Motherhood in early adolescence: a case-control study in Southern Brazil.

This paper investigates factors associated with motherhood among adolescents from 14 to 16 years of age in Porto Alegre, Brazil. This is a case-control study with 431 adolescent mothers (cases) and 862 adolescents who had never given birth (controls). D. ata were obtained through home visits by an interviewer-applied questionnaire. Sociodemographic characteristics, quality of social and family relationships, lifestyle and history of abuse were studied as potential determinants to early adolescent motherhood. Conditional logistic regression was used for data analysis according to a two-stage hierarchical model. Results showed that lower economic class, schooling failure, tobacco consumption, alcoholic drunkenness at least once in life and having a mother who gave birth before 20 years of age were positively associated with early adolescent motherhood. Later menarche and having relatives or having friends in whom to trust remained as protective factors. Schooling failure, which obtained the highest risk, points to the important role of the school in this population's development and its potential to stimulate healthy life habits.

Motherhood in early adolescence: a case-control study in Southern Brazil / Maternidade na adolescência inicial: estudo caso-controle no sul do Brasil

Abstract This paper investigates factors associated with motherhood among adolescents from 14 to 16 years of age in Porto Alegre, Brazil. This is a case-control study with 431 adolescent mothers (cases) and 862 adolescents who had never given birth (controls). D. ata were obtained through home visits by an interviewer-applied questionnaire. Sociodemographic characteristics, quality of social and family relationships, lifestyle and history of abuse were studied as potential determinants to early adolescent motherhood. Conditional logistic regression was used for data analysis according to a two-stage hierarchical model. Results showed that lower economic class, schooling failure, tobacco consumption, alcoholic drunkenness at least once in life and having a mother who gave birth before 20 years of age were positively associated with early adolescent motherhood. Later menarche and having relatives or having friends in whom to trust remained as protective factors. Schooling failure, which obtained the highest risk, points to the important role of the school in this population's development and its potential to stimulate healthy life habits.

Resumo Este artigo visa investigar fatores associados à maternidade em adolescentes moradoras em Porto Alegre, com idade entre 14 e 16 anos. Estudo caso-controle com 431 mães adolescentes (casos) e 862 adolescentes que nunca tiveram filho (controles). Os dados foram obtidos através de visitas domiciliares e mediante aplicação de questionário estruturado. Foram estudadas variáveis sociodemográficas, qualidade das relações sociais e familiares, estilo de vida e histórico de abuso como possíveis determinantes da maternidade na adolescência. Os dados foram analisados através de regressão logística condicional, utilizando modelo hierarquizado. Os resultados mostram que pertencer aos estratos socioeconômicos mais baixos, possuir mãe que teve o seu primeiro filho até os 19 anos, defasagem escolar, uso de tabaco e embriaguez alcóolica pelo menos uma vez na vida foram positivamente associados à maternidade na adolescência. Menarca mais tardia e ter familiares ou ter amigos em quem confiar foram fatores de proteção. Defasagem escolar, que obteve razão de odds mais elevada, aponta o importante papel da escola na formação desta população e no seu potencial para estimular hábitos de vida sadios.

Percepção da imagem corporal em escolares do norte do Brasil / Body image perception in scholars of a school in the Brazilian north region

INTRODUCTION: In the adolescence period, an individual experiences biopsychosocial changes and dissatisfaction with body image is quite prevalent at this stage OBJECTIVE: To investigate the prevalence of body image dissatisfaction and its association with demographic and psychosocial factors, sexual maturity, nutritional condition and lifestyle METHODS: Cross-sectional study with a sample representing 831 eighth grade students from Porto Velho, Rondônia, Brazil, stratified into clusters. The data were obtained by questionnaires - the Body Shape Questionnaire and Global School-based Student Health Survey - and anthropometry. The associations of interest were tested in a multivariate analysis with Cox regression adjusted for cross-sectional studies RESULTS: The prevalence of body image dissatisfaction was 22 per cent. The outcome was significantly more prevalent among girls (PR: 4.69; CI: 95%: 3.09 - 7.12), young Caucasians (PR: 1.32; CI: 95%: 1.02 - 1.72), those who used tobacco (RP: 1.53; CI: 95%: 1.12 - 2.09), who were overweight or obese (PR: 2.77; CI: 95%: 2.18 - 3.51), and who reported feelings of sadness (PR: 1.35; CI: 95%: 1.05 - 1.73) and loneliness (PR: 1.66; CI: 95%: 1.30 - 2.11). The students with lower weight were more satisfied with their image CONCLUSION: The results point to the need for parents, educators and health professionals to act jointly in developing actions that reinforce the positive qualities of youth, especially in girls. Encouraging physical activity and healthy habits can promote overall health, improving satisfaction with body image

