Self-rated health among teachers: prevalence, predictors, and impact on absenteeism, presenteeism, and sick leave.

Introduction: Self-rated health is an important indicator of health in the population, but among teachers, predictive sociodemographic, occupational, and health variables and the impact of self-rated health on absenteeism, presenteeism, and sick-leave are unknown. Objectives: The objectives of this study were to determine the prevalence of and factors associated with poor self-rated health among elementary school teachers and to investigate whether poor self-rated health can predict absenteeism, presenteeism, and sick leave. Methods: The sample comprised 493 elementary school teachers from Londrina, Paraná, Brazil. A self-report questionnaire was used to assess self-rated health and sociodemographic, occupational, and lifestyle factors, health indicators, chronic diseases, disabilities, and number of days of absenteeism, presenteeism, and sick leave. Poisson regression was used to estimate prevalence ratios and rate ratios. Results: The prevalence of poor self-rated health was 16.4% and the variables positively associated with this outcome were health insurance (prevalence ratio = 2.35), inadequate school infrastructure (prevalence ratio = 1.56), physical activity (prevalence ratio = 0.60), poor perceived fitness (prevalence ratio = 2.44), voice disorders (prevalence ratio =1.46), common mental disorders (prevalence ratio = 1.74), emotional exhaustion (prevalence ratio = 1.61), low personal accomplishment (prevalence ratio = 1.64), chronic disease (prevalence ratio = 2.39), and disability (prevalence ratio = 1.57). Poor self-rated health was positively associated with both absenteeism (rate ratio=1.71) and presenteeism (rate ratio = 1.74). Conclusions: Occupational and individual characteristics associated with impaired physical and mental health should be targeted to improve self-rated health among teachers. Furthermore, a single question on self-rated health is a useful tool for monitoring and preventing absenteeism and presenteeism among teachers.

Introdução: A autopercepção de saúde é um importante indicador de saúde na população; no entanto, em professores, as variáveis preditoras sociodemográficas, ocupacionais e de saúde, bem como o impacto da autopercepção de saúde no absenteísmo, presenteísmo e licenças médicas são desconhecidos. Objetivos: Determinar a prevalência e os fatores associados à autopercepção de saúde ruim em professores do ensino fundamental e investigar se é preditora de absenteísmo, presenteísmo e licenças médicas. Métodos: A amostra foi composta por 493 professores da cidade de Londrina, Paraná, Brasil. Um questionário de autorrelato foi utilizado para avaliar a autopercepção de saúde; os fatores sociodemográficos, ocupacionais e de estilo de vida; os indicadores de saúde; a presença de doenças crônicas e incapacidade; e as taxas de absenteísmo, presenteísmo e licenças médicas. Foi utilizada regressão de Poisson para estimar as razões de prevalência e as razões de taxa. Resultados: A prevalência da autopercepção de saúde ruim foi de 16,4%, tendo as seguintes variáveis apresentado associação positiva com o desfecho: plano de saúde (razão de prevalência = 2,35), infraestrutura escolar inadequada (razão de prevalência = 1,56), atividade física (razão de prevalência = 0,60), percepção de baixa aptidão física (razão de prevalência = 2,44), distúrbios vocais (razão de prevalência = 1,46), transtornos mentais comuns (razão de prevalência = 1,74), exaustão emocional (razão de prevalência = 1,61), baixa realização profissional (razão de prevalência = 1,64), doença crônica (razão de prevalência = 2,39) e incapacidade (razão de prevalência = 1,57). A autopercepção de saúde ruim apresentou associação positiva com o absenteísmo (razão de taxas = 1,71) e presenteísmo (razão de taxas =1,74). Conclusões: Características ocupacionais e individuais associadas à deterioração da saúde física e mental devem ser foco de ações de prevenção, a fim de melhorar a autopercepção de saúde docente. Uma única pergunta sobre a autopercepção de saúde é uma ferramenta útil para monitorar e prevenir o absenteísmo e presenteísmo docente.

