Rationale and methods of a cluster-randomized controlled trial to promote active and healthy lifestyles among Brazilian students: the "Fortaleça sua Saúde" program.

BACKGROUND: Interventions on adolescents' lifestyle are important, but the main mechanisms that explain the changes (mediating variables) on lifestyle are unclear. This paper presents the rationale and methods of an intervention program focused on promoting active and healthy lifestyles (especially physical activity [PA] practice and reducing screen time) among Brazilian students-the Fortaleça sua Saúde program (Portuguese for "strengthen your health"). METHODS/DESIGN: This is a school-based cluster-randomized controlled trial. Three intervention and three control (no intervention) full-time public schools were randomly selected in Fortaleza, northeastern Brazil. Students (n = 1,272) from classes in Grades 7-9 were eligible, and 1,085 (548 in the intervention and 537 in control schools) completed the baseline and follow-up measures. The program duration was approximately four months and took place in 2014. Intervention strategies focused on teacher training, activities on health in the curriculum, active opportunities in the school environment (the availability of equipment for PA), and health education (health materials for students and parents). Data collection was undertaken before and immediately after the intervention. The primary variables included the practice of PA (weekly PA volume, PA behavior change stage and preference for PA during leisure-time) and screen time (TV and computer/video games). Potential intrapersonal, interpersonal and environmental mediators of PA and screen time were evaluated by a standardized questionnaire. Other lifestyle components (e.g., eating habits, substance use), psychological (e.g., self-rated health, body satisfaction) and biological (general and abdominal obesity) aspects, as well as academic performance were also evaluated in the total sample. Depressive symptoms, eating disorders, sleep quality, objectively-measured PA, and sedentary time were evaluated in obese students. DISCUSSION: If effective, this program will contribute to the development of public policies for the promotion of active and healthy lifestyles in youth, especially those from low- and middle-income countries. The main intrapersonal, interpersonal and/or environmental mediators of PA and screen time may also be indicated. Finally, we anticipate that the proposed strategies may be adaptable to public schools and may even be extended to the entire school system. TRIAL REGISTRATION: ClinicalTrials.Gov: NCT02439827 . Registration date: May 3, 2015.

Perception of lower back pain associated with use of body armor in police officers of the countryside specialized battalion of Ceará, Brazil.

Introduction: The strict demands of the military environment, associated with the increase in violence, as well as the frequent use of body armor, can further aggravate health problems. Objectives: To investigate the perception of police officers of the Countryside Specialized Police Battalion in relation to comfort, fatigue, and lower back pain, resulting from the use of body armor. Methods: This was a cross-sectional study conducted with 260 male military police officers (34.62 ± 5.83 years old) belonging to the ostensive rural police battalion in the state of Ceará, Brazil. The questionnaire related to comfort, fatigue, and lower back pain was used to identify the perception of pain from the use of body armor, with staggered responses, and the results were analyzed using the SPSS 21.0 software. Results: Regarding the use of body armor, 41.5% of participants perceived it to be little comfortable in general; furthermore, 45 and 47.5% of military police officers considered it little comfortable in relation to weight and use during operational activities, respectively. With regard to body measurements, 48.5% reported being little comfortable, and 70% perceived that the body armor is adjustable to the body. At the end of the work shift, 37.3% complained of lower back pain, and 45.8% felt moderate fatigue. Moreover, 70.1% felt pain in the lower back after the work shift. Conclusions: Military police officers reported lower back pain at the end and after the work shift due to use of body armor, as well as little comfort of the protective equipment and moderate fatigue at the end of the work shift.