INTRODUÇÃO: Enquanto evidências sugerem que níveis de coordenação motora e de índice de massa corporal (IMC) estão negativamente correlacionados, pouco se sabe sobre a influência dos níveis de atividade física na associação entre essas variáveis em adolescentes OBJETIVO: Analisar as associações entre os níveis de coordenação motora e o IMC em adolescentes com peso saudável e com sobrepeso/obesos, controlando pelos níveis de atividade física MÉTODO: Cinquenta e seis escolares (50% adolescentes com sobrepeso/obesos), entre 12 e 14 anos, participaram do estudo. Os instrumentos Physical Activity Questionnaire for Older Children e o Körperkoordinationstest für Kinder foram usados para avaliar os níveis de atividade física e de coordenação motora, respectivamente. Correlações bivariadas e parciais foram usadas para analisar o inter-relacionamento entre os níveis de coordenação motora, IMC e atividade física. O teste de Análise de Covariância foi utilizado para comparar os níveis de coordenação entre adolescentes com peso saudável e com sobrepeso/obesos, considerando o nível de atividade física como covariável RESULTADOS: Foram encontradas correlações significativamente negativas (p < 0,05), de fraca a moderada, entre IMC e níveis de coordenação no grupo como um todo, nos grupos com peso saudável e com sobrepeso/obesos. No entanto, quando controladas pelos níveis de atividade física, não foram observadas correlações significativas no grupo com peso saudável. Ademais, adolescentes com sobrepeso/obesos apresentaram menores níveis de coordenação motora que adolescentes com peso saudável CONCLUSÃO: Os níveis de atividade física influenciam a associação entre os níveis de coordenação motora e IMC em adolescentes com peso saudável, mas não em adolescentes com sobrepeso/obesos

Uso de álcool, tabaco e outras drogas por adolescentes escolares de Porto Velho-RO, Brasil / Use of alcohol, tobacco and other drugs by adolescents students from Porto Velho-RO, Brazil / Uso de alcohol, tabaco y otras drogas por adolescentes escolares de Porto Velho-RO, Brasil

OBJETIVO: estudar a prevalência e fatores associados ao uso de tabaco, álcool e outras drogas. MÉTODOS: estudo transversal com adolescentes escolares da rede estadual de ensino de Porto Velho-RO, Brasil; foram investigadas as associações mediante regressão de Cox multivariada, calculadas as razões de prevalência (RP) e intervalos de confiança de 95% (IC95%). RESULTADOS: a prevalência do consumo de álcool, tabaco e outras drogas foi de 24,0%, 6,4% e 2,3% respectivamente; o uso de álcool associou-se ao consumo de tabaco (RP 6,68; IC95% 3,17-14,10; p<0,001), uso de drogas ilícitas (RP 4,34; IC95% 1,28-14,76; p=0,010) e consumo de álcool pelos pais (RP 1,52; IC95% 1,14-2,02; p<0,001); o consumo de tabaco pelos pais e amigos e o uso de outras drogas pelos amigos estiveram associados ao consumo dessas substâncias pelos estudantes. CONCLUSÃO: evidencia-se a necessidade de envolver a escola e a família em ações direcionadas à prevenção do uso dessas substâncias entre adolescentes.

OBJETIVO: estudiar la prevalencia y factores asociados al uso de tabaco, alcohol y otras drogas. MÉTODO: estudio transversal con adolescentes escolares de la red estadual de enseñanza de Porto Velho-RO, Brasil; se investigaron las asociaciones mediante la regresión de Cox multivariante, calculadas las razones de prevalencia (RP) e intervalos de confianza de 95% (IC95%). RESULTADOS: la prevalencia del consumo de alcohol, tabaco y otras drogas fue de 24,0%, 6,4% y 2,3% respectivamente; el uso de alcohol se asoció al consumo de tabaco (RP 6,68; IC95% 3,17-14,10; p<0,001), uso de drogas ilícitas (RP 4,34; IC95% 1,28-14,76; p=0,010) y al consumo de alcohol por los padres (RP 1,52; IC95% 1,14-2,02; p<0,001); el consumo de tabaco por los padres y amigos y el uso de otras drogas por los amigos estuvieron asociados al consumo de esas substancias por los estudiantes. CONCLUSIÓN: se evidencia la necesidad de involucrar a la escuela y a la familia en acciones dirigidas a la prevención del uso de esas substancias entre adolescentes.

OBJECTIVE: to study the prevalence of tobacco, alcohol and drug use and associated factors. METHODS: this was a cross-sectional study with adolescents attending state schools in Porto Velho-RO, Brazil; associations were investigated using multivariate Cox regression. Prevalence ratios (PR) and 95% confidence intervals (95%CI) were calculated. RESULTS: the prevalence of alcohol, tobacco and other drug consumption was 24.0%, 6.4% and 2.3%, respectively; alcohol use was associated with tobacco use (PR 6.68; 95%CI 3.17;14.10;p=0.00), illicit drug use (PR 4.34; 95%CI 1.28;14.76; p=0.01) and parental alcohol consumption (PR 1.52; 95%CI 1.14;2.02; p=0.00); consumption of tobacco by parents and friends and use of other drugs by friends were associated with the consumption of these substances by the students. CONCLUSION: there is an evident need to involve schools and families in actions directed to preventing the use of these substances among adolescents.

Fatores associados ao início da vida sexual ativa de escolares em uma cidade do sul do Brasil / Associated factors in the initiation of sexual activity of students in a city in southern Brazil

Estudo transversal com objetivo de investigar a prevalência do início da vida sexual (IVS) e fatores associados em escolares da 7ª série da rede municipal de ensino. A amostra representativa de 1170 escolares foi analisada com regressão de Cox multivariada. A prevalência de IVS foi de 20,3%, sendo maior entre meninos (RP: 2,4 IC95%:1,86-3,06); cor de pele não branca (RP: 1,3 IC95%:1,05-1,64); uso na vida de álcool (RP: 2,3 IC95%: 1,68-3,24), tabaco (RP: 2,1 IC95%:1,62-2,61) e drogas ilícitas (RP: 1,6 IC95%:1,11-2,29); sentimento de discriminação (RP: 1,4 IC95%:1,01-1,96) e ideação suicida (RP: 1,3 IC95%:1,03-1,67); pais não sabem o que os jovens fazem no tempo livre (RP: 1,6 IC95%:1,28-2,08) e jovens que faltam a aula sem conhecimentos dos pais (RP: 1,6 IC95%:1,32-2,07). O sobrepeso/obesidade (RP: 0,7 IC95%:0,47-0,94) teve comportamento protetor para o início da vida sexual. O IVS precoce esteve associado com estilo de vida pouco saudável e má qualidade da relação dos jovens com seus pais.(AU)

