Process modeling is an indispensable task in the discipline of Business Process Management. The process models created in this task help its readers in to acquiring a higher comprehension of a process, allowing for the discovery of opportunities for its improvement. However, the comprehension of a process model is not guaranteed, as process modeling is a complex task that depends on the proficiency of the process modeler to avoid the creation of badly designed constructs. Process modeling guidelines are an essential tool in this regard, though they are dispersed across the many studies of the literature and not all of them have empirical evidence validating their effects. In addition to this problem, it is still an open questions if a set of process modeling guidelines makes the process modeling task more challenging and how effective modelers are in using them. It is also unclear how receptive process analysts are to the modeling guidelines. This dissertation presents a systematic literature review we conducted to collect and analyze the modeling guidelines found in the literature. It investigated a total of 520 articles, extracting a total of 45 modeling guidelines spread across 4 different categories. These 45 guidelines were simplified into a set of 20 guidelines, based on their significance to create more comprehensible process models and their practicality. This dissertation also presents the findings of an empirical experiment performed by 13 subjects that compared the results of two process modeling tasks with and without the support of the 20 modeling guidelines presented by the review, in which it was possible to observe that the subjects recognize the usefulness of the guidelines, but find them difficult to understand and use.

OBJETIVO: Comparar a eficácia e a tolerabilidade dos fármacos antiepiléticos (FAE) no tratamento em monoterapia de pacientes com epilepsia focal ou generalizada. MÉTODOS: Uma revisão sistemática foi realizada por meio da busca nas bases de dados eletrônicas Pubmed, Scopus, Web of Science e Cochrane Register of Controlled Trials. Foram incluídos os ensaios clínicos controlados com pacientes com epilepsia, em tratamento com FAE, via oral, em monoterapia, e que avaliaram o número de pacientes que atingiram a remissão das crises epilépticas, que interromperam o tratamento devido à ineficácia terapêutica ou à ocorrência de reações adversas (RAM) intoleráveis. Meta-análises de comparação de múltiplos tratamentos foram realizadas por meio do modelo bayesiano de efeitos randômicos que permitiu o cálculo do Odds Ratio meta-analítico para os FAE estudados. Também foi realizado um ranqueamento da probabilidade de cada FAE ser a melhor opção em eficácia e tolerabilidade. RESULTADOS E CONCLUSÕES: A busca identificou 18874 publicações, no entanto apenas 71 estudos foram selecionados, compreendendo 17555 pacientes com epilepsia. Vinte e nove estudos apresentaram os desfechos de eficácia no tratamento de crises focais, 19 em crises generalizadas e 58 apresentaram dados de tolerabilidade. Nesses estudos, 15 FAE foram avaliados. No tratamento das crises focais, os FAE de nova geração levetiracetam (LEV), lamotrigina (LTG), oxcarbazepina, sultiame e topiramato (TPM) demonstraram possuir eficácia equivalente à carbamazepina (CBZ), clobazam e valproato (VPA). No entanto, a CBZ apresentou o pior perfil de tolerabilidade devido à grande probabilidade do paciente abandonar o tratamento devido à RAM intoleráveis. Quanto ao tratamento das crises generalizadas, a LTG, LEV e TPM são tão eficazes quanto o VPA para o tratamento de crises generalizadas tônico-clônicas, tônicas e clônicas. O VPA e a etosuximida constituem as melhores opções para o tratamento de crises de ausências, enquanto que a LTG mostrou-se menos eficaz. Para o tratamento de crises mioclônicas e espasmos infantis mais ensaios clínicos randomizados são necessários para fornecer boas evidências que possam guiar a decisão clínica dos profissionais de saúde. Dentre os FAE com perfil de eficácia adequado, a LTG destacou-se pela menor probabilidade de manifestar