Introdução: As rigorosas exigências do ambiente militar associadas ao aumento da violência, bem como ao uso frequente do colete balístico, podem agravar ainda mais os problemas de saúde. Objetivos: Investigar a associação do uso de colete balístico em relação ao conforto, à fadiga e à queixa de lombalgia em policiais do batalhão especializado do Ceará. Métodos: Tratou-se de um estudo transversal realizado com 260 policiais militares do sexo masculino (34,62 ± 5,83 anos) pertencentes ao batalhão de policiamento ostensivo rural do estado do Ceará. O questionário relacionado a conforto, fadiga e dores na região lombar foi utilizado para identificar a percepção de dor pelo uso do colete balístico, com respostas escalonadas, e seus resultados foram analisados no software SPSS 21.0. Resultados: Quanto ao uso do colete, 41,5% perceberam ser pouco confortável no geral; e 45 e 47,5% dos policiais militares consideraram ser pouco confortável em relação ao peso e em relação ao uso durante as atividades operacionais, respectivamente. No que se refere às medidas corporais, 48,5% reportaram ser confortável, e 70% percebem o colete como ajustável ao corpo. No momento da finalização do turno de trabalho, 37,3% apresentam dores na região lombar e 45,8% sentem fadiga moderada. Após o encerramento do turno de trabalho, 70,1% sentem dores na região lombar. Conclusões: Os policiais militares perceberam dores na região lombar ao final e depois do turno de trabalho pelo uso do colete balistico, além de relatarem sobre o pouco conforto do equipamento de proteção e sobre a fadiga moderada ao fim do turno de trabalho.

Lack of professional recognition: main reason for stress in military police.

Introduction: Military police officers play a crucial role in contemporary society, which is marked by the increase in criminality. Therefore, these professionals are constantly under pressure, both socially and professionally, so occupational stress is something present in their routine. Objectives: To investigate the stress levels of military police officers in the municipality of Fortaleza and its metropolitan region. Methods: This was a cross-sectional, quantitative study, conducted with 325 military police officers (53.1% men; 20> 51 years old) who belonged to military police battalions. The Police Stress Questionnaire was used to identify the stress level, following the Likert scale from 1 to 7; the higher the score, the higher the stress level. Results: The results indicated that the lack of professional recognition is the main stress factor among military police officers (Median = 7.00). Other items were relevant to the quality of life of these professionals, which are: "risks of injuries or wounds resulting from the profession", "working on days off", "lack of human resources", "excessive bureaucracy in the police service", " having the perception that we are pressured to give up free time "," lawsuits resulting from police service," "going to court, relationship with the judicial actors, " and "use of inadequate equipment for the service," respectively (Median = 6. 00). Conclusions: The stress of these professionals is organizational in nature and comes from factors that transcend the violence with which they deal.

Introdução: O policial militar desempenha uma função de suma relevância na sociedade contemporânea, a qual é marcada pelo avanço da criminalidade. Desse modo, esse profissional se encontra constantemente sob pressão, tanto social quanto trabalhista, de maneira que o estresse ocupacional é algo presente em sua rotina. Objetivos: Investigar os níveis de estresse em policiais militares da cidade de Fortaleza e região metropolitana. Métodos: Trata-se de um estudo transversal, de natureza quantitativa, realizado com 325 policiais militares, sendo (53,1% do sexo masculino; 20 > 51 anos de idade) pertencentes aos batalhões de policiamento militar. O questionário Police Stress Questionnaire foi utilizado para identificar o nível de estresse, seguindo a escala Likert de 1 a 7 - quanto maior a pontuação, maior o nível de estresse. Resultados: Os resultados indicaram que a falta de reconhecimento profissional é o principal fator de estresse entre os policiais militares (mediana = 7,00). Outros itens foram relevantes na qualidade de vida desses profissionais, são eles: "riscos de lesões ou ferimentos resultantes da profissão", "trabalhar em dias de folga", "falta de recursos humanos", "excesso de burocracia no serviço policial", "ter a percepção que somos pressionados a abdicar o tempo livre", "processos de justiça decorrentes do serviço policial", "idas ao tribunal, relação com os intervenientes judiciais" e "uso de equipamentos inadequado para o serviço" respectivamente (mediana = 6,00). Conclusões: O estresse desses profissionais é de cunho organizacional e provém de fatores que transcendem à violência com a qual lidam.

