Arlinda Barbosa Moreno

Interobserver reliability of the international classification of primary care at a primary health care unit

We evaluated the International Classification of Primary Care interobserver reliability for coding the complaints reported at a primary public health unit. The study sample consisted of 300 appointments. Reasons for appointment were registered by physicians on the medical record and coding was performed by two investigators. Reliability among the classifiers as to the number of coded reasons was calculated by weighted kappa. Crude kappa coefficients were used for the remaining analyses (chapter codes and full codes). A total of 634 reasons were coded by the first classifier and 699 by the second one. Crude reliability of numbers of reasons was moderate, with a 0.71 weighted kappa (95% Confidence Interval [95%CI]: 0.68-0.73). Regarding chapter codes and full codes, reliability was substantial (kappa = 0.89; 95%CI: 0.87-0.91) and moderate (kappa = 0.72; 95% CI: 0.68-0.76), respectively. Our results suggest a good performance of the Classification for coding reasons for visit in primary care, even when data are obtained from physician consultation notes.

Job strain and binge eating among Brazilian workers participating in the ELSA-Brasil study: does BMI matter?

To assess the association between job strain and binge eating as well as the effect‐modifying influence of body mass index (BMI) on this association.

Saúde global: uma análise sobre as relações entre os processos de globalização e o uso dos indicadores de saúde

O objetivo do trabalho e discutir a construcao da chamada saude global, identificando seus usos politicos e epistemologicos. O uso retorico dos indicadores de saude globais e suas relacoes com os processos de globalizacao sao tratados como analisadores. Realizou-se pesquisa bibliografica e documental, cuja analise partiu de uma perspectiva critica e construcionista da producao de conhecimento e dos processos de globalizacao na saude, tendo como referencia a obra do sociologo Boaventura Santos. Apesar do uso do adjetivo global, o trabalho destacou a disputa politica e epistemologica em curso nas relacoes entre globalizacao e saude, e o uso retorico de indicadores de saude globais para a construcao de politicas para paises pobres e em desenvolvimento. Considerou-se que esta estrategia visa influenciar sistemas nacionais de saude numa perspectiva transcultural e colonizadora, apagando os saberes, as tradicoes e modos de subjetivacao locais.The objective of this paper is to discuss the construction of Global Health, identifying its political and epistemological uses. The rhetorical use of global health indicators and their relations to globalization processes are treated here as analyzers. A bibliographic and documentary research on the subject was performed. The analysis has a critical and constructionist perspective about knowledge production and globalization processes in health, and it is based on the work of the sociologist Boaventura Santos. In spite of the use of the adjective ‘global’, the study highlights the epistemological and political dispute that is in progress in the relations between globalization and health, and the rhetorical use of global health indicators for the construction of policies for poor and developing countries. It is considered that this strategy aims to influence national healthcare systems in a cross-cultural and colonizing perspective that extinguishes local knowledge and traditions, as well as local modes of subjectivity.

Omega 3 Consumption and Anxiety Disorders: A Cross-Sectional Analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Few studies have evaluated the association between diet and mental disorders, and it has been established that ω-3 (n-3) fatty acids may have a beneficial effect for sufferers of anxiety disorders. This study is part of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)—a population-based cohort study on diet and mental health—and searched for associations between anxiety disorders and consumption of n-3 polyunsaturated fatty acids (PUFA). The study had a cross-sectional design, with a total sample of 12,268 adults. Dietary exposure was measured by a quantitative food-frequency questionnaire, and mental diagnoses were assessed by the Clinical Interview Schedule—Revised Version and diagnosed according to the International Classification of Diseases (ICD-10). Logistic regression models were built using quintiles of n-3, ω 6 (n-6), n-6/n-3 ratio, and PUFA, using the 1st quintile as reference. Anxiety disorders were identified in 15.4% of the sample. After adjusting for sociodemographic variables, cardiovascular risk factors, diet variables, and depression, intakes in the 5th quintile were inversely associated with anxiety disorders for EPA (OR = 0.82, 95% CI = 0.69–0.98), DHA (OR = 0.83, 95% CI = 0.69–0.98), and DPA (OR = 0.82, 95% CI = 0.69–0.98). Participants in the fifth quintile of n-6/n-3 ratio had a positive association with anxiety disorders. Although results suggest a possible protective effect of n-3 fatty acids against anxiety, all associations lost significance after adjustment for multiple comparisons.