RAM intoleráveis. / OBJECTIVE: To compare the efficacy and tolerability of the antiepileptic drugs (AED) in monotherapy of patients with focal or generalized epilepsy. METHODS: A systematic review was in the Medline/Pubmed, Scopus, Web of Science and Cochrane Register of Controlled Trials databases. We included randomized clinical trials of patients with epilepsy treated with oral monotherapy AED, which evaluated number of patients becoming seizure free at the maintenance treatment period; number of patients which withdrawals from the study because of therapeutic inefficacy and number of patients which withdrawals from the study because of intolerable adverse reaction. Network meta-analyses were performed using Bayesian random effects model. We also carried out a ranking of the probability of each AED be the best option in the efficacy and tolerability outcomes. Sensitivity analyses were conducted in order to check the robustness of the results. RESULTS AND CONCLUSIONS: The research identified 18,874 publications, but only 71 studies were selected, comprising 17555 patients with epilepsy.Twenty-nine trials showed the efficacy outcomes in the treatment of focal seizures, 19 in generalized seizures and 58 showed tolerability data. In the treatment of focal seizures, levetiracetam (LEV), lamotrigine (LTG), oxcarbazepine, sultiame and topiramate (TPM) have demonstrated equivalent efficacy to carbamazepine (CBZ), clobazam and valproate (VPA). LTG, LEV and TPM are as effective as the VPA for the treatment of generalized tonic-clonic, tonic and clonic seizures. VPA and ethosuximide are the best options for the treatment of absence seizures, whereas LTG was less effective. For the treatment of myoclonic seizures and infantile spasms, more randomized clinical trials are needed to provide good evidence to guide the clinical decision of health professionals. Among the AED with adequate efficacy profile, LTG stands out as the AED with the best tolerability profile, suggesting it may be the best option for the treatment of patients with epilepsy.

A necrose pulpar pode ser comumente observada no paciente odontopediátrico que sofreu trauma dentário ou que apresenta profundas lesões de cárie dentária. Sabese que existe uma falta de consonância a cerca de quais sinais são utilizados para o diagnóstico da necrose pulpar em dentes decíduos, o que acarreta em uma literatura carente de estudos que integrem todas as informações a cerca desta patologia. Assim, o objetivo desta revisão sistemática foi realizar um levantamento para compilar e discutir os critérios descritos na literatura para realizar o diagnóstico de necrose pulpar em dentes decíduos. Esta revisão foi realizada seguindo as orientações do \"PRISMA Statement\". A busca para acessar os artigos existentes foi realizada até outubro de 2017 e a base de dados bibliográficos escolhida foi o PubMed. As palavras chaves utilizadas combinaram termos relacionados a crianças, dentição decídua e necrose pulpar. Dois examinadores, de maneira independente, analisaram os critérios de inclusão e de exclusão, sem restrição de idioma, e em casos de divergência um terceiro examinador, considerado expert no assunto, foi consultado para decisão final. Dessa maneira, foram encontrados 1823 artigos, dos quais 401 foram incluídos para leitura na íntegra, restando 59 (14,7%) que compreenderam os estudos de interesse para esta revisão sistemática. A concordância entre os examinadores foi calculada através do teste de Cohen\'s Kappa, resultando em K = 1,0 para a etapa de inclusão e K = 0,97 para a etapa de exclusão. Considerando o objetivo dos estudos encontrados, 49,1% eram estudos de tratamento, no qual a necrose pulpar era abordada como critério de inclusão dos participantes no estudo, seguido de 18,6% trabalhos de levantamento, sendo todos a respeito de trauma dentário. Foi observado que em apenas 13,5% dos artigos a necrose pulpar foi abordada como o desfecho do estudo. Em 95% dos estudos a definição do conceito sobre a necrose pulpar foi fornecida pelos próprios autores. No restante, quando a referência era