Confiabilidade teste-reteste de aspectos da rede social no Estudo Pró-Saúde Test-retest reliability of measures of social network in the "Pró-Saúde" Study

OBJETIVO: Avaliar os níveis de confiabilidade teste-reteste de informações relativas à rede social no Estudo Pró-saúde. MÉTODOS: Foi estimada a confiabilidade pelo estudo teste-reteste por meio de questionário multidimensional aplicado a uma coorte de trabalhadores de uma universidade. O mesmo questionário foi preenchido duas vezes por 192 funcionários não efetivos da universidade, com duas semanas de intervalo entre as aplicações. A concordância foi estimada pela estatística Kappa (variáveis categóricas), estatística Kappa ponderado e modelos log-lineares (variáveis ordinais), e coeficiente de correlação intraclasse (variáveis discretas). RESULTADOS: As medidas de concordância situaram-se acima de 0,70 para a maioria das variáveis. Estratificando-se as informações segundo gênero, idade e escolaridade, observou-se que a confiabilidade não apresentou padrão consistente de variabilidade. A aplicação de modelos log-lineares indicou que, para as variáveis ordinais do estudo, o modelo de melhor ajuste foi o de "concordância diagonal mais associação linear por linear". CONCLUSÕES: Os altos níveis de confiabilidade estimados permitem concluir que o processo de aferição dos itens sobre rede social foi adequado para as características investigadas. Estudos de validação em andamento complementarão a avaliação da qualidade dessas informações.<br>OBJECTIVE: To evaluate test-retest reliability of social network-related information of the" Pró-Saúde" study. METHODS: A test-retest reliability study was conducted using a multidimensional questionnaire applied to a cohort of university employees. The same questionnaire was filled out twice by 192 non-permanent employees with two weeks apart. Agreement was estimated using kappa statistics (categorical variables), weighted kappa statistics, log-linear models (ordinal variables), and intraclass correlation coefficient (discrete variables). RESULTS: Estimates of reliability were higher than 0.70 for most variables. Stratified analyses revealed no consistently varying patterns of reliability according to gender, age or schooling strata. Log-linear modelling showed that, for the study ordinal variables, the model of best fit was "diagonal agreement plus linear by linear association". CONCLUSIONS: The high level of reliability estimated in this study suggests that the process of measurement of social network-related aspects was adequate. Validation studies, which are currently being conducted, will complete the quality assessment of this information

Signalling pathways in bradykinin- and nitric oxide-induced hypotension in the normotensive rat; role of K(+)-channels

1. Bradykinin and nitric oxide (NO) are potent hypotensive agents. In the present study, the role of K(+)-channels in the signalling pathways responsible for their hypotensive action was investigated in normotensive, anaesthetized rats. The rats were treated with ion-channel inhibitors before administration of bradykinin (2.8, 5.6, 28 and 56 nmol kg(−1), i.v.) followed in some of the protocols by nitroprusside (1.1, 3.5, 7, 14, and 28 nmol kg(−1), i.v.). 2. No attenuation of the hypotensive response to bradykinin was detected for inhibitors of the Na-K-Cl-cotransporter (30 μmol kg(−1) furosemide), the ATP-sensitive K(+)-channel (40 μmol kg(−1) glibenclamide), high conductance Ca(2+)-activated K(+)-channel (180 μmol kg(−1) tetraethylammonium, 54 μmol kg(−1) tetrabutylammonium, 35 nmol kg(−1) iberiotoxin, 35 nmol kg(−1) charybdotoxin) or the low conductance Ca(2+)-activated K(+)-channel (74 nmol kg(−1) apamin). 3. However, the voltage-sensitive K(+)-channel (I(A)) inhibitor 4-aminopyridine (4.05–40.5 μmol kg(−1)) induced a concentration-dependent (P<0.0001) attenuation of the hypotensive response (P<0.0001). Bradykinin had no effect on heart rate in anaesthetized rats and this observation was not altered by pretreatment with 4-aminopyridine. 4. 4-Aminopyridine (53 μmol kg(−1)) also significantly attenuated the hypotensive response to nitroprusside (P<0.0003) without altering the heart rate concentration-response curve. Of the two Ca(2+)-activated K(+)-channel inhibitors tested on nitroprusside-induced hypotension, tetrabutylammonium induced a slight attenuation (P<0.0101), whereas iberiotoxin had no effect. 5. We therefore concluded that, although the acute hypotensive response to bradykinin in the normotensive rat is not mediated through nitric oxide synthesis, the hypotensive response to both agents was mediated through opening of voltage-sensitive K(+)-channels (I(A)), resulting in a decrease in peripheral vascular resistance

Eventos de vida produtores de estresse e transtornos mentais comuns: resultados do Estudo Pró-Saúde Stressful life events and common mental disorders: results of the Pro-Saude Study

O objetivo do estudo é investigar a associação entre eventos de vida produtores de estresse (EVPE) e transtornos mentais comuns (TMC). Dados seccionais da fase 1 de um estudo de coorte (Estudo Pró-Saúde) foram coletados entre 4.030 funcionários. Informações foram obtidas por meio de um questionário multidimensional autopreenchível (General Health Questionnaire) que avaliou a presença de TMC nas duas semanas anteriores, ocorrência de EVPE nos 12 meses anteriores e variáveis sociodemográficas. Após ajuste por sexo, idade, renda e situação conjugal, problemas financeiros graves foram os eventos associados a uma chance mais elevada de TMC (OR = 2,6; IC95%: 2,2-3,0), seguidos de agressão física (OR = 2,1; IC95%: 1,5-2,9), mudança forçada de moradia (OR = 1,9; IC95%: 1,5-2,4), doença grave (OR = 1,8; IC95%: 1,5-2,1), rompimento de relação amorosa (OR = 1,9; IC95%: 1,6-2,3), internação hospitalar (OR = 1,4; IC95%: 1,1-1,8) e assalto ou roubo (OR = 1,5; IC95%: 1,2-1,8). Os resultados apontam para a necessidade de se investigar efeitos de longo prazo associados a estes eventos, assim como de fatores que potencialmente modifiquem seu impacto, de forma a subsidiar ações de prevenção mais efetivas na área da saúde mental.<br>This study investigates the association between stressful life events (SLE) and common mental disorders (CMD) among university employees in Rio de Janeiro, Brazil. Phase 1 sectional data from a cohort study (the Pro-Saude Study) were collected among 4,030 participants. A standardized self-administered questionnaire (General Health Questionnaire) assessed the presence of CMD during the previous two weeks, the occurrence of SLE in the previous 12 months, and socio-demographic characteristics. After adjustment for gender, age, income, and marital status, severe financial problems were associated with the greatest risk of CMD (OR = 2.6; 95%CI: 2.2-3.0), followed by physical aggression (OR = 2.1; 95%CI: 1.5-2.8), disruption of a love relationship (OR = 1.9; 95%CI: 1.6-2.3), forced change of residence (OR = 1.9; 95%CI: 1.5-2.4), serious disease (OR = 1.8; 95%CI: 1.5-2.1), hold-up or theft (OR = 1.5; 95%CI: 1.2-1.8), and hospitalization (OR = 1.4; 95%CI: 1.1-1.8). Results suggest that long-term effects of SLE should be investigated, as well as other potential modifying factors in the development and maintenance of CMD in order to support more effective mental health interventions