Global health: an analysis of the relations between the processes of globalization and the use of health indicators

O objetivo do trabalho e discutir a construcao da chamada saude global, identificando seus usos politicos e epistemologicos. O uso retorico dos indicadores de saude globais e suas relacoes com os processos de globalizacao sao tratados como analisadores. Realizou-se pesquisa bibliografica e documental, cuja analise partiu de uma perspectiva critica e construcionista da producao de conhecimento e dos processos de globalizacao na saude, tendo como referencia a obra do sociologo Boaventura Santos. Apesar do uso do adjetivo global, o trabalho destacou a disputa politica e epistemologica em curso nas relacoes entre globalizacao e saude, e o uso retorico de indicadores de saude globais para a construcao de politicas para paises pobres e em desenvolvimento. Considerou-se que esta estrategia visa influenciar sistemas nacionais de saude numa perspectiva transcultural e colonizadora, apagando os saberes, as tradicoes e modos de subjetivacao locais.The objective of this paper is to discuss the construction of Global Health, identifying its political and epistemological uses. The rhetorical use of global health indicators and their relations to globalization processes are treated here as analyzers. A bibliographic and documentary research on the subject was performed. The analysis has a critical and constructionist perspective about knowledge production and globalization processes in health, and it is based on the work of the sociologist Boaventura Santos. In spite of the use of the adjective ‘global’, the study highlights the epistemological and political dispute that is in progress in the relations between globalization and health, and the rhetorical use of global health indicators for the construction of policies for poor and developing countries. It is considered that this strategy aims to influence national healthcare systems in a cross-cultural and colonizing perspective that extinguishes local knowledge and traditions, as well as local modes of subjectivity.

Salud global: un análisis sobre las relaciones entre los procesos de globalización y el uso de los indicadores de salud

O objetivo do trabalho e discutir a construcao da chamada saude global, identificando seus usos politicos e epistemologicos. O uso retorico dos indicadores de saude globais e suas relacoes com os processos de globalizacao sao tratados como analisadores. Realizou-se pesquisa bibliografica e documental, cuja analise partiu de uma perspectiva critica e construcionista da producao de conhecimento e dos processos de globalizacao na saude, tendo como referencia a obra do sociologo Boaventura Santos. Apesar do uso do adjetivo global, o trabalho destacou a disputa politica e epistemologica em curso nas relacoes entre globalizacao e saude, e o uso retorico de indicadores de saude globais para a construcao de politicas para paises pobres e em desenvolvimento. Considerou-se que esta estrategia visa influenciar sistemas nacionais de saude numa perspectiva transcultural e colonizadora, apagando os saberes, as tradicoes e modos de subjetivacao locais.The objective of this paper is to discuss the construction of Global Health, identifying its political and epistemological uses. The rhetorical use of global health indicators and their relations to globalization processes are treated here as analyzers. A bibliographic and documentary research on the subject was performed. The analysis has a critical and constructionist perspective about knowledge production and globalization processes in health, and it is based on the work of the sociologist Boaventura Santos. In spite of the use of the adjective ‘global’, the study highlights the epistemological and political dispute that is in progress in the relations between globalization and health, and the rhetorical use of global health indicators for the construction of policies for poor and developing countries. It is considered that this strategy aims to influence national healthcare systems in a cross-cultural and colonizing perspective that extinguishes local knowledge and traditions, as well as local modes of subjectivity.