citada, esta também apresentava a definição de necrose pulpar através dos próprios autores. A respeito da causa da necrose pulpar, foi encontrado que a maioria dos dentes decíduos a apresenta devido a lesões de cárie dental, sendo os molares decíduos os mais afetados. Observou-se que em relação aos critérios utilizados para realizar o diagnóstico da necrose pulpar, 44% dos estudos utilizam os critérios clínicos e radiográficos de maneira conjunta. Foi permitido calcular a ocorrência dos sinais clínicos utilizados em 27,1% dos estudos, dos sinais observados nos exames complementares em 50,8%, e da necrose pulpar em 15,2%. Além disso, permitiu-se identificar sinais e sintomas que foram relacionados com a presença da necrose pulpar em 23,7% dos estudos. Assim, é possível concluir que existe uma combinação de sinais clínicos e radiográficos para realizar o diagnóstico de necrose pulpar em dentes decíduos, destacando-se a presença da fístula em 57,6% dos estudos, e a presença de lesão periapical e/ou lesão de furca em 71,2%. Concluiu-se também que 76,2% dos estudos não utilizam testes pulpares. / Pulpal necrosis may be commonly observed in children that suffered dental trauma or severe caries lesions. It is known that there is a lack of agreement regarding which signs should be used to diagnose pulpal necrosis in primary teeth, leading to a literature in needy of studies that integrate all the information about this disease. Therefore, the aim of this systematic review was to perform a data collection to compile and discuss the criteria described in the literature to perform the diagnose of pulpal necrosis in primary teeth. This systematic review was conducted following the \"PRISMA Statement\". To access the literature a search was conducted through PubMed in order to identify papers published until October 2017. The search strategy combined words related to children, deciduous teeth and pulpal necrosis. Two reviewers, independently, identified the inclusion and exclusion criteria, with no language restriction, and in cases of disagreement a third examiner, considered an expert in the subject, was consulted for the final decision. Therefore, 1823 articles were identified, from them 401 were included for complete scanning, remaining 59 (14.7%) studies that fulfilled the eligibility criteria for this systematic review. The interexaminer agreement was measured through Cohen\'s Kappa Statistic, resulting in K = 1.0 for the inclusion criteria and K= 0.97 for the exclusion criteria. Regarding the aim of the studies that were found, 49.1% were treatment studies, where pulpal necrosis was accessed as inclusion criterion for the participants of the study, followed by 18.6% studies of investigation, all about dental trauma. It was observed that only in 13.5% of the papers pulpal necrosis was approached as the outcome of the study. In 95% of the studies, the definition about the concept of pulpal necrosis was given by the authors themselves. In the remaining studies, when the reference was quoted, it also reported the definition by the authors themselves. Considering the cause of pulpal necrosis, it was found that most of the deciduous teeth were affected by caries lesions and the primary molars were the most affected. It was also observed that related to the criteria for the diagnosis of pulpal necrosis, 44% studies apply clinical and radiographic criteria combined. It was possible to calculate the occurrence of the used clinical signs in 27.1% of the studies, of the signs observed in auxiliary exams in 50,8% and of the pulpal necrosis in 15.2%. Besides, it was possible to identify signs and symptoms that were related to the presence of pulpal necrosis in 23.7% of the studies. Hence, it is possible to conclude that there is a combination of clinical and radiographic signs to perform the diagnosis of pulpal necrosis in primary teeth, highlighting the presence of sinus tract in 57.6% of the studies and the presence of periapical/ interradicular lesion in 71.2%. It was also concluded that in 76.2% of the studies do not use pulp sensibility tests.

