriers and facilitators, and the integration of a holistic approach were determined. Two hundred and eighteen papers were evaluated, most of which focused on the implementation of this service through prospective observational studies. A minority of studies reported on a holistic approach, a smaller number examined the effect of social determinants of health, the patient's medication experiences and the pharmacotherapy outcomes from the patient's perspective. Despite the progress achieved, most of the referents do not yet reflect a broader view of the patient's life situation and its relationship to pharmacotherapy and the ways in which the pharmacist implements holistic elements to solve or prevent drug-related problems.

Holistic Integration of Omics Tools for Precision Nutrition in Health and Disease.

The combination of multiple omics approaches has emerged as an innovative holistic scope to provide a more comprehensive view of the molecular and physiological events underlying human diseases (including obesity, dyslipidemias, fatty liver, insulin resistance, and inflammation), as well as for elucidating unique and specific metabolic phenotypes. These omics technologies include genomics (polymorphisms and other structural genetic variants), epigenomics (DNA methylation, histone modifications, long non-coding RNA, telomere length), metagenomics (gut microbiota composition, enterotypes), transcriptomics (RNA expression patterns), proteomics (protein quantities), and metabolomics (metabolite profiles), as well as interactions with dietary/nutritional factors. Although more evidence is still necessary, it is expected that the incorporation of integrative omics could be useful not only for risk prediction and early diagnosis but also for guiding tailored dietary treatments and prognosis schemes. Some challenges include ethical and regulatory issues, the lack of robust and reproducible results due to methodological aspects, the high cost of omics methodologies, and high-dimensional data analyses and interpretation. In this review, we provide examples of system biology studies using multi-omics methodologies to unravel novel insights into the mechanisms and pathways connecting the genotype to clinically relevant traits and therapy outcomes for precision nutrition applications in health and disease.

Holistic or sequential approach to curriculum: what works best for young children? / Enfoque holístico o secuencial curricular: ¿cuál es más efectivo con los niños? / As aproximações holística ou seqüencial para o curriculum: qual é a melhor para as crianças?

In this article two approaches to constructing a curriculum for young children are considered: the Holistic approach and the Sequential approach. In both constructs all developmental areas are included in a longitudinal line of development for children aged three to six. In the Holistic approach all of the developmental areas are integrated around a unifying theme to which all of the activities are connected. It is a horizontal approach with no hierarchy in difficulty or complexity. In the Sequential approach each developmental area is considered separately with no relationship to the other areas. It is a vertical approach with a distinct order of difficulty and complexity. Which approach is most effective for the optimal development of young children? Which approach is structured in a way that is most natural for children and provides for both the development of children’s self regulation and optimal stimulation of learning by the teacher? It is concluded that the holistic approach works best with a sequential framework as structuring principle. Both holistic approach and sequential framework are applied in the Pyramid Method (Van Kuyk, 2003, 2009). Research makes clear that this approach works in practice.

En este artículo se consideran dos enfoques respecto a la construcción de un curriculum para los niños: el Enfoque Holístico y el Enfoque Secuencial. En ambos constructos, se incluyen todas las áreas del desarrollo mediante una proyección longitudinal del desarrollo de los niños con edades entre los tres y los seis años. En el Enfoque Holístico se integran todas las áreas del desarrollo en torno a un tema unificador al cual se hallan conectadas todas las actividades. Este enfoque constituye una aproximación horizontal no jerárquica en lo concerniente a complejidad o dificultad. En el Enfoque Secuencial, se considera cada área del desarrollo de manera separada y sin ninguna referencia respecto a las otras áreas. Es una aproximación vertical con un orden diferente de dificultad y de complejidad. Cuál enfoque es el más efectivo para el desarrollo óptimo de los niños? Qué enfoque se halla estructurado de tal manera que sea el más natural para los niños y contribuya tanto al desarrollo de la auto-regulación de los niños como de la estimulación óptima del aprendizaje por parte del profesor? Se concluye que el Enfoque Holístico funciona mejor con un marco secuencial como su principio estructurador. Tanto el Enfoque Holístico como el Enfoque Secuencial se aplican en el Método Piramidal (Van Kuyk, 2003, 2009). La investigación explica que este enfoque funciona en la práctica.

Duas aproximações respeito à construção do curriculum para as crianças são consideradas neste artigo: as Aproximações tanto Holística como Seqüencial. Todas as áreas do desenvolvimento são incluídas numa linha longitudinal de desenvolvimento para crianças com idades entre três e seis anos em ambos construtos. Na Aproximação Holística, todas as áreas do desenvolvimento são integradas em redor de um tema unificador ao qual estão conectadas todas as atividades pertinentes. É uma aproximação horizontal sem nenhuma hierarquia de dificuldade ou complexidade. Na Aproximação Seqüencial, cada área de desenvolvimento é considerada separadamente e sem nenhuma relação com as outras áreas. É uma aproximação vertical com uma ordem diferente de dificuldade e complexidade. Qual aproximação é a mais efetiva para o melhor desenvolvimento das crianças? Qual aproximação está estruturada de modo que seja muito natural para as crianças e forneça uma estimulação ótima da aprendizagem pela parte do professor para o desenvolvimento de auto-regulaçao das crianças. Se conclui que a Aproximação Holística é mais efetiva com um quadro seqüencial como o seu principio estruturador. Tanto o quadro holístico como o seqüencial são aplicados no Método da Pirâmide (Van Kuyk, 2003, 2009). A pesquisa clarifica que esta aproximação funciona na pratica.