Cross-sectional study in order to investigate the prevalence of sexual debut (PSD) and associated factors in students from 7th grade of municipal schools. A representative sample of 1170 students was analyzed with multivariate Cox regression. The prevalence of PSD was 20.3%, which is higher among boys (PR: 2.4 CI95%: 1.86 - 3.06); non-white skin color (PR: 1.3 CI95%: 1.05- 1.64); use of alcohol (RP: 2.3 CI95%: 1.68 -3.24), tobacco (RP: 2.1 CI95%: 1.62 - 2.61) and illicit drugs (PR: 1.6 CI95%: 1.11 -2.29); feelings of discrimination (RP: 1.4 CI95%: 1.01 - 1.96) and suicidal ideation (PR: 1.3 95%CI: 1.03 to 1.67); parents do not know what the adolescent does in free time (RP: 1.6 CI95%: 1.28 to 2.08) and adolescents who miss class without parental knowledge (RP: 1.6 95% CI: 1.32 -2.07). Overweight/obesity (RP: 0.7 CI95%: 0.47 - 0.94) had a protective behavior to sexual debut. Early PSD was associated with unhealthy lifestyle and poor quality of the relationship of young people with their parents.(AU)

Fatores associados ao início da vida sexual ativa de escolares em uma cidade do sul do Brasil / Associated factors in the initiation of sexual activity of students in a city in southern Brazil

Estudo transversal com objetivo de investigar a prevalência do início da vida sexual (IVS) e fatores associados em escolares da 7ª série da rede municipal de ensino. A amostra representativa de 1170 escolares foi analisada com regressão de Cox multivariada. A prevalência de IVS foi de 20,3%, sendo maior entre meninos (RP: 2,4 IC95%:1,86-3,06); cor de pele não branca (RP: 1,3 IC95%:1,05-1,64); uso na vida de álcool (RP: 2,3 IC95%: 1,68-3,24), tabaco (RP: 2,1 IC95%:1,62-2,61) e drogas ilícitas (RP: 1,6 IC95%:1,11-2,29); sentimento de discriminação (RP: 1,4 IC95%:1,01-1,96) e ideação suicida (RP: 1,3 IC95%:1,03-1,67); pais não sabem o que os jovens fazem no tempo livre (RP: 1,6 IC95%:1,28-2,08) e jovens que faltam a aula sem conhecimentos dos pais (RP: 1,6 IC95%:1,32-2,07). O sobrepeso/obesidade (RP: 0,7 IC95%:0,47-0,94) teve comportamento protetor para o início da vida sexual. O IVS precoce esteve associado com estilo de vida pouco saudável e má qualidade da relação dos jovens com seus pais.(AU)

Cross-sectional study in order to investigate the prevalence of sexual debut (PSD) and associated factors in students from 7th grade of municipal schools. A representative sample of 1170 students was analyzed with multivariate Cox regression. The prevalence of PSD was 20.3%, which is higher among boys (PR: 2.4 CI95%: 1.86 - 3.06); non-white skin color (PR: 1.3 CI95%: 1.05- 1.64); use of alcohol (RP: 2.3 CI95%: 1.68 -3.24), tobacco (RP: 2.1 CI95%: 1.62 - 2.61) and illicit drugs (PR: 1.6 CI95%: 1.11 -2.29); feelings of discrimination (RP: 1.4 CI95%: 1.01 - 1.96) and suicidal ideation (PR: 1.3 95%CI: 1.03 to 1.67); parents do not know what the adolescent does in free time (RP: 1.6 CI95%: 1.28 to 2.08) and adolescents who miss class without parental knowledge (RP: 1.6 95% CI: 1.32 -2.07). Overweight/obesity (RP: 0.7 CI95%: 0.47 - 0.94) had a protective behavior to sexual debut. Early PSD was associated with unhealthy lifestyle and poor quality of the relationship of young people with their parents.(AU)

Consumo de álcool e tabaco em escolares da rede pública de Santarém-PA / Consumption of alcohol and tobacco in students of public schools of Santarém-PA

OBJETIVO: Investigar a prevalência de uso na vida e nos últimos 30 dias de álcool e tabaco e sua associação com características de escolares do oitavo ano da rede pública de Santarém-PA em 2010. MATERIAL E MÉTODOS: Estudo transversal com amostra representativa de 689 escolares, sendo os dados coletados em entrevista e analisados com regressão de Cox. RESULTADOS: O uso na vida de tabaco foi de 12,1% e, destes, 36,1% consumiram nos últimos 30 dias. Houve associação entre uso na vida de cigarro e sexo masculino, consumo pelos pais e amigos, e experiência com álcool pelo jovem. O uso na vida de álcool foi de 40,7% e nos últimos 30 dias, 50,7%. Encontrou-se associação entre uso na vida de álcool e uso de tabaco na vida pelo jovem e consumo de álcool pelos pais. CONCLUSÃO: Os resultados apontam relação significativa entre consumo dessas substâncias pelos pais e pelos filhos.(AU)