A Brucelose é uma zoonose causada por bactérias do gênero Brucella que têm no leite cru, e seus derivados, uma importante via de transmissão para o homem. Considerando a situação endêmica da brucelose no Brasil e que o consumo de queijos fabricados com leite cru é um hábito persistente, torna-se relevante a organização das informações disponíveis para a futura e necessária estimativa do risco associado ao consumo deste tipo de produto. Os dados foram levantados com o uso da Revisão Sistemática de Literatura, sobre os diversos fatores que podem modular a sobrevivência da bactéria no queijo. Os resultados obtidos demonstraram que há poucos dados, especialmente quantitativos, sobre o tema. Forneceram dados qualitativos 16 artigos, dentre estes 4 (totalizando 9 experimentos) foram utilizados para análise quantitativa por meta-análise, pelo método de meta-regressão. Os resultados demonstraram existir influência do tempo de cura sobre a diminuição da população bacteriana, também associada a valores reduzidos de pH e atividade de água. Foram detectadas lacunas de conhecimento relacionadas a dose infectante, a interação deste agente com a microbiota natural do leite e do queijo, e a falta de dados experimentais sobre o comportamento de sobrevivência da Brucella em queijos. A obtenção destes dados poderá facilitar a construção de modelos de predição da sobrevivência deste agente nestes produtos futuramente. / Brucellosis is a zoonosis, caused by a bacterium from the genus Brucella that have in raw milk and dairy products an important route of transmission for man. Considering that bovine brucellosis is endemic in Brazil, and that the consumption of cheeses made with raw milk is a persistent habit, the organization of the available information becomes relevant, for the estimation of the risk associated with the consumption of this type of product in the future. The data were collected using systematic literature review, on the various factors that can modulate the survival of the bacteria in milk and cheese. The results obtained show that there are few data, especially quantitative, on the subject. Qualitative data were provided from 16 articles, 4 of which (9 different lab experiments) were used for quantitative analysis by meta-analysis, using the meta-regression method. The results detected the influence of de curing time on the decrease of the bacterial population, also associated to reduced values of pH and water activity. Knowledge gaps about infectious dose, antagonistic/synergistic interactions from this agent with the natural cheese/milk microbiota and a lack of experimental data about the Brucella survival behavior in cheeses were also detected by this research. The obtaining of these data may facilitate the construction of models for predicting the survival of this agent in these products in the future.

Non-medical prescribers make an increasing contribution to healthcare across the UK yet little is known about influences on their prescribing decision-making. The aim of this programme of research was to explore and describe prescribing decision-making by non-medical prescribers. A two stage programme of research was carried out. Stage 1 was a systematic review of the social and cognitive influences on prescribing decision-making by non-medical prescribers. Despite a paucity of research, various influences on prescribing decision-making were reported including evidence based guidelines, peer support and patient (or parental) relationships and expectations. While confidence and clinical experience as a practitioner were cited as influences, the lack of prescribing experience and aspects of pharmacological knowledge also impacted on prescribing decision-making, resulting in a cautious approach. Stage 2 of the research employed a phenomenological methodology underpinned by the Theoretical Domains Framework of behavioural determinants (TDF). It comprised three phases. In Phase 1, semi-structured interviews with five nurse prescribers and eight pharmacist prescribers in NHS Grampian explored their experiences and perceptions of influences on their prescribing decision-making, and the impact of these influences. Multiple and sometimes contradictory influences were uncovered. Twelve of the fourteen domains of the TDF were found to be influential along with multi-disciplinary working and experience; optimism and reinforcement did not feature. In Phase 2, these participants recorded reflections on prescribing decisions which they considered noteworthy in relation to their practice, and in Phase 3 participants were interviewed about their reflections. Complexity was a feature of many, in the patients’ clinical or social circumstances or in relation to wider concerns. The same 12 domains were found to be influential as were multi-disciplinary working, experience and complexity. This programme of research has produced original findings which it is hoped will impact on the education, training and practice of these increasingly important prescribers.

This thesis sought to explore the phenomenon of discontinuing neuroleptic medication for psychosis. It comprises three standalone papers. Papers one and two have been prepared for submission to journals and in accordance with the journal guidelines. Paper one is a systematic literature review synthesising studies investigating the association between neuroleptic discontinuation and functional outcomes. Databases were systematically searched and thirteen studies were included in the review. Evidence regarding the association between discontinuation from neuroleptic medication and functional outcomes was mixed. Findings are limited by the scarcity of evidence, diversity in the study methods and designs used, and methodological and design quality issues. Paper two is a qualitative study exploring personal accounts of making choices about neuroleptic medication, specifically considering decisions to discontinue. Twelve participants were interviewed and a constructivist grounded theory approach was used to analyse transcripts. The findings suggest that making sense of choices relates to a continuation-discontinuation spectrum and involves three interrelated tasks. The tasks are: forming a personal theory of the need for, and acceptability of, neuroleptic medication; negotiating the challenges of forming alliances with others; and weaving a safety net to safeguard wellbeing. A theoretical model explaining the processes involved in the tasks and the mediating factors is presented and discussed. The clinical implications of the findings are discussed with reference to existing literature. Paper three is not intended for publication and is a critical review of the research process, in which the strengths and weaknesses of the systematic review and empirical study are evaluated. Personal and professional reflections on the experience of conducting a systematic review and an empirical qualitative study are discussed and the implications of the research for future clinical practice and research are considered.

