Sweat conductivity diagnostic accuracy for cystic fibrosis: a systematic review and meta-analysis.

OBJECTIVE: We conducted a systematic review and meta-analysis of diagnostic test accuracy studies to summarise the properties of sweat conductivity (SC) to rule in/out cystic fibrosis (CF). DATA SOURCE: We searched PubMed, Embase, Web of Science, Google Scholar, SciELO and LILACS up to 13 March 2023. STUDY SELECTION: We selected prospective and retrospective diagnostic test accuracy studies which compared SC, measured through two well-established and commercially available devices, that is, Nanoduct or Sweat-Chek Analyser, to quantitative measurement of sweat chloride. MAIN OUTCOME MEASURES: Pooled sensitivity, specificity, positive likelihood ratio (+LR) and negative likelihood ratio (-LR), and their corresponding 95% CIs. DATA EXTRACTION AND SYNTHESIS: The Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies guidelines were followed. Data were extracted by one reviewer and checked by another. The hierarchical summary receiver operating characteristics model was used to estimate diagnostic test accuracy. RESULTS: Ten studies involving 8286 participants were included. The pooled estimates of sensitivity, specificity, +LR and -LR were 0.97 (95% CI 0.94 to 0.98), 0.99 (95% CI 0.98 to 0.99), 171 (95% CI 58 to 500) and 0.02 (95% CI 0.01 to 0.05), respectively. Sensitivity analyses did not reveal a substantial impact of study-level factors on the results, such as study quality, cut-off values for a positive test, study sample size and participant age group. The quality of evidence was considered moderate. CONCLUSION: SC demonstrated excellent diagnostic performance. In addition, its accuracy parameters suggest its role as an alternative to the sweat test for CF diagnosis. PROSPERO REGISTRATION NUMBER: CRD42022284504.

Suicidal thought in southern Brazil: Who are the most susceptible?

BACKGROUND: Suicide is one of the leading causes of death among adolescents and young adults worldwide. However, risk factors for suicidal thoughts might change across cultures and contexts. We aimed to assess the prevalence and associated factors of suicidal thought among adults in a southern Brazilian city. METHODS: This population-based cross-sectional study used a multistage sampling procedure to evaluated individuals with 18 years or more, living in a southern city in Brazil. We collected suicidal thought using a question from the Patient Health Questionnaire-9. In addition, we collected information on sociodemographic, behavioral, and health variables, through a questionnaire using standardized and validated instruments. We calculated prevalence ratios (PR) using Poisson Regression models with robust adjustment of the variance. RESULTS: We collected information from 1295 individuals, 6.6% were positive for suicidal thought. In multivariate analysis, factors independently associated with suicidal thoughts included: being a woman, poor, reporting current tobacco use, having household food insecurity, having three or more morbidities, being in the upper tertile of the stress scores, having had a depression diagnostic in the last year and sadness. LIMITATIONS: We cannot say that the associations found are causal. Suicidal thoughts were assessed from a single question. CONCLUSION: Suicidal thought is a prevalent condition, most likely associated with being a woman, having worst socioeconomic conditions, a poorer health, a higher stress, using tobacco and having depression and/or sadness.

Vaccination against influenza among pregnant women in southern Brazil and associated factors / Vacinação contra Influenza entre gestantes no Sul do Brasil e fatores associados

Abstract This article aims to identify the prevalence and factors associated with influenza vaccination in pregnant women. This is a cross-sectional study conducted in a municipality in the southernmost region of Brazil, which included all women giving birth in 2016. The outcome was having received the vaccine against influenza during pregnancy. Sociodemographic, behavioral and prenatal care characteristics and morbidities were analyzed. The analysis included sample description, the prevalence of vaccination for each independent variable and a multivariate analysis. Two thousand six hundred ninety-four pregnant women were interviewed, of which 53.9% reported having been vaccinated. Factors associated with increased prevalence of vaccination were mother's higher schooling, prenatal care, tetanus vaccination and prenatal care performed in a public service. On the other hand, prenatal care onset after the first quarter reduced the prevalence of vaccination. The results point to the need to reinforce the importance of vaccination against influenza among pregnant women and among health professionals, regardless of the severity of the current epidemiological setting.

