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We systematically reviewed the association of ambient air pollution with blood pressure (BP) as a primary outcome in adolescents (10-19 years). Five databases (Ovid Medline, Ovid Embase, Web of Science, The Cochrane Library, and LILACS) were searched for relevant articles published up to August 2022. Meta-analyses were conducted using STATA v17 (Protocol - OSF Registries https://doi.org/10.17605/OSF.IO/96G5Q). Eight studies (5 cohort, 3 cross-sectional) with approximately 15,000 adolescents were included. Data from 6 studies were suitable for inclusion in the meta-analyses. In sub-group analyses, non-significant positive associations were observed for cohort studies assessing long-term exposure to PM

BACKGROUND: The legacies of colonization and of policies of forced assimilation continue to be a cause of intergenerational trauma, manifested through feelings of marginality, depression, anxiety and confusion, which place indigenous peoples at increased risk of suicide. OBJECTIVES: To assess the quality, content, delivery and effectiveness of interventions for preventing suicides among indigenous adolescents. DESIGN AND SETTING: Systematic review conducted with Cochrane methodology, Campo Grande, Mato Grosso do Sul, Brazil. METHODS: The Cochrane library, MEDLINE, EMBASE, CINAHL, LILACS and PsycINFO databases were searched for studies published up to February 2021. The following inclusion criteria were used: published in any language; interventions that aimed to prevent suicides among indigenous adolescents; randomized or non-randomized study with a control or comparative group; and validated measurements of mental health problems. RESULTS: Two studies were identified: one on adolescents in the remote Yup’ik community in south-western Alaska, and the other on Zuni adolescents in New Mexico. Both studies showed evidence of effectiveness in interventions for reducing some of the risk factors and increasing some of the protective factors associated with suicide. High levels of community engagement and culture-centeredness were key anchors of both studies, which ensured that the intervention content, delivery and outcome measurements aligned with the beliefs and practices of the communities. Both studies were judged to have a moderate risk of bias, with biases in sample selection, attrition and inadequate reporting of results. CONCLUSIONS: The current evidence base is small but signaled the value of culturally appropriate interventions for prevention of suicide among indigenous adolescents. REGISTRATION DETAILS: The study protocol is registered in the international prospective register of systematic reviews (PROSPERO); no. CRD42019141754.

Background/objectives The detection of dental caries in the early stages, particularly on the occlusal surfaces, has become a mainstay of contemporary clinical practice. The objective of the study was to verify the accuracy of laser fluorescence (LF) for caries detection. Methods A comprehensive search of the MEDLINE (PubMed), EMBase, Cochrane Central Register of Controlled Trials, IBECS, BIOSIS, Web of Science, SCOPUS, Congress Abstracts and Grey literature databases was undertaken from 1980 through January 2016. We included cross-sectional studies that evaluated laser fluorescence in caries diagnoses in vitro and compared them with histological analyses. Results A total of 39 articles were included in the meta-analysis, which included 2082 caries sites. The pooled sensitivity was 0.71 (0.69, 0.73), and the specificity was 0.81 (0.73, 0.82). The DOR was 14.93 (11.2, 19.9). A summary receiver operating characteristic curve (SROC) was constructed. The area under the curve was 0.865. Conclusion This meta-analysis showed that LF in vitro had the ability to diagnose occlusal caries lesions in permanent teeth and enamel and dentin caries. This article is protected by copyright. All rights reserved

Testing Treatments is a book written to help everyone understand why testing treatments is so important, why treatment tests have to be fair, and how everyone can help to promote better research for better health care. The book proved to be very popular and its second edition has already been translated into a dozen languages, with more translations in the pipeline. The texts of the original English and all the translations are feely downloadable from Testing Treatments interactive at www.testingtreatments.org. The editors of all the different language websites have established an TTi Editorial Alliance, to share experiences and provide each other with mutual support. The TTi Editorial Alliance seeks to promote a world in which health professionals, patients and the public use reliable research to inform their health decisions. Its missions are (i) To promote a global network, involving members of the public in partnership with professionals, to communicate and discuss basic principles and general knowledge about testing treatments; (ii) to help the public increase critical thinking and skills in accessing, apprehending, appraising and using research evidence; and (iii) to help patients and the public to participate more actively in health research.