The recent changes in legislation and codes of practice expand the role of the educational psychologist to a wider age range: 0-25. Moreover, surveys suggest an increasing number of children and young people experience difficulties with mental health, including depression. A systematic literature review of what narratives young people use to communicate depression was undertaken in the first paper. Despite an abundance of literature about depression in clinical settings, only eight studies met the inclusion criteria and were incorporated in the synthesis. A number of issues were identified including ways and methods of communicating depression and the impact of normative pressures and gendered experiences. Findings have implications for practitioners working with young people and have been used to develop a tentative framework for effective practice. The second paper reports on qualitative research, adapting a phenomenological approach. The self-selected participant sample (three university students, aged 19-21) had experiences of living with depression. Each participant was interviewed three times, using focused semi-structured interviews. The data were subsequently transcribed and analysed using a framework of Interpretative Phenomenological Analysis (Smith, Flowers & Larkin, 2009). The themes were grouped into superordinate themes and interpreted in the light of researcher's own experiences and knowledge. Two reported themes 'the weariness of the world was upon me' and 'it all fell down to chance' discuss embodied experiences of living with depression and barriers and facilitators to accessing help, which was mostly coincidental. Finally, the third paper discusses evidence-based practice, ways of achieving impact in research, and dissemination of research at individual, organisational and academic level. Overall, the present research suggests that educational psychologists can play an important role in raising awareness of children and young people living with depression, as well as promoting mental health, wellbeing and resilience in a variety of educational settings and amongst practitioners working with children and young people.

Care home admission following acute hospitalisation is a lived reality across Scotland, experienced by over 8,000 people annually. The aim of this thesis was to develop an understanding of new care home admission following acute hospitalisation. Methods and findings from the mixed-methods approach are presented in three parts. Part One: Identifying relevant research - includes a review of quality assessment tools for systematic reviewing; a systematic review and meta-analysis of quantitative data from observational studies of predictors of care home admission from hospital; and a methodological chapter on developing a search filter to improve accessibility of existing research findings supported by the findings of an international survey of care home researchers. The systematic review identified 53 relevant studies from 16 countries comprising a total population of 1,457,881 participants. Quantitative synthesis of the results from 11 of the studies found that increased age (OR 1.02 per year increase; 95%CI 1.00-1.04), female sex (OR 1.41; 95%CI 1.03-1.92), dementia & cognitive impairment (OR 2.14; 95%CI 1.24-3.70) and functional dependency (OR 2.06; 95%CI 1.58-2.69) were all associated with an increased risk of care home admission after hospitalisation. Despite international variation in service provision, only two studies described the model of care provided in the care home setting. The survey identified that there is a lack of shared terminology in the published literature to describe settings for adults who are unable to live independently in their own homes and require care in a long-term institutional setting. A search filter to identify relevant research could help to overcome differences in terminology and improve synthesis of existing research evidence. Part Two: Exploring current clinical practice - reports the findings of a retrospective cohort study of new care home admissions from hospital using case-note review methodology accompanied by findings from inductive thematic analysis of a single dataset from a qualitative case study design exploring the experiences of a patient, their family, and practitioners (n=5). The cohort study (n=100) found a heterogeneous picture with long hospital admissions (range 14-231 days), frequent transfers of care (31% experienced three or more transfers), varied levels of documented assessment and a lack of documented patient involvement in the decision-making processes. The qualitative interviews allowed the patient voice to emerge, alongside the professional and family narrative which dominated case-note documentation. Inductive thematic analysis identified nine major themes exploring how decisions are made to discharge individuals directly into a care home from the acute hospital setting: biography & personality; professional role; family role; limitations in local model of care; ownership of decision; risk; realising preferences; uncertainty of care home admission process; and psychological impact of in-hospital care. Part Three: Harnessing routinely-collected data - includes the challenges of identifying care home residency at admission and discharge from hospital, presenting analysis of the accuracy of Scottish Morbidity Record 1 (SMR01) coding in