Factors associated with musculoskeletal disorders and disability in elementary teachers: A cross-sectional study.

The purpose of this study was to analyze factors associated with musculoskeletal disorders and disability in elementary teachers. This is a cross-sectional study from a representative sample of Brazilian elementary teachers (n = 530). Data were collected using a self-report questionnaire. Sociodemographic, work-related, and behavioural characteristics were the exposure variables. The outcomes were musculoskeletal symptoms, disability, and musculoskeletal disease. Musculoskeletal disease was used as an outcome, as well as an exposure variable when musculoskeletal symptoms and disability were the outcomes. Prevalence ratios (PR) were estimated by Poisson regression. Variables associated with musculoskeletal symptoms were: length of employment ≥20 years (PR = 1.41), perception of inappropriate infrastructure of schools (RP = 1.21), physical activity (PR = 0.80), and high stress (PR = 1.16) for upper limbs; high stress (PR = 1.23) and perception of inappropriate infrastructure of schools (RP = 1.16) for back/neck; common mental disorders (PR = 1.14 to 1.30), and musculoskeletal disease (PR = 1.19-1.62) for all regions of the body. Musculoskeletal disease (PR = 2.46 to 3.37) and perception of inappropriate infrastructure of schools (PR = 1.53 to 1.95) were associated to disability in all regions of the body. Length of employment >20 years was associated with disability in the upper limbs (PR = 2.06). Common mental disorders were associated with disability in the upper limbs (PR = 1.53) and back and neck (PR = 1.47) while sitting time >120 min/day was inversely associated with disability in the lower limbs (PR = 0.64). The predictors of musculoskeletal disease were length of employment ≥20 years (PR = 1.97), perception of inappropriate infrastructure of schools (PR = 1.57), strength and flexibility activities (PR = 1.66), TV viewing time ≥ 120 min (PR = 1.37), sports practice (PR = 0.39), and common mental disorders (PR = 1.39). Although the associations varied according to the outcome, common mental disorders, perception of inappropriate infrastructure of schools, high stress, and length of employment are variables to be considered in the prevention of musculoskeletal disorders in teachers. When analyzed as an exposure variable, musculoskeletal disease was the main predictor of musculoskeletal symptoms and disability.

O conteúdo lutas no ensino médio: discursos dos professores de Educação Física da fronteira Brasil-Bolívia / The content fights in middle school: speeches of Physical Education teachers from the Brazil-Bolivia border / El contenido luchasen la enseñanza medio: discursos de los maestros de Educación Física de la frontera Brasil-Bolivia

Este trabalho objetivou analisar o discurso dos professores de nível médio sobre a aplicação do conteúdo Lutas nas aulas de Educação Física em Corumbá/MS, cidade fronteiriça Brasil-Bolívia. Nos baseamos metodologicamente no trabalho de Ferreira (2006), ao adaptarmos o seu modelo de pesquisa. Os resultados apontaram que a maioria (83%) dos entrevistados têm o conteúdo no seu plano de ensino. Contudo, a maior parte utiliza procedimentos que não oportunizam vivências. Observamos ainda o predomínio da Capoeira a ser trabalhada, ao contrário das Lutas informais. A maioria entende que o conteúdo em debate não gera violência e agressão, mas que isso dependeria da atitude do professor. Nossos resultados se aproximam do estudo tomado como referência e apontam outras preocupações sobre o tema.

The objective of this study was to analyze the discourse of middle level teachers on the application of content Fights in the classes of Physical Education in Corumbá / MS, border city Brazil-Bolivia. We base methodologically on the work of Ferreira (2006) when adapting his research model. The results showed that the majority (83%) of respondents had the content in their teaching plan. However, the vast majority use procedures that do not provide experience. We also observed the predominance of Capoeira to be worked on, unlike the informal struggles. Most understand that the content under debate does not generate violence and aggression, but that this would depend on the teacher's attitude. Our results approximate the study taken as reference and point out other concerns about the theme.