To compare the efficacy of cardiovascular training (CT) with resistance training (RT) in improving the health-related quality of life (HRQoL) and physical function of patients with systemic lupus erythematosus (SLE).A randomized controlled trial was conducted with participants randomly allocated to either a CT (n = 21), RT (n = 21), or control group (n = 21). The outcomes assessed were: HRQoL using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), severity of depression using the Beck Depression Inventory (BDI), disease activity using the SLE Disease Activity Index (SLEDAI), and aerobic capacity using a 12-minute walk test (T12).Sixty-three patients (61 women and two men), aged 42.9 ± 14.4 years, with a mean body mass index (BMI) of 28.7 ± 10.6 kg/m(2), disease duration of 3.8 ± 3.3 years, and not physically active participated in the study. HRQoL improved for both exercise groups but was superior in the RT group. There was no significant difference in physical function between the intervention groups, except for aerobic capacity. Neither training programme was associated with a change in disease activity.Exercise intervention proved to be better than not exercising. CT was better than RT in improving HRQoL.

CONTEXTO E OBJETIVO: A tomada de decisão em saúde é complexa e deve envolver o profissional de saúde, o paciente e a evidência de melhor nível. A velocidade de geração da informação cria barreiras para manter-se atualizado. Diante disso, metodologistas propuseram um novo tipo de estudo, as overviews de revisões sistemáticas (OoRs). O objetivo é introduzir e demonstrar o papel das OoRs na síntese de informações para profissionais da área da saúde, gestores, pesquisadores e pacientes. TIPO DE ESTUDO E LOCAL: Estudo de série temporal realizado no Centro Cochrane do Brasil, em conjunto com o Programa de Pós-Graduação em Medicina Interna e Terapêutica da Disciplina de Medicina de Urgência e Medicina Baseada em Evidências do Departamento de Medicina da Universidade Federal de São Paulo (UNIFESP). MÉTODOS: Para mostrar o crescimento das publicações que fornecem evidência com alto nível e assim justificar a importância das OoRs na síntese e integração das informações, três filtros para desenhos de estudos foram aplicados em duas bases de dados. Uma equação de predição do número esperado de publicações foi desenvolvida e aplicada. RESULTADOS: Na presente década, o número de ensaios clínicos randomizados no Medline poderá chegar a 2.863.203 e o número de revisões sistemáticas poderá chegar a 174.262. Nove OoRs e 15 protocolos de OoRs foram publicados na Biblioteca Cochrane. CONCLUSÕES: Com o crescimento exponencial das publicações, demonstrado neste estudo, um novo tipo de estudo, direcionado especialmente aos decisores em saúde, foi proposto, a OoRs, o qual poderá reduzir incertezas para a tomada de decisão e gerar uma nova hierarquia na pirâmide de evidências. CONTEXT AND OBJECTIVE: Healthcare decision-making is complex and should involve healthcare professionals, patients and the best level of evidence. The speed of information production creates barriers against keeping up to date. In this light, methodologists have proposed a new type of study: overviews of systematic reviews (OoRs). The aim here was to introduce and demonstrate the role of OoRs in information synthesis for healthcare professionals, managers, researchers and patients. DESIGN AND SETTING: Time-series study conducted at the Brazilian Cochrane Center, jointly with the Postgraduate Program on Internal Medicine and Therapeutics, Discipline of Emergency Medicine and Evidence-Based Medicine, Department of Medicine, Federal University of São Paulo. METHODS: To show the growth in the numbers of published papers that provide high-level evidence and thus demonstrate the importance of OoRs for synthesis and integration of information, three filters for study designs were applied to two databases. An equation for predicting the expected number of published papers was developed and applied. RESULTS: Over the present decade, the number of randomized controlled trials in Medline might reach 2,863,203 and the number of systematic reviews might reach 174,262. Nine OoRs and 15 OoRs protocols have been published in the Cochrane Library. CONCLUSIONS: With the exponential growth of published papers, as shown in this study, a new type of study directed especially towards healthcare decision-makers was proposed, named overview of systematic reviews. This could reduce the uncertainties in decision-making and generate a new hierarchy in the pyramid of evidence. Federal University of São Paulo Program on Internal Medicine and Therapeutics Brazilian Cochrane Centre Brazilian Cochrane Centre Itapeva Social and Agrarian Sciences College EPM-UNIFESP Federal University of São Paulo UNIFESP, Program on Internal Medicine and Therapeutics EPM-UNIFESP SciELO