Commercial enzyme-linked immunosorbent assay versuspolymerase chain reaction for the diagnosis of chronic Chagas disease: a systematic review and meta-analysis

Chronic Chagas disease diagnosis relies on laboratory tests due to its clinical characteristics. The aim of this research was to review commercial enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) diagnostic test performance. Performance of commercial ELISA or PCR for the diagnosis of chronic Chagas disease were systematically searched in PubMed, Scopus, Embase, ISI Web, and LILACS through the bibliography from 1980-2014 and by contact with the manufacturers. The risk of bias was assessed with QUADAS-2. Heterogeneity was estimated with the I2 statistic. Accuracies provided by the manufacturers usually overestimate the accuracy provided by academia. The risk of bias is high in most tests and in most QUADAS dimensions. Heterogeneity is high in either sensitivity, specificity, or both. The evidence regarding commercial ELISA and ELISA-rec sensitivity and specificity indicates that there is overestimation. The current recommendation to use two simultaneous serological tests can be supported by the risk of bias analysis and the amount of heterogeneity but not by the observed accuracies. The usefulness of PCR tests are debatable and health care providers should not order them on a routine basis. PCR may be used in selected cases due to its potential to detect seronegative subjects.

Respiratory syncytial virus seasonality in Brazil: implications for the immunisation policy for at-risk populations

Respiratory syncytial virus (RSV) infection is the leading cause of hospitalisation for respiratory diseases among children under 5 years old. The aim of this study was to analyse RSV seasonality in the five distinct regions of Brazil using time series analysis (wavelet and Fourier series) of the following indicators: monthly positivity of the immunofluorescence reaction for RSV identified by virologic surveillance system, and rate of hospitalisations per bronchiolitis and pneumonia due to RSV in children under 5 years old (codes CID-10 J12.1, J20.5, J21.0 and J21.9). A total of 12,501 samples with 11.6% positivity for RSV (95% confidence interval 11 - 12.2), varying between 7.1 and 21.4% in the five Brazilian regions, was analysed. A strong trend for annual cycles with a stable stationary pattern in the five regions was identified through wavelet analysis of the indicators. The timing of RSV activity by Fourier analysis was similar between the two indicators analysed and showed regional differences. This study reinforces the importance of adjusting the immunisation period for high risk population with the monoclonal antibody palivizumab taking into account regional differences in seasonality of RSV.

Social and commercial entrepreneurship: same, different, or both?

Entrepreneurship has been the engine propelling much of the growth of the business sector as well as a driving force behind the rapid expansion of the social sector. This article offers a comparative analysis of commercial and social entrepreneurship using a prevailing analytical model from commercial entrepreneurship. The analysis highlights key similarities and differences between these two forms of entrepreneurship and presents a framework on how to approach the social entrepreneurial process more systematically and effectively. We explore the implications of this analysis of social entrepreneurship for both practitioners and researchers.

Nursing performance in the policy transfer of directly observed treatment of tuberculosis

Objective Analyzing the policy transfer of directly observed treatment of tuberculosis from the perspective of nursing. Method This is a descriptive study with qualitative approach, which had 10 nurses of the Family Health Strategy in São Paulo as subjects. The interviews were carried out between May and June 2013, and were adopted the technique of thematic content analysis and the referential of policy transfer. Results On the signification of this treatment, are related the senses of disciplinary monitoring, the bond and approximation to the context of patients’ lives. Operationally, nurses, community health agents and nursing technicians stand out as agents of implementation of this policy, developing multiple actions of user embracement. The nurse is evidenced as an educator in health, leader in the family health team, and capable of creating emotional bond with users. Conclusion It was found that the innovations proposed in the treatment are incipient in the daily work of nurses.

The Brazilian policy for reduction of accidents and violence aligns with international perspectives?

The study analyzed The Brazilian Policy for Reduction of Morbidity and Mortality from Accidents and Violence, in the socio-political perspective. We used as a base the chapter “Violence: a global public health problem” from the World Report on Violence and Health. The analysis revealed convergent and divergent elements of the Brazilian Policy in comparison with the international perspectives. We verified that the Brazilian Policy tried to converge to the international policies, however: it emphasizes the health promotion actions, but are limited to the context and behavior of individuals and individual communities; the performance of health professionals is expected without providing more structural investments, as the improvement in work conditions, the increase of financial and material resources; there are few clear definitions of the government and economical sector responsibilities.

Growth and Nutrition of Eucalypt Rooted Cuttings Promoted by Ectomycorrhizal Fungi in Commercial Nurseries

ABSTRACT Ectomycorrhizal fungi (EMF) may improve the adaptation of eucalypts saplings to field conditions and allow more efficient fertilizer use. The effectiveness of EMF inoculum application in promoting fungal colonization, plant growth, nutrient uptake, and the quality of rooted cuttings was evaluated forEucalyptus urophylla under commercial nursery conditions. For inoculated treatments, fertilization of the sapling substrate was reduced by 50 %. The experiment was carried out in a completely randomized design in a 4 × 4 factorial arrangement, wherein the factors were inoculum application rates of 0 (control), 5, 10, and 15 gel beads of calcium alginate containing the vegetative mycelium of Amanita muscaria, Elaphomyces antracinus, Pisolithus microcarpus, andScleroderma areolatum, plus a non-inoculated treatment without fertilization reduction in the substrate (commercial). Ectomycorrhizal fungi increased plant growth and fungal colonization as well as N and K uptake evenly. The best plant growth and fungal colonization were observed for the highest application rate. The greatest growth and fungal colonization and contents of P, N, and K were observed at the 10-bead rate. Plant inoculation with Amanita muscaria, Elaphomyces anthracinus, and Scleroderma areolatum increased P concentrations and contents in a differential manner. The Dickson Quality Index was not affected by the type of fungi or by inoculum application rates. Eucalypt rooted cuttings inoculated with ectomycorrhizal fungi and under half the amount of commercial fertilization had P, N, and K concentrations and contents greater than or equal to those of commercial plants and have high enough quality to be transplanted after 90 days.