Perceived barriers to physical activity during the 2nd lockdown in a northeastern state of Brazil.

Background: The practice of physical activity has been recommended during the pandemic period of COVID-19 as a way of preventing the worsening of physical and mental health. After the increase in COVID-19 cases in Brazil and the new lockdown decrees, many people have reported that they are unable to engage in physical activity during the lockdown. Aims: The present study aimed to investigate the barriers to physical activity in the 2nd lockdown in the state of Ceará, Northeast Brazil. Methods: 1036 (55.6% women) residents of the state of Ceará, Northeastern Brazil participated in the study. For data collection, a questionnaire was used including sample characterization questions, physical activity, and barriers to physical activity during the 2nd lockdown in the state of Ceará. This instrument was made available by Google Forms, between March 8th and 19th, 2021. Descriptive statistics and logistic regression were used for data analysis. Results: The three most relevant barriers were: Lack of motivation (7.3%), lack of space at home (5.9%) professional instructions (2.8%). The lack of space at home barrier was associated with age (OR = 2.56; CI 95% 1.05-6.02) and living in the capital (OR = 2.53; CI 95% 1.26-5.33). The barriers, taking care of children (OR = 3.75; CI 95% 1.37-10.2) and increased time spent on daily activities (OR = 2.20; CI 95% 1.02-4.74) were associated with living in the metropolitan region. Conclusion: The lack of motivation, space at home, and professional instruction showed as being limiting factors to physical activity during the lockdown, indicating plans of action aimed at encouraging the practice of physical activity during a pandemic period.

Adaptation of the night eating questionnaire for Brazilian adolescents.

INTRODUCTION: Night Eating Syndrome (NES) is characterized by a delay in the circadian rhythm of food intake and affects 1.5% of the general population, occurring more frequently in obese people. The Night Eating Questionnaire (NEQ) was originally developed for the American adult population. It is a self-administered instrument widely used in the identification and follow-up of individuals with NES. Although the NEQ has been translated and validated for Brazilian adults, there are no reports of its adaptation for use in Brazilian adolescents. The present study aimed to adapt and evaluate reliability and reproducibility of the NEQ for Brazilian adolescents. MATERIAL AND METHODS: Initially, a semantic adaptation of the Portuguese version of the NEQ was performed by 3 professionals with experience with adolescents. The suggested text was analyzed and consolidated item by item by the researchers and then presented to 21 adolescents from an intermediate school in Fortaleza. The questions with low level of understanding (<90%) were modified and the questionnaire was re-applied to 23 adolescents, obtaining satisfactory understanding. RESULTS: The version of the NEQ for Brazilian adolescents, compared to the adult version, contains changes in items 3, 5, 6, 7 and 13. The questionnaire was administered to 463 students aged 11 to 17 years (mean ± SD = 13.7 ± 1.2), from 3 schools. The internal consistency, measured by the Cronbach's alpha coefficient, was 0.73. The reproducibility that was measured after one week in 27 adolescents was 0.92 (95% CI 0.82-0.96). CONCLUSION: The new version of the NEQ for Brazilian adolescents presents excellent reproducibility and good internal consistency and is a simple and useful instrument to evaluate nocturnal eating symptoms in this age group.

Sleep duration and daytime sleepiness in a large sample of Brazilian high school adolescents.