El trabajo objetivó analizar el discurso de los maestros de nivel medio sobre la aplicación del contenido Luchas en las clases de Educación Física en Corumbá/MS, ciudad fronteriza Brasil-Bolivia. Basamos, metodológicamente, en el trabajo de Ferreira (2006) al adaptar su modelo de investigación. Los resultados apuntaron que la mayoría (83%) de los entrevistados tienen el contenido en su plan de enseñanza. Sin embargo, la gran parte utiliza de procedimientos que no oportunizan vivencias. Observamos también el predominio de la Capoeira a ser trabajada, al contrario con las Luchas informales. La mayoría entiende que el contenido en debate no genera violencia y agresión, pero que eso dependería de la actitud del profesor. Nuestros resultados se aproximan al estudio tomado como referencia y apuntan otras preocupaciones sobre el tema.

[Agreement between two cutoff points for physical activity and associated factors in young individuals]. / Concordância entre dois pontos de corte para atividade física e fatores associados em jovens.

OBJECTIVE: To analyze the agreement between two cutoff points for physical activity (300 and 420 minutes/week) and associated factors in youth. METHODS: The study enrolled 738 adolescents of Londrina city, Paraná, Southern Brazil. The following variables were collected by a self report questionnaire: presence of moderate to vigorous physical activity, gender, age, father and mother education level, with whom the adolescent lives, number of siblings, physical activity perception, participation in Physical Education classes, facilities available to physical activity practice and sedentary behavior. Prevalence of physical activity between criterions were compared using McNemar test and the agreement was analysed by Kappa index. Multivariate analysis was performed using Poisson regression with robust variance adjustment was applied. RESULTS: The prevalence for physical activity was significantly different: 22,3% for 300 minutes/week and 12,8% for 420 minutes/week (p<0,05), but the agreement was strong (k=0,82, p<0,001). The variables gender, father education, physical activity perception and sedentary behavior were associated to physical activity in both analyzed criteria. Participation in Physical Education class and facilities available to physical activity practice were associated to physical activity only with 300 minutes/week cutoff point. CONCLUSION: Caution is suggested regarding cutoffs use for physical activity in epidemiological studies, considering they can result in differences in prevalence of physical activity and its associated factors.

Concordância entre dois pontos de corte para atividade física e fatores associados em jovens / Agreement between two cutoff points for physical activity and associated factors in young individuals

Objetivo: Analisar a concordância entre dois pontos de corte para atividade física (300 e 420 minutos/semana) e os fatores associados em jovens. Métodos: Participaram do estudo 738 adolescentes da cidade de Londrina-PR, Brasil. A prática de atividade física em intensidade moderada a vigorosa e as variáveis sexo, idade, escolaridade paterna e materna, com quem mora, número de irmãos, percepção de atividade física, participação nas aulas de educação física, local para prática de atividade física e comportamento sedentário foram coletadas por meio de um questionário. A prevalência de atividade física entre os critérios foi comparada por meio do teste de McNemar, a concordância avaliada, por meio do índice Kappa, e a análise multivariada, por meio da regressão de Poisson com ajuste robusto da variância. Resultados: A prevalência de atividade física foi significativamente diferente: 22,3% para 300 minutos/semana e 12,8% para 420 minutos/semana (p<0,05), e a concordância foi forte (k=0,82, p<0,001). As variáveis sexo, escolaridade paterna, percepção de atividade física e comportamento sedentário se associaram com a atividade física em ambos os critérios analisados. A participação nas aulas de educação física e a disponibilidade de locais para prática se associaram apenas com o ponto de corte 300 minutos/semana. Conclusões: Sugere-se cautela ao utilizar pontos de corte para atividade física em estudos epidemiológicos, considerando que pode resultar em diferença na prevalência de atividade física e dos fatores a ela associados...