OBJECTIVE: investigate the prevalence in life and in the last 30 days of alcohol and tobacco use and the association with adolescent students from the eighth grade of the public schools in Santarém-PA, 2010. METHOD: Cross-sectional study, with 689 students. Data were collected using validated questionnaires and analyzed with Cox regression. RESULTS: The tobacco use was 12,1%, of these 36,1% in the last 30 days. There was an association between the lifetime use of cigarettes and the male population, the consumptions by parents and by friends, and the experience with alcohol by the teenagers. The lifetime use of alcohol was 40,7% and in the last 30 days 50,7%. An association was found between the lifetime use of alcohol by the teenagers with the lifetime use of tobacco and the consumption of alcohol by parents. CONCLUSION: It is indicated a significant relationship between the consumption of the parents and the children.(AU)

Vida sexual de adolescentes escolares da rede pública de Porto Velho-RO / Sex life of school adolescents from Porto Velho-RO

OBJETIVO: Estudar a prevalência de início de vida sexual (IVS) e seus fatores associados em escolares do 8º ano da rede pública de Porto Velho-RO, em 2010. MATERIAL E MÉTODOS: estudo transversal com amostra representativa de 996 escolares analisada com teste T Student e regressão de Cox. RESULTADOS: a prevalência de IVS foi 25,5%. O IVS associou-se com sexo, idade, prática de atividades físicas, consumo de álcool, tabaco e drogas, falta às aulas sem o conhecimento dos pais, sentimento de tristeza e planejamento suicida. Os jovens que referiram que seus pais os entendem, que sabem onde estão no seu tempo livre e sentem discriminação apresentaram menos início de vida sexual. CONSIDERAÇÕES FINAIS: A escola deve discutir com seus alunos questões referentes à sexualidade e a estilos de vida saudáveis o mais precocemente possível, a fim de prepará-los para sua iniciação sexual e uma vida com mais qualidade.(AU)

OBJECTIVE: To study the prevalence of the beginning of sexual life (IVS) and related factors in school adolescents on the 8° year of the public school in Porto Velho-RO in 2010. MATERIAL AND METHODS: Transversal study with a representative sample of 996 school analyzed with t-Student test and Cox Regression. RESULTS: The prevalence of IVS was 25.5%. The IVS is associated with age, physical activity, alcohol, tobacco and drugs consumption, missing school without their parents' knowledge, sadness and suicidal plans. The adolescents, who reported that their parents understand them, know where they are in their free time and feel discrimination showed fewer sexual beginning. CONCLUSION: The school has to deal with the students questions related to sexuality and healthy lifestyle the early as possible, in a way to prepare them for their sexual initiation and a life with more quality.(AU)

Síndrome de Burnout: estudo de base populacional com servidores do setor público / Burnout Syndrome: population-based study on public servants / Síndrome de Burnout: estudio de base poblacional con servidores del sector público

OBJETIVO: Identificar preditores da síndrome de Burnout em trabalhadores do setor público. MÉTODOS: Estudo transversal com amostra representativa de 879 servidores públicos municipais de uma cidade da região metropolitana de Porto Alegre, RS. Utilizou-se um questionário elaborado para a coleta de variáveis demográficas e relacionadas às características do trabalho. A percepção sobre o ambiente laboral foi analisada a partir da Work Atmosphere Scale; para avaliar a síndrome de Burnout, utilizou-se o Maslach Burnout Inventory. Foram realizadas três análises de regressão linear múltipla pelo método stepwise em que cada dimensão da síndrome foi considerada como desfecho, enquanto as demais variáveis foram estimadas como preditoras e controladas por sexo e idade. RESULTADOS: As variáveis relacionadas à percepção do ambiente de trabalho foram as que mais contribuíram para a ocorrência de burnout. A percepção do trabalho como estressante e a presença de pessoas que atrapalham o ambiente laboral participaram do modelo explicativo das três dimensões. Nove variáveis compuseram o modelo preditor, que explicou 43% da ocorrência da Exaustão Emocional. "Perceber o trabalho como estressante" apresentou maior poder explicativo. Na Despersonalização, oito variáveis compuseram o modelo em 25%; "perceber o trabalho como estressante" foi, mais uma vez, a variável de maior poder explicativo. A Baixa Realização Profissional mostrou um conjunto de variáveis com poder explicativo de 20%; ambiente de trabalho considerado bom apresentou maior peso, associando-se inversamente. CONCLUSÕES: A percepção dos servidores públicos sobre seu ambiente de trabalho tem importante papel como preditor da síndrome de Burnout. Avaliar o trabalho como estressante e presença de pessoas que atrapalham o ambiente mostraram-se como elementos de maior relevância.

OBJECTIVE: To identify predictors of burnout syndrome among workers in the public sector. METHODS: Cross-sectional study with a representative sample consisting of 879 municipal civil servants in a city of the metropolitan region of Porto Alegre, Southern Brazil. In order to measure the demographic variables and related characteristics of work we used a questionnaire developed for this purpose.The perception of the work environment was measured by the Work Atmosphere Scale. The Maslach Burnout Inventory was used to assess burnout syndrome. Three multiple stepwise linear regression tests were performed, in which each dimension of the syndrome was considered outcome while the other variables were estimated as predictors, adjusted for gender and age. RESULTS: The variables related to perceptions of work environment were the ones which most contributed to the occurrence of burnout. Perceiving work as stressful and the presence of people who negatively affect the work environment contributed to the explanatory model of the three dimensions. There were nine variables which comprised a predictive model which explained 43% of Emotional Exhaustion. The variable 'perceives how stressful the job appeared to be' had the highest explanatory power. In Despersonalization, eight variables comprised 25% of the model and, once again, 'perceives how stressful the job appeared to be' was the variable with the highest explanatory power. 'Low Professional Fulfillment' revealed a set of variables with an explanatory power of 20%; a working environment considered to be good showed a higher weighting, showing it to be inversely associated. CONCLUSIONS: Public servants' perceptions of their work environment play an important role as a predictor of burnout. Viewing work as stressful and the presence of people who negatively affect the environment proved to be the elements of greatest importance.

