The intravaginal probe and the surface electrodes in perianal region are equivalent for healthy nulliparous women. The choice must be done according to the values and preferences of the patient.
Introduction:The pad test is an assessment tool for urinary incontinence (UI) severity classification and therapeutic response monitoring. However, the reliability and reproducibility of this test have been questioned.Objectives: To summarize the evidence regarding the accuracy measures and reproducibility of different pad test protocols for assessing UI. Methods: A systematic review of the diagnostic accuracy of this tool was performed (CRD42020219392). Eligibility criteria: Studies reporting data on the accuracy measures and reproducibility of the pad test when used for detecting UI in adult men and women. Data sources: MEDLINE, Science Direct, Cochrane, Web of Science, LILACS, and Pedro. Data extraction and synthesis: Two reviewers independently screened the articles, extracted the data, and evaluated the risk of bias (RoB) using the QUADAS-2 tool. Results: From 1048 studies, 18 studies were included. Eight of these reported accuracy data, and 12 reported reproducibility properties. A total of 1070 individuals were analyzed, whose mean age ranged from 20 to 90 years. The accuracy of the long-duration protocols was generally moderate to high (sensitivity, 60%-93%; specificity, 60%-84%). The 1-h protocols obtained higher accuracy values. The overall reproducibility was moderate to high (κ ≥ 0.66). Limitations:The RoB was high and, due to different cutoff points adopted by studies, the bivariate model was not satisfied to perform a meta-analysis. Discussion: The 1-h pad test was more accurate but less reproducible when compared to the long-duration tests. Pad test results should be used with caution in clinical practice. K E Y W O R D S data accuracy, exposure, measures of association, reproducibility of results, risk or outcome, severity of illness index
Objective: Handgrip strength (HGS) is an indicator of general muscular strength and in cancer patients acts as a relevant marker associated with mortality and health. This study aimed to evaluate the association between peripheral muscle function and health-related quality of life (HRQoL) in breast cancer (BC) survivors. Methods: Systematic review registered on PROSPERO under number: CRD 42021225206. The searches were carried out on MEDLINE via Pubmed, PEDro, Cochrane Library, Embase, CINAHL via EBSCO and Science Direct databases. Observational studies evaluating the association between handgrip strength (HGS) and HRQoL in adult female BC survivors were included. No linguistic or time restrictions were applied. Two reviewers reviewed full texts for inclusion and performed data extraction and risk of bias using the Newcastle and Ottawa scale (NOS). Results: Five articles were included and involved 587 patients, mean age of 47 to 59 years. The percentage of decreased HGS ranged from 38.3% to 60.3%. HGS was associated with different quality of life measures. From meta-analysis including 220 patients, the correlation coefficient between HGS and HRQoL was 0.26 (95% CI: 0.07-0.35). Conclusions: Breast cancer survivors face decline of HGS. In this population HGS was correlated with HRQoL. However, more evidence are necessary.
OBJETIVO Construir e validar um modelo lógico para a atenção nos Centros Especializados em Reabilitação (CER) a partir da análise do processo de trabalho e de questões organizativas de centros do Rio Grande do Norte. MÉTODOS Estudo metodológico desenvolvido em três etapas: 1) estudo documental de legislações e portarias relacionadas ao serviço de saúde e à Rede de Cuidados à Pessoa com Deficiência (RCPD); 2) realização de grupos focais, com estudo censitário dos CER do Rio Grande do Norte, para compreender e avaliar o cotidiano do serviço; e 3) sistematização das informações coletadas e, por fim, proposição e validação do modelo lógico avaliativo. RESULTADOS O modelo englobou cinco categorias centrais do processo de trabalho e organizacional: “demandas”, “recursos” (insumos, financeiros e força de trabalho), “processos”, “produtos e resultados” e “missão, valores e fatores externos”. CONCLUSÃO O modelo lógico construído foi adequado para representação gráfica do processo de trabalho e questões organizativas dos CER. Evidenciou-se que o funcionamento dos serviços está alinhado com as normativas. Contudo, ainda há lacunas organizacionais que precisam ser abordadas a fim de melhorar a resolutividade do serviço e a articulação com outros pontos da rede.
Purpose To evaluate the sleep quality and its association with disability, fatigue and quality of life of breast cancer survivors. Methods This is a cross‐sectional pilot study developed with breast cancer survivors. The data collection instruments consisted of general and clinical information on the disease and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0); Pittsburgh Sleep Quality Index (PSQI); Functional Assessment of Chronic Illness Therapy‐Fatigue (FACIT‐F); and Disabilities of the arm and Shoulder (DASH). Descriptive statistical analysis, correlation tests, tests for means comparison and linear regression were performed. Cohen's d analysed the effect size. The significance was set at p < 0.05. Results 71,9% of women had poor sleep quality. Subjective poor sleep quality was a predictor of worse scores for fatigue (p = 0.007), quality of life by FACT‐G (p = 0.010) and FACIT‐F (p = 0.004), the functional performance of upper limbs (p = 0.001) and disability (p = 0.003). Conclusions Breast cancer survivors with subjective poor sleep quality had more fatigue, less upper limb‐related functional performance, more disability and worse quality of life.
BACKGROUND: The World Health Organization Disability Assessment Schedule (WHODAS 2.0) is a practical, generic and widely used tool to assess the functioning and disability in several settings and health conditions. Although the use of categorical variables is common, this choice to present data could separate persons with very close functioning profiles into different categories. PURPOSE: This study aims to compare different ways of expressing the WHODAS score and give elements for the researcher to understand and choose the most appropriate way to statistically analyse the WHODAS scores. METHODS: A methodological study with secondary data of one hundred ninety-five women. The WHODAS score was analysed in different ways and associated with sociodemographic characteristics, lifestyle, and health aspects. The Poisson regression was chosen with the final WHODAS score in four variations (continuous, dichotomous, polytomous, and quartiles), and the presence of chronic disease. RESULTS: The analysis showed statistical significance in the univariate analysis for the adjustment variables and all the variations of the disability variable. The distribution analysis of the prevalence ratio and the AIC evidenced that the WHODAS score as a continuous variable had the lower AIC and statistical significance, as well as the most significant area under the ROC curve. CONCLUSIONS: These results show that the use of the continuous variable is the most indicated and that the categorization of the WHODAS score should be avoided.
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