Resumo O objetivo deste artigo é identificar a prevalência da imunização contra a gripe em mulheres grávidas e seus fatores associados. Estudo transversal realizado em um município no extremo sul do Brasil, que incluiu todas as mulheres que deram à luz no ano de 2016. O desfecho foi ter recebido a vacina contra a gripe durante a gravidez. Características sociodemográficas, comportamentais, do pré-natal e morbidades foram analisadas como fatores associados à vacinação. A análise constou de descrição da amostra, prevalência da vacinação para cada uma das variáveis independentes e análise multivariada. Foram entrevistadas 2.694 parturientes, das quais 53,9% informaram ter recebido a vacina. Os fatores associados a uma maior prevalência de imunização foram: maior escolaridade materna, realização do pré-natal, ter realizado a vacina antitetânica e fazer o pré-natal em um serviço público. Por outro lado, o início do pré-natal após o primeiro trimestre reduziu a prevalência de imunização. Os resultados apontam para a necessidade de reforçar a importância da imunização contra a Influenza entre mulheres grávidas e entre profissionais da saúde, independentemente da gravidade do atual cenário epidemiológico.

Vaccination against influenza among pregnant women in southern Brazil and associated factors.

This article aims to identify the prevalence and factors associated with influenza vaccination in pregnant women. This is a cross-sectional study conducted in a municipality in the southernmost region of Brazil, which included all women giving birth in 2016. The outcome was having received the vaccine against influenza during pregnancy. Sociodemographic, behavioral and prenatal care characteristics and morbidities were analyzed. The analysis included sample description, the prevalence of vaccination for each independent variable and a multivariate analysis. Two thousand six hundred ninety-four pregnant women were interviewed, of which 53.9% reported having been vaccinated. Factors associated with increased prevalence of vaccination were mother's higher schooling, prenatal care, tetanus vaccination and prenatal care performed in a public service. On the other hand, prenatal care onset after the first quarter reduced the prevalence of vaccination. The results point to the need to reinforce the importance of vaccination against influenza among pregnant women and among health professionals, regardless of the severity of the current epidemiological setting.

Eu vivi, ninguém me contou: Educação Popular em estratégia Saúde da Família na beira do Pantanal, Mato Grosso do Sul, Brasil / I have lived it, nobody told me: popular health education in the Family Health Strategy at the borders of Pantanal - Mato Grosso do Sul state, Brazil / Yo lo viví, nadie me contó: educación popular en la estrategia de salud de la familia en las orillas del Pantanal, Mato Grosso do Sul, Brasil

O que motivou a elaboração deste artigo foi a possibilidade de investigar a contribuição da Educação Popular à reorganização da Atenção Primária à Saúde (APS). Realizou-se uma pesquisa qualitativa com usuários e profissionais de uma Unidade de Saúde da Família da área urbana de Rio Negro, Mato Grosso do Sul, Brasil. Os dados foram obtidos por meio de entrevistas, diários de campo, arquivos de fotografias, áudio, vídeo, publicações, relatórios e informações de um blog. A análise dos dados evidenciou evolução no processo de cuidado, humanização das relações entre profissionais e usuários, compreensão do fazer em APS e satisfação profissional, constatando que a Educação Popular é coerente e positiva para a Estratégia Saúde da Família atingir seus pressupostos...

This paper was inspired by the possibility of studying the contributions of Popular Education to the re-organization of Primary Health Care (PHC). A qualitative study was conducted with users and health providers of a Family Health Service in the urban area of Rio Negro, Mato Grosso do Sul state, Brazil. Data was obtained using interviews, field diaries, photo archives, audio, video, publications, reports and blog information. Our findings highlighted an evolution in the health care process, humanization of the relationship between health care providers and patients, as well as in the understanding of providing PHC and professional satisfaction. We concluded that Popular Education is coherent and positive for achieving the objectives of the Family Health Strategy...

Lo que motivó la elaboración de este artículo fue la posibilidad de investigar la contribución de la Educación Popular para la reorganización de la Atención Primaria en Salud (APS). Se realizó un estudio cualitativo con usuarios y funcionarios en una Unidad de Salud de la Familia de la zona urbana de Rio Negro, Mato Grosso do Sul, Brasil. Los datos se obtuvieron por medio de entrevistas, diarios de campo, archivos fotográficos, audio, video, publicaciones, informes e informaciones de un blog. El análisis de los datos mostró una evolución en el proceso de cuidado, humanización de las relaciones entre profesionales y usuarios, así como comprensión del modo de hacer en la APS y satisfacción profesional. Se constató que la influencia de la Educación Popular es coherente y positiva para que la Estrategia de Salud de la Familia pueda lograr sus objetivos...

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