OBJETIVO: Identificar predictores del Síndrome de Burnout en trabajadores del sector público. MÉTODOS: Estudio transversal con muestra representativa de 879 servidores públicos municipales de una ciudad de la región metropolitana de Porto Alegre, RS, Brasil. Se utilizó un cuestionario elaborado para la colecta de variables demográficas y relacionadas a las características del trabajo. La percepción sobre el ambiente laboral fue analizada a partir de la Work Atmosphere Scale; para evaluar el síndrome de Burnout, se utilizó el Maslach Burnout Inventory. Se realizaron tres análisis de regresión linear múltiple por el método stepwise en el que cada dimensión del síndrome fue considerada como resultado, mientras que las demás variables fueron estimadas como predictores y controladas por sexo y edad. RESULTADOS: Las variables relacionadas a la percepción del ambiente de trabajo fueron las que más contribuyeron en la ocurrencia de burnout. La percepción del trabajo como estresante y la presencia de personas que causan confusión en el ambiente laboral participaron del modelo explicativo de las tres dimensiones. Nueve variables conformaron el modelo predictor, explicando 43% de la ocurrencia del agotamiento emocional. “Percibir el trabajo como estresante” presentó mayor poder explicativo. En la despersonalización, ocho variables constitutyeron el modelo en 25%; “percibir el trabajo como estresante” fue una vez más, la variable de mayor poder explicativo. La baja realización profesional mostró un conjunto de variables con poder explicativo de 20%; ambiente de trabajo considerado bueno, presentó mayor peso, asociándose inversamente. CONCLUSIÓN: La percepción de los servidores públicos sobre su ambiente de trabajo tiene importante papel como predictor del síndrome de Burnout. Evaluar el trabajo como estresante y presencia de personas que originan confusión en el ambiente se mostraron como elementos de mayor relevancia.

[Burnout Syndrome: population-based study on public servants]. / Síndrome de Burnout: estudo de base populacional com servidores do setor público.

OBJECTIVE: To identify predictors of burnout syndrome among workers in the public sector. METHODS: Cross-sectional study with a representative sample consisting of 879 municipal civil servants in a city of the metropolitan region of Porto Alegre, Southern Brazil. In order to measure the demographic variables and related characteristics of work we used a questionnaire developed for this purpose.The perception of the work environment was measured by the Work Atmosphere Scale. The Maslach Burnout Inventory was used to assess burnout syndrome. Three multiple stepwise linear regression tests were performed, in which each dimension of the syndrome was considered outcome while the other variables were estimated as predictors, adjusted for gender and age. RESULTS: The variables related to perceptions of work environment were the ones which most contributed to the occurrence of burnout. Perceiving work as stressful and the presence of people who negatively affect the work environment contributed to the explanatory model of the three dimensions. There were nine variables which comprised a predictive model which explained 43% of Emotional Exhaustion. The variable 'perceives how stressful the job appeared to be' had the highest explanatory power. In Despersonalization, eight variables comprised 25% of the model and, once again, 'perceives how stressful the job appeared to be' was the variable with the highest explanatory power. 'Low Professional Fulfillment' revealed a set of variables with an explanatory power of 20%; a working environment considered to be good showed a higher weighting, showing it to be inversely associated. CONCLUSIONS: Public servants' perceptions of their work environment play an important role as a predictor of burnout. Viewing work as stressful and the presence of people who negatively affect the environment proved to be the elements of greatest importance.

Fatores associados à síndrome de burnout em funcionários públicos municipais / Associate factors at burnout syndrome in municipal public workers / Factores asociados al síndrome de burnout en trabajadores públicos municipales

Trata-se de estudo transversal - com amostra representativa de servidores públicos municipais de uma cidade da região metropolitana de Porto Alegre-RS - que investigou a síndrome de burnout e sua associação com características do cargo, percepção sobre o trabalho e contexto laboral. Utilizaram-se o Maslach Burnout Inventory, versão de Human Services Survey, e um questionário. A dimensão exaustão emocional teve os maiores índices, associando-se, principalmente, com trabalho à noite, turno integral ou variado e licenças de saúde. As três dimensões se associaram significativamente com variáveis que refletiam percepção negativa do ambiente e contexto do trabalho; baixa realização profissional só se associou com variáveis relacionadas à percepção do trabalho e contexto laboral, além de licenças de saúde, mas com nenhuma referente às características do cargo. O estudo mostra a importância da organização do trabalho no desenvolvimento da síndrome e a necessidade de intervenções preventivas, principalmente no âmbito das relações interpessoais.

It is a cross-sectional study aimed to evaluate the Burnout Syndrome in public workers of a city’s metropolitan region of Porto Alegre - RS, and its possible associations with characteristics of the position and the perception of type of work and workplace. The instrument used was composed of the Maslach Burnout Inventory, version Human Services Survey and a questionary. The Emotional Exhaustion dimension had higher scores. There was a relation, mainly of night shift, day shift or varied shifts to the health absences. The three dimensions of Burnout were associated with the variables that revealed dissatisfaction with the type of work and workplace. Low level of professional fulfillment was only associated to the variables related to the work perception and the labor context as well as health absences. Neither of them were related to the characteristics of the position of the worker. The study shows the importance of the work organization on the development of the syndrome and the necessity of preventive interventions, mainly regarding the interpersonal relationships at work.