Objective: To analyze the agreement between two cutoff points for physical activity (300 and 420 minutes/week) and associated factors in youth. Methods: The study enrolled 738 adolescents of Londrina city, Paraná, Southern Brazil. The following variables were collected by a self report questionnaire: presence of moderate to vigorous physical activity, gender, age, father and mother education level, with whom the adolescent lives, number of siblings, physical activity perception, participation in Physical Education classes, facilities available to physical activity practice and sedentary behavior. Prevalence of physical activity between criterions were compared using McNemar test and the agreement was analysed by Kappa index. Multivariate analysis was performed using Poisson regression with robust variance adjustment was applied. Results: The prevalence for physical activity was significantly different: 22,3% for 300 minutes/week and 12,8% for 420 minutes/week (p<0,05), but the agreement was strong (k=0,82, p<0,001). The variables gender, father education, physical activity perception and sedentary behavior were associated to physical activity in both analyzed criteria. Participation in Physical Education class and facilities available to physical activity practice were associated to physical activity only with 300 minutes/week cutoff point. Conclusion: Caution is suggested regarding cutoffs use for physical activity in epidemiological studies, considering they can result in differences in prevalence of physical activity and its associated factors...

Diagnostic accuracy of anthropometric indices in predicting excess body fat among seven to ten-year-old children.

PURPOSE: To evaluate the accuracy of the body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) in detecting excess body fat among schoolchildren in Florianópolis, Santa Catarina. METHODS: Cross-sectional study with 2,772 schoolchildren aged seven to ten years. Receiver Operating Characteristic (ROC) curves were used to compare the diagnostic accuracy of the BMI, the WC and the WHtR in identifying children with excess body fat (defined as values that were equal to or higher than the 90th percentile of the standardized residuals obtained from the sum of the four skinfolds thickness). Likelihood ratio estimates were used to select, for each anthropometric index, the cut-off points that presented the highest association with excess body fat. RESULTS: The BMI, WC and WHtR performed well in detecting excess body fat, indicated by areas under the ROC curve (AUC) close to 1.0, with slightly higher AUC for the BMI in comparison to the WC and the WHtR concerning both sexes. Highly sensitive and specific cut-off points were derived for the three anthropometric indices. Sensitivity ranged from 85.7 to 92.9% for the BMI, from 78.6 to 89.7% for the WC, and from 78.6 to 89.2% for the WHtR. Specificity ranged from 83.2 to 91.4%, from 75.0 to 90.7%, and from 77.4 to 88.3% for the BMI, the WC and the WHtR, respectively. CONCLUSION: BMI, WC and WHtR can be used as diagnostic tests to identify excess body fat in children from seven to ten years of age.

Diagnostic accuracy of anthropometric indices in predicting excess body fat among seven to ten-year-old children / Acurácia diagnóstica de índices antropométricos na predição do excesso de gordura corporal em crianças de sete a dez anos

PURPOSE: To evaluate the accuracy of the body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) in detecting excess body fat among schoolchildren in Florianópolis, Santa Catarina. METHODS: Cross-sectional study with 2,772 schoolchildren aged seven to ten years. Receiver Operating Characteristic (ROC) curves were used to compare the diagnostic accuracy of the BMI, the WC and the WHtR in identifying children with excess body fat (defined as values that were equal to or higher than the 90th percentile of the standardized residuals obtained from the sum of the four skinfolds thickness). Likelihood ratio estimates were used to select, for each anthropometric index, the cut-off points that presented the highest association with excess body fat. RESULTS: The BMI, WC and WHtR performed well in detecting excess body fat, indicated by areas under the ROC curve (AUC) close to 1.0, with slightly higher AUC for the BMI in comparison to the WC and the WHtR concerning both sexes. Highly sensitive and specific cut-off points were derived for the three anthropometric indices. Sensitivity ranged from 85.7 to 92.9% for the BMI, from 78.6 to 89.7% for the WC, and from 78.6 to 89.2% for the WHtR. Specificity ranged from 83.2 to 91.4%, from 75.0 to 90.7%, and from 77.4 to 88.3% for the BMI, the WC and the WHtR, respectively. CONCLUSION: BMI, WC and WHtR can be used as diagnostic tests to identify excess body fat in children from seven to ten years of age. .