NHS Fife and the Community Health Index (CHI) Institution Flag in NHS Fife and NHS Tayside. This is followed by a descriptive analysis of the Scottish Care Home Census (2013-16) as a novel social care data source to explore care home admissions from hospital and the methodology for a data linkage study using these data. Identifying care home residents in routine data sources is challenging. In 18,720 admissions to NHS Fife, SMR01 coding had a sensitivity of 86.0% and positive predictive value of 85.8% in identifying care home residents on admission. At discharge the sensitivity was 87.0% and positive predictive value was 84.5%. From a sample of 10,000 records, the CHI Institution Flag had a sensitivity of 58.6% in NHS Fife and 89.3% in NHS Tayside, with positive predictive values of 99.7% and 97.7% respectively. From 2013-16, of 21,368 admissions to care homes in Scotland, 56.7% were admitted from hospital. There was significant regional variation in rates of care home admission from hospital (35.9-64.7%) and proportion of Local Authority funded places provided to admissions from hospital (34.4-73.9%). Those admitted from hospital appeared to be more dependent and sicker than those admitted from home. This thesis has established a series of challenges in how care homes and their residents are identified. It has questioned the adequacy of the evidence to guide practitioners and sought to raise the profile of this vulnerable and complex population and how best to support them in making decisions regarding admission from the acute hospital. It has progressed our understanding of this under-explored area and proposes a programme of future mixed-methods research involving patients, families, practitioners and policy-makers.

Background Dementia has been a global priority for over a decade, with a recognition that it presents a growing challenge for all those directly affected, as well as for health and social care services. For those who are caring for a relative at home, carer burden has been found to be predictive of physical and mental health problems, and can impact on the decision to place a relative in fulltime residential care. Gaining a fuller understanding of factors that impact on caregiver burden may help inform the development of effective interventions for this population. This thesis comprises a systematic review of the literature on individual behavioural and psychological symptoms of dementia (BPSD) and their impact on carer burden, a cross-sectional study of one hundred and ten dementia caregivers, exploring the impact of executive functioning deficits, and potential mediating mechanisms, on carer burden and positive gain, and a development and feasibility study of an Acceptance and Commitment Therapy (ACT) group intervention for dementia caregivers. Systematic Review Twenty-one studies measured the association between at least one individual symptom, or symptom cluster, and carer burden, and are included in the review. All studies found at least one symptom to be significantly associated with burden. However, due to the heterogeneity of studies in this field, there was insufficient evidence to establish whether any symptoms are more closely associated than others. Issues regarding the conceptualisation of burden and measurement of BPSD are highlighted and suggestions for addressing this in future studies proposed. Method One hundred and ten dementia caregivers completed five self-report questionnaires as part of a cross-sectional design, aiming to explore the role of executive functioning deficits, dementia management strategies and experiential avoidance in 2 the development of carer burden and positive gain. Drawing on these findings, a group intervention, based on ACT, was developed and delivered to twenty-three dementia caregivers. Data on attendance, attrition and qualitative feedback was collected as an indication of acceptability, and a quasi-experimental design, involving four pre, post and follow-up measures was employed to provide preliminary data on effectiveness. The measures used in both studies were the Dysexecutive Questionnaire (DEX) (study 1 only), Zarit Burden Interview (ZBI), Positive Aspects of Caregiving Questionnaire (PAC), Dementia Management Strategies Scale (DMSS) and Experiential Avoidance in Caregiving Questionnaire (EACQ). Results & Conclusions In study one, executive functioning deficits were found to account for most variance in burden. The use of negative management strategies and Active Avoidant Behaviour (a subscale of the EACQ), were also associated with higher levels of burden, while positive management strategies were associated with positive gain. The results suggest that management strategies and experiential avoidance could be potential mediating mechanisms in the development of carer burden, and so were targeted in the ACT group intervention in study two. Findings from study two indicate that the group intervention was feasible and acceptable to caregivers, with subjective change reported in understanding of behavioural changes in the care-recipient, ability to handle negative emotions and valued living. Suggestions are made regarding alternative outcome measures for future studies in order to capture participants’ experience more fully, as there was little statistically significant change in this study. Suggestions are also made regarding future directions for the intervention.