Estudio transversal con una muestra representativa de los trabajadores del ayuntamiento de una ciudad de la Comunidad de Porto Alegre - RS, que investigó el síndrome de burnout y su asociación con características de la función ejercida, percepción acerca del trabajo y contexto laboral. El instrumento utilizado fue el Maslach Burnout Inventory, versión Human Services Survey y un cuestionario. La dimensión agotamiento emocional fue la que tuvo los más altos índices y estuvo asociada con trabajo nocturno, turno completo o variado y ausentismo laboral por problemas de salud. Hubo asociación estadísticamente significativa entre las tres dimensiones y variables que reflejan una percepción negativa del ambiente y contexto laboral. Baja realización profesional tuvo asociación tan solo con variables relativas a la percepción del trabajo y contexto laboral, y absentismo laboral por problemas de salud, pero no presentó asociación con características de la función ejercida. El estudio demuestra la importancia de la organización del trabajo en el desarrollo del síndrome y la necesidad de intervenciones preventivas principalmente en el ámbito de las relaciones interpersonales.

A case-control study of factors associated with multiple psychiatric readmissions.

OBJECTIVE: This case-control study explored factors associated with multiple psychiatric admissions, focusing on service-related and individual-level factors. METHODS: The case group consisted of 307 adults admitted to either of two public psychiatric hospitals in southern Brazil during a 12-month period; they had had three or more psychiatric admissions in the two years before the current admission. To account for the recurrent nature of psychiatric admissions, a concurrent case-control design was adopted, which allowed patients in the case group to return at discharge to the population at risk of readmission. The control group consisted of individuals who had their first inpatient readmission in 2006 (N=354). A hierarchical model with four levels was used for data analysis. RESULTS: Individuals who had been referred to community psychosocial support units after their most recent discharge had about 20% lower odds of multiple readmissions than those referred to usual outpatient care. Those who lived closer to the hospital (residents of the same city) were more likely to have multiple readmissions. The adjusted multivariate hierarchical analysis revealed that a diagnosis of schizophrenia or psychotic symptoms was associated with multiple readmissions, as were younger age at first admission and a greater number of previous admissions. CONCLUSIONS: The study suggests that community psychosocial support services play a strong role in preventing multiple psychiatric admissions. Further research is needed to identify the specific components of these services that reduce readmission and to analyze their cost-effectiveness.

Child sexual abuse in southern Brazil and associated factors: a population-based study.

BACKGROUND: The prevalence of child sexual abuse (CSA) in the population has been poorly described in developing countries. Population data on child sexual abuse in Brazil is very limited. This paper aims to estimate lifetime prevalence of child sexual abuse and associated factors in a representative sample of the population aged 14 and over in a city of southern Brazil. METHODS: A two-stage sampling strategy was used and individuals were invited to respond to a confidential questionnaire in their households. CSA was defined as non-consensual oral-genital, genital-genital, genital-rectal, hand-genital, hand-rectal, or hand-breast contact/intercourse between ages 0 and 18. Associations between socio-demographic variables and CSA, before and after age 12, were estimated through multinomial regression. RESULTS: Complete data were available for 1936 respondents from 1040 households. Prevalence of CSA among girls (5.6% 95%CI [4.8;7.5]) was higher than among boys (1.6% 95%CI [0.9;2.6]). Boys experienced CSA at younger ages than girls and 60% of all reported CSA happened before age 12. Physical abuse was frequently associated with CSA at younger (OR 5.6 95%CI [2.5;12.3]) and older (OR 9.4 95%CI [4.5;18.7]) ages. CSA after age 12 was associated with an increased number of sexual partners in the last 2 months. CONCLUSION: Results suggest that CSA takes place at young ages and is associated with physical violence, making it more likely to have serious health and developmental consequences. Except for gender, no other socio-demographic characteristic identified high-risk sub-populations.

[Access by hearing-disabled individuals to health services in a southern Brazilian city]. / Acesso de pessoas deficientes auditivas a serviços de saúde em cidade do Sul do Brasil.

This cross-sectional study aimed to compare access to health services and preventive measures by persons with hearing disability and those with normal hearing in Canoas, Rio Grande do Sul State, Brazil. The sample included 1,842 individuals 15 years or older (52.9% of whom were females). The most frequent income bracket was twice the minimum wage or more, or approximately U$360/month (42.7%). Individuals with hearing disability were more likely to have visited a physician in the previous two months (PR = 1.3, 95%CI: 1.10-1.51) and to have been hospitalized in the previous 12 months (PR = 2.1, 95%CI: 1.42-3.14). Regarding mental health, individuals with hearing disability showed 1.5 times greater probability of health care due to mental disorders and 4.2 times greater probability of psychiatric hospitalization as compared to those with normal hearing. Consistent with other studies, women with hearing disability performed less breast self-examination and had fewer Pap smears. The data indicate the need to invest in specific campaigns for this group of individuals with special needs.

Acesso de pessoas deficientes auditivas a serviços de saúde em cidade do Sul do Brasil / Access by hearing-disabled individuals to health services in a southern Brazilian city

Este estudo transversal, de base populacional, tem como objetivo comparar o acesso dos portadores de deficiência auditiva incapacitante a serviços assistenciais e de prevenção com os ouvintes de Canoas, Rio Grande do Sul, Brasil. A amostra incluiu 1.842 pessoas com 15 anos ou mais, sendo a maioria mulheres (52,9 por cento). A renda individual de dois salários mínimos ou mais foi a mais freqüente (42,7 por cento). As pessoas com deficiência auditiva incapacitante tiveram 30 por cento maior probabilidade de ter consultado nos dois meses anteriores à entrevista (RP = 1,3, IC95 por cento: 1,10-1,51) e ter sido internado nos 12 meses anteriores à entrevista (RP = 2,1, IC95 por cento: 1,42-3,14). Nas variáveis relativas à saúde mental, os deficientes auditivos tiveram 1,5 mais probabilidade de terem consultado para problemas de nervos (IC95 por cento: 1,18-1,95) e 4,2 mais probabilidades de terem sido internados em hospital psiquiátrico que os ouvintes (IC95 por cento: 2,17-8,16). Assim como encontrado na literatura, as mulheres deficientes auditivas realizaram menos auto-exame das mamas e exame citopatológico de colo uterino. Os dados encontrados indicam a necessidade de investir em educação em saúde e campanhas específicas para o grupo de pessoas investigado.

This cross-sectional study aimed to compare access to health services and preventive measures by persons with hearing disability and those with normal hearing in Canoas, Rio Grande do Sul State, Brazil. The sample included 1,842 individuals 15 years or older (52.9 percent of whom were females). The most frequent income bracket was twice the minimum wage or more, or approximately U$360/month (42.7 percent). Individuals with hearing disability were more likely to have visited a physician in the previous two months (PR = 1.3, 95 percentCI: 1.10-1.51) and to have been hospitalized in the previous 12 months (PR = 2.1, 95 percentCI: 1.42-3.14). Regarding mental health, individuals with hearing disability showed 1.5 times greater probability of health care due to mental disorders and 4.2 times greater probability of psychiatric hospitalization as compared to those with normal hearing. Consistent with other studies, women with hearing disability performed less breast self-examination and had fewer Pap smears. The data indicate the need to invest in specific campaigns for this group of individuals with special needs.

Sentimento de discriminação em estudantes: prevalência e fatores associados / Feelings of discrimination among students: prevalence and associated factors

OBJETIVO: Estimar a prevalência e fatores associados ao sentimento de discriminação entre estudantes. MÉTODOS: Estudo transversal com amostra representativa de 1.170 escolares de um total de 2.282 matriculados na sétima série do ensino fundamental em escolas municipais de Gravataí (RS), em 2005. Os participantes foram selecionados por amostragem aleatória por conglomerado. Os dados foram obtidos com instrumentos auto-aplicados (Global School-based Student Health Survey, body shape questionnaire, classificação socioeconômica) preenchidos em sala de aula. Foi utilizada a regressão de Cox modificada para estudos transversais, segundo modelo hierarquizado em quatro etapas. RESULTADOS: A prevalência de sentimento de discriminação foi de 21,0 por cento, mais prevalente entre: as meninas (RP=1,93, IC 95 por cento 1,51;2,46); os que apresentaram absenteísmo escolar (RP=1,54, IC 95 por cento 1,21;1,97); os que fizeram uso na vida de tabaco (RP=1,53, IC 95 por cento 1,18;1,98); os preocupados com sua imagem corporal (RP=1,42, IC 95 por cento 1,07;1,88); os com sentimento de solidão (RP=2,50, IC 95 por cento 1,80;3,46) e tristeza (RP=1,29, IC 95 por cento 1,02;1,62); os com dificuldade para dormir (RP:1,41, IC 95 por cento 1,08;1,83); os com ideação suicida (RP=1,45, IC 95 por cento 1,13;1,85) e os que sofreram algum tipo de injúria acidental (RP=1,56, IC 95 por cento 1,23;1,97) ou intencional (RP=2,04, IC 95 por cento 1,51;2,76). CONCLUSÕES: O sentimento de discriminação esteve associado ao sexo e à experiência com tabaco. Sua associação com fatores psicossociais indica a coexistência de situações adversas, como a insatisfação com a imagem corporal, sintomas depressivos e presença de injúrias. Esses resultados mostram a importância da atuação conjunta de professores e profissionais de saúde na identificação precoce desse sentimento, orientação e acompanhamento de jovens enfrentando essas situações.

OBJECTIVE: To estimate the prevalence of and factors associated with feelings of discrimination among students. METHODS: Cross-sectional study with a representative sample of 1,170 students from a total of 2,282 students enrolled in the 7th grade of an elementary school of the city of Gravataí, Southern Brazil, in 2005. Participants were selected by conglomerate random sampling. Data were obtained from self-applied instruments (Global School-based Student Health Survey, Body Shape Questionnaire, socioeconomic classification) that were completed in the classroom. Cox regression, modified for cross-sectional studies, was employed, according to a four-stage hierarchical model. RESULTS: Prevalence of feelings of discrimination was 21.0 percent. These feelings were more prevalent among: girls (PR=1.93, 95 percent CI 1.51;2.46); those showing school absenteeism (PR=1.54, 95 percent CI 1.21;1.97); those who had used tobacco in their lives (PR=1.53, 95 percent CI 1.18;1.98); those concerned about their body image (PR=1.42, 95 percent CI 1.07;1.88); those with feelings of loneliness (PR=2.50, 95 percent CI 1.80;3.46) and sadness (PR=1.29, 95 percent CI 1.02;1.62); those with sleep difficulties (PR:1.41, 95 percent CI 1.08;1.83); those with suicidal ideation (PR=1.45, 95 percent CI 1.13;1.85) and those who had suffered some type of accidental (PR=1.56, 95 percent CI 1.23;1.97) or intentional injury (PR=2.04, 95 percent CI 1.51;2.76). CONCLUSIONS: Feelings of discrimination were associated with sex and experience with tobacco. Its association with psychosocial factors indicates the coexistence of adverse situations, such as dissatisfaction with body image, depressive symptoms and presence of insults. These findings show the importance of health professionals and teachers acting together to identify these feelings early on, and guide and follow adolescents facing such situations.