OBJETIVO: Avaliar a acurácia do índice de massa corporal (IMC), circunferência da cintura (CC) e razão cintura-estatura (RCEst) no diagnóstico do excesso de gordura corporal em escolares de Florianópolis, Santa Catarina. MÉTODOS: Estudo transversal com 2.772 escolares de sete a dez anos. Curvas ROC (Receiver Operating Characteristic) foram utilizadas para comparar a acurácia diagnóstica do IMC, CC e RCEst na identificação de crianças com excesso de gordura corporal (definido como valores iguais ou superiores ao percentil 90 do resíduo padronizado do somatório de quatro dobras cutâneas). A estimativa da razão de verossimilhança foi utilizada para selecionar, em cada índice antropométrico, o ponto de corte de maior associação com o excesso de gordura corporal. RESULTADOS: O IMC, a CC e a RCEst obtiveram bom desempenho na detecção do excesso de gordura corporal, indicado por áreas sob a curva (ASC) ROC próximas a 1,0, com uma ASC um pouco maior para o IMC do que para a CC e RCEst em ambos os sexos. Para os três índices antropométricos, pontos de corte altamente sensíveis e específicos foram derivados. A sensibilidade variou de 85,7 a 92,9% para o IMC, de 78,6 a 89,7% para a CC e de 78,6 a 89,2% para a RCEst. A especificidade variou de 83,2 a 91,4%, de 75,0 a 90,7% e de 77,4 a 88,3% para o IMC, CC e RCEst, respectivamente. CONCLUSÃO: O IMC, a CC e a RCEst podem ser usados como teste diagnóstico para identificar o excesso de gordura corporal em crianças de sete a dez anos. .

Práticas esportivas e recreativas em adolescentes com excesso de peso: análise da composição corporal e do desempenho motor / Sports and recreational activities in overweight adolescents: analyze of body composition and motor performance

Este estudo analisou o impacto de atividades esportivas e recreativas na composição corporal e no desempenho motor de adolescentes com excesso de peso. Vinte e dois adolescentes (13 no Grupo Esportivo e 9 no Grupo Recreativo) foram selecionados por conveniência para participar de 3 sessões semanais com 60 minutos de atividades específicas para cada grupo, durante 11 meses. A composição corporal e o desempenho motor foram avaliados antes e após os programas. Verificou-se nos adolescentes do Grupo Esportivo e Recreativo redução na dobra cutânea subescapular (12,55% e 14,65%), soma das dobras cutâneas (12,39% e 14,52%) e percentual de gordura corporal (11,52% e 7,58%), bem como aumento na massa corporal magra (7,85% e 9,45%) após os programas de exercício físico. Todas as variáveis do desempenho motor também apresentaram alterações significativas (p<0,05). Evidenciou-se que práticas esportivas e recreativas ocasionaram alterações positivas na composição corporal e no desempenho motor dos adolescentes.

This study examined the impact of sports and recreational activities on body composition and motor performance of overweight adolescents. Twenty-two adolescents (13 in Sports and 9 in Recreation) were selected for convenience to participate in 3 weekly sessions with 60 minutes of specific activities for each group, during 11 months. The body composition and motor performance were assessed before and after the programs. It was verified in Sports and Recreation adolescents the reduction in subscapular skinfold thickness (12.55% and 14.65%), sum of skinfolds thickness (12.39% and 14.52%) and percentage body fat (11.52% and 7.58%) and increase in lean body mass (7.85% and 9.45%) after physical exercise programs. All variables of motor performance also showed significant changes (p<0.05). It was evidenced that sports and recreational caused positive changes in body composition and motor performance of adolescents.