Vertebrados exóticos são introduzidos intencionalmente como recurso, como uma alternativa para fins econômicos ou de lazer. Aqueles que se tornam capazes de expandir espontaneamente as novas populações em áreas naturais são conhecidas como invasores e frequentemente estão implicados em efeitos indesejados em populações, comunidades e ecossistemas autóctones. Uma destas espécies é o cervo axis Axis axis, introduzido mundialmente para a caça. Apesar da sua ampla distribuição e utilização, pouco se sabe sobre seus efeitos nas áreas invadidas e em quais regiões esta espécie pode se tornar invasora. Isto dificulta as tomadas de decisão, pois avaliar os efeitos da introdução e prever as áreas em risco de invasão são tarefas fundamentais para estratégias de prevenção, priorização e ações de controle. Assim, esse trabalho teve como objetivos revisar os efeitos do cervo axis em áreas invadidas, utilizando um protocolo de revisão sistemática, e modelar a possível distribuição mundial e regional desta espécie, utilizando variáveis bioclimáticas. Realizamos buscas por estudos sobre efeitos em áreas alóctones em três bancos de dados, utilizando três conjuntos de palavras chaves. Classificamos os estudos que atenderam aos critérios do protocolo segundo o nível de inferência sobre os efeitos em Efeito Demonstrado e Efeito Sugerido. Extraímos os tipos de efeitos relatados e a região de ocorrência. Para a modelagem de distribuição, utilizamos o algoritmo Maxent e variáveis preditoras bioclimáticas. Os pontos de ocorrência utilizados incluem sua distribuição original e três regiões onde a espécie é invasora e das quais foi possível obter ou estimar coordenadas. A revisão sistemática resultou em apenas quatro trabalhos classificados em Efeito Demonstrado, os quais apontam a competição com espécies nativas, alteração da composição florística e faunística e facilitação da entrada de outras espécies invasoras. Os efeitos sugeridos incluem seis trabalhos mostrando a ocorrência de parasitas, um caso de hibridização com outra espécie de cervídeo em cativeiro e um estudo mostrando a degradação das áreas de florestas causada pelo cervo axis em conjunto com outras espécies invasoras. O modelo de distribuição demonstra que amplas extensões da América do Sul, África Central e Sudeste Asiático são suscetíveis à invasão, portanto, nestas áreas deve-se evitar a introdução e controlar a expansão. O sul do Brasil, Uruguai, norte da Argentina e Paraguai são possíveis áreas de ocorrência segundo os modelos bioclimáticos. / Alien vertebrates are intentionally introduced for leisure and economic purposes. Those who become able to expand their populations in the new areas are known as invasive and are often involved in undesirable effects in indigenous populations, communities and ecosystems. The axis deer was introduced worldwide for hunting. Despite its wide distribution and use, little is known about its effects on the invaded areas and regions in which this species can become invasive. This complicates the decision-making because assessing the effects of the introduction and predict areas at risk of invasion are key tasks for prevention strategies, prioritization and control actions. Like this. So, this study aimed to summarize the effects of the axis deer in invaded areas using a systematic review protocol and to model the potential distribution of this species globally and in South America using bioclimatic variables. To summarized the effects we conducted searches for studies on non-native areas in three databases, using three sets of key-words and classified the studies that met the criteria of the protocol according to the level of inference about the effects they investigated. We extracted the types mentioned effects and occurrence region. To model the potential distribution based on bioclimatic variables we used the program Maxent. We used occurrences from the original distribution and three regions where the species is invasive about which geographical coordinates could be obtained or estimated. Four studies demonstrated effects of the axis deer due to competition with native species, changes in the floristic and faunistic composition and facilitation of other invasion processes. Six studies speculated the occurrence of disease transmition, hybridization with other species and difuse degradation of forest areas in combination with other invasive species. The distribution model demonstrated that large extensions of South America, Central Africa and Southeast Asia are susceptible to invasion. In the southern cone of South America Brazil, Uruguay, northern Argentina and Paraguay include extensive areas prone to invasion based on the bioclamatic models.