OBJETIVO: Estimar la prevalencia y factores asociados al sentimiento de discriminación entre estudiantes. MÉTODOS: Estudio transversal con muestra representativa de 1.170 escolares de un total de 2.282 matriculados en la séptima serie de la enseñanza fundamental en escuelas municipales de Gravataí (Sur de Brasil), en 2005. Los participantes fueron seleccionados por muestreo aleatorio por conglomerado. Los datos fueron obtenidos con instrumentos auto-aplicados (Global School-based Student Health Survey, body shape questionnaire, clasificación socioeconómica) llenados en sala de aula. Fue utilizada la regresión de Cox modificada para estudios transversales, según modelo jerarquizado en cuatro etapas. RESULTADOS: La prevalencia de sentimiento de discriminación fue de 21,0 por ciento, más prevalente entre: las niñas (RP= 1,93, IC 95 por ciento 1,51; 2,46); los que presentaron ausentismo escolar (RP= 1,54, IC 95 por ciento 1,21; 1,97); los que hicieron uso de tabaco en la vida (RP= 1,53, IC 95 por ciento 1,18; 1,98); los preocupados con su imagen corporal (RP=1,42, IC 95 por ciento 1,07;1,88); aquellos con sentimiento de soledad (RP=2,50, IC 95 por ciento 1,80;3,46); y tristeza (RP=1,29, IC 95 por ciento 1,02;1,62); aquellos con dificultad para dormir (RP:1,41, IC 95 por ciento 1,08;1,83); los que presentaron ideación suicida (RP=1,45, IC 95 por ciento 1,13;1,85) y los que sufrieron algún tipo de injuria accidental (RP=1,56, IC 95 por ciento 1,23;1,97) o intencional (RP=2,04, IC 95 por ciento 1,51;2,76). CONCLUSIONES: El sentimiento de discriminación estuvo asociado al sexo y a la experiencia con tabaco. Su asociación con factores psicosociales indica la coexistencia de situaciones adversas, como la insatisfacción con la imagen corporal, síntomas depresivos y presencia de injurias. Estos resultados muestran la importancia de la actuación conjunta de profesores y profesionales de salud en la identificación precoz de ese sentimiento, orientación...

[Feelings of discrimination among students: prevalence and associated factors]. / Sentimento de discriminação em estudantes: prevalência e fatores associados.

OBJECTIVE: To estimate the prevalence of and factors associated with feelings of discrimination among students. METHODS: Cross-sectional study with a representative sample of 1,170 students from a total of 2,282 students enrolled in the 7th grade of an elementary school of the city of Gravataí, Southern Brazil, in 2005. Participants were selected by conglomerate random sampling. Data were obtained from self-applied instruments (Global School-based Student Health Survey, Body Shape Questionnaire, socioeconomic classification) that were completed in the classroom. Cox regression, modified for cross-sectional studies, was employed, according to a four-stage hierarchical model. RESULTS: Prevalence of feelings of discrimination was 21.0%. These feelings were more prevalent among: girls (PR=1.93, 95% CI 1.51;2.46); those showing school absenteeism (PR=1.54, 95% CI 1.21;1.97); those who had used tobacco in their lives (PR=1.53, 95% CI 1.18;1.98); those concerned about their body image (PR=1.42, 95% CI 1.07;1.88); those with feelings of loneliness (PR=2.50, 95% CI 1.80;3.46) and sadness (PR=1.29, 95% CI 1.02;1.62); those with sleep difficulties (PR:1.41, 95% CI 1.08;1.83); those with suicidal ideation (PR=1.45, 95% CI 1.13;1.85) and those who had suffered some type of accidental (PR=1.56, 95% CI 1.23;1.97) or intentional injury (PR=2.04, 95% CI 1.51;2.76). CONCLUSIONS: Feelings of discrimination were associated with sex and experience with tobacco. Its association with psychosocial factors indicates the coexistence of adverse situations, such as dissatisfaction with body image, depressive symptoms and presence of insults. These findings show the importance of health professionals and teachers acting together to identify these feelings early on, and guide and follow adolescents facing such situations.

[Suicide planning among teenage students: prevalence and associated factors]. / Planejamento suicida entre adolescentes escolares: prevalência e fatores associados.

This cross-sectional study evaluated the prevalence of suicide planning and associated factors in a representative sample of 12- to-18-year-old students in Porto Alegre, Rio Grande do Sul State, Brazil. Two self-administered questionnaires were used to collect data: a questionnaire, standardized by the World Health Organization, about use of alcohol and drugs, violence, feelings of loneliness and sadness, family relationships, suicide planning, behavior in school, and relationships with friends; and the Body Shape Questionnaire. Prevalence of suicide planning was 6.3%. Multivariate analysis using Cox regression showed that the prevalence of suicide planning was higher among girls and among adolescents that reported problems in the relationships with their parents. Drug use by friends and having a small number of close