Karina Araújo Pinto

Afericoes e exames clinicos realizados nos participantes do ELSA-Brasil

The article describes assessments and measurements performed in the Brazilian Longitudinal Study for Adult Health (ELSA-Brasil). Some assessments including anthropometric assessment, casual blood pressure measurement, and ankle-brachial index have an established clinical application while others including pulse wave velocity, heart rate variability, and carotid intima-media thickness have no established application and do not have reference values for healthy Brazilian population but may be important predictors of cardiovascular outcomes. Blood pressure measurement following postural change maneuver was included in the ELSA-Brasil because it has not been much tested in epidemiological studies. Innovative approaches were developed for assessing the ankle-brachial index using an automatic device instead of the mercury column to measure blood pressure and for assessing the anterior-posterior diameter of the right lobe of the liver by ultrasound for quantitative assessment of nonalcoholic fatty liver disease. All ELSA-Brasil subjects were younger (35 years or more) than those included in other cohorts studying subclinical atherosclerosis. The inclusion of younger individuals and a variety of assessments make the ELSA-Brasil a relevant epidemiology study nationwide and worldwide.

A prática da enfermeira em auditoria em saúde.

El objetivo de la investigacion es conocer la practica de la enfermera en la auditoria de salud. La concepcion de analisis adoptada fue la de la hermeneutica-dialectica, y se desarrollo en tres locales: la auditoria interna de una organizacion hospitalaria, la auditoria externa de un comprador privado de servicios de salud y el sistema de auditoria del ambito estatal del Sistema Unico de Salud (SUS) en Bahia, Brasil. Fueron entrevistadas nueve enfermeras auditoras. En la auditoria del SUS, las enfermeras expresaron satisfaccion en el ejercicio de esta practica y en la valorizacion de su papel profesional. En la auditoria privada - interna y externa a las organizaciones de salud - las acciones de las enfermeras estan dirigidas a atender los intereses de sus contratantes, y poco se relacionan con la asistencia prestada por el equipo de enfermeria y con las necesidades de los usuarios de los servicios.

Nurses' practice in health audit

El objetivo de la investigacion es conocer la practica de la enfermera en la auditoria de salud. La concepcion de analisis adoptada fue la de la hermeneutica-dialectica, y se desarrollo en tres locales: la auditoria interna de una organizacion hospitalaria, la auditoria externa de un comprador privado de servicios de salud y el sistema de auditoria del ambito estatal del Sistema Unico de Salud (SUS) en Bahia, Brasil. Fueron entrevistadas nueve enfermeras auditoras. En la auditoria del SUS, las enfermeras expresaron satisfaccion en el ejercicio de esta practica y en la valorizacion de su papel profesional. En la auditoria privada - interna y externa a las organizaciones de salud - las acciones de las enfermeras estan dirigidas a atender los intereses de sus contratantes, y poco se relacionan con la asistencia prestada por el equipo de enfermeria y con las necesidades de los usuarios de los servicios.

Conflito trabalho-família e uso do tempo: avaliação psicométrica de um instrumento no ELSA-Brasil

ABSTRACT In this study, we evaluated the psychometric properties of the items to measure the work-family conflict and the time use for personal care and leisure, included in the baseline questionnaire of the Longitudinal Study of Adult Health (ELSA-Brazil). We evaluated temporal stability (7-14 days) using kappa statistic and the validity of the construct by the correlation of Kendall’s tau with other variables. Test-retest stability was discreet to moderate and the correlations were compatible with the underlying theory. Future studies in the context of ELSA-Brazil and in other populations will complement the assessment of its relevance.

Gender, time use and overweight and obesity in adults: Results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Perceived time constraints have been highlighted in sociological studies as representing a core issue in determining quality of life. The objective of this study was to test the hypothesis that gender inequalities regarding insufficiency of time play a role in the development of overweight and obesity in adults. The study used baseline data (2008–2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), which monitors a cohort of 15,105 civil servants of 35 to 74 years of age. Insufficient time for personal care and leisure due to professional and domestic duties, as detailed in a structured questionnaire, comprised the main exposure variable. The outcome variable was overweight/obesity measured according to body mass index. Prevalence ratios were calculated using multinomial logistic regression. A greater proportion of women compared to men reported insufficient time for personal care and leisure (34.5% versus 23.8%, respectively). The prevalence of overweight was greater in men, while obesity was more common in women. Insufficient time for personal care and leisure was associated with overweight (PR = 1.29; 95% CI: 1.04–1.61) and obesity (PR = 1.65; 95% CI: 1.28–2.12) only in women working over 40 hours/week. No significant association was found for males. These results suggest that the length of the working week influences factors underlying weight gain, possibly issues linked to behavior and/or stress mechanisms. The fact that such an association was restricted to women suggests that the results originate from gender inequalities involving relationships between time and health. The findings of this study provide data on which to base public policies aimed at encouraging the redistribution of domestic responsibilities in the direction of gender equity, as well as macrosocial policies such as providing public schools for workers’ children.

La práctica de la enfermera en auditoría de salud

El objetivo de la investigacion es conocer la practica de la enfermera en la auditoria de salud. La concepcion de analisis adoptada fue la de la hermeneutica-dialectica, y se desarrollo en tres locales: la auditoria interna de una organizacion hospitalaria, la auditoria externa de un comprador privado de servicios de salud y el sistema de auditoria del ambito estatal del Sistema Unico de Salud (SUS) en Bahia, Brasil. Fueron entrevistadas nueve enfermeras auditoras. En la auditoria del SUS, las enfermeras expresaron satisfaccion en el ejercicio de esta practica y en la valorizacion de su papel profesional. En la auditoria privada - interna y externa a las organizaciones de salud - las acciones de las enfermeras estan dirigidas a atender los intereses de sus contratantes, y poco se relacionan con la asistencia prestada por el equipo de enfermeria y con las necesidades de los usuarios de los servicios.