OBJECTIVE: To investigate the prevalence and main factors associated with short and long sleep duration and excessive daytime sleepiness in Brazilian adolescents. METHODS: This was a cross-sectional study of 11.525 students of both genders, aged 14-17 years, from the public high-school system. Sleep duration was assessed by self-report and <8 h of sleep per day was considered short sleep and >10 h, long sleep. Socio-demographic and behavioral factors were investigated through a purpose-built questionnaire and daytime somnolence was assessed by the Epworth sleepiness scale (ESS). RESULTS: The overall prevalence of short and long sleep was 54.7% and 3.3%, respectively. Frequency of short sleep was lowest in the afternoon shift (38.2%) and highest in the morning shift (62.9%) and full-day students (70.0%). Insufficient sleep was more frequent in working (63.0%) than non-working adolescents (53.1%; p = 0.001) and among those who used their cell phone before bedtime (56.3%) compared to non-users (49.7%, p = 0.001). On average, ESS score was higher in subjects with short and long sleep (respectively, 9.7 ± 4.4 and 10.0 ± 4.5) compared to those with normal sleep duration (8.9 ± 4.2; p = 0.001). CONCLUSION: Insufficient sleep and excessive daytime sleepiness are very common among urban high-school Brazilian adolescents. Full day and morning school shifts are associated with short sleep and daytime somnolence, suggesting later start times may have a role in reducing sleep loss in these subjects. Older age, work activity, and cell phone use before bedtime, are also risk factors for of short sleep in adolescents. Although less common, long sleep can also be associated with excessive daytime sleepiness.

Barreiras percebidas para a prática de atividade física em universitários da área da saúde de uma instituição de ensino superior da cidade de Fortaleza, Brasil / Perceived barriers to the practice of physical activity in University Students of Health Sciences of a higher education institution in the city of Fortaleza, Brazil

O objetivo deste estudo foi analisar a prática de atividade física e as principais barreiras percebidas, bem com investigar sua associação com variáveis sociodemográficas, em universitários da área da saúde. Estudo transversal realizado com 736 universitários (≤ 18 e ≥ 36 anos de idade) de ambos os sexos, de uma instituição de ensino superior da cidade de Fortaleza, Brasil. Foram coletadas informações sociodemográficas, prática de atividade (sim ou não) e barreiras percebidas. O teste do Qui-quadrado foi utilizado para associação das variáveis sociodemográficas com as principais barreiras percebidas e a prática de atividade física, adotando-se p≤0,05. As principais barreiras percebidas foram: jornada de estudos extensa (33,4%), falta de energia/cansaço (20,7%), falta de companhia (18,1%), jornada de trabalho extensa (17,8%) e falta de interesse (17,0%). Essas barreiras foram associadas ao semestre letivo (p≤0,001). A jornada de estudos extensa e jornada de trabalho extensa estiveram associadas ao sexo (p≤0,004) e a faixa etária (p≤0,001). A prática de atividade física esteve associada ao sexo, curso e semestre letivo (p≤0,001). Conclui-se que a jornada de estudos extensa foi apontada como a principal barreira para a prática de atividade física entre os universitários. Em geral as principais barreiras percebidas eram de cunho social, comportamental e físicas. As principais barreiras percebidas estiveram associadas ao semestre letivo.

This study aimed to analyze the physical activity and the main barriers perceived by university students, as well as to investigate Its association with sociodemographic variable. This was a Cross-sectional study with 736 university students (≤ 18 and ≥ 36 years old) of both genders, at a higher education institution in the city of Fortaleza, Brazil. Sociodemographic information, activity practice (yes or no) and perceived barriers were collected. The chi-square test was used to associate the sociodemographic variables with the main perceived barriers and the practice of physical activity, adopting p≤0.05. The main perceived barriers were extensive study hours (33.4%), lack of energy / fatigue (20.7%), lack of company (18.1%), extensive workload (17.8%) and lack of Of interest (17.0%). These barriers were associated to the semester (p≤0.001). The extensive study journey and extended working day were associated with gender and age group (p≤0.004 and p≤0.001 respectively). The practice of physical activity was associated to sex, course and semester (p≤0.001). It was concluded that the extensive study periods was considered the main barrier to physical activity among university students. It is expected that these results will serve as a reference for the systematization of possible interventions in order to develop healthy living habits in university students. In general, the main perceived barriers were social, behavioral and physical. The main perceived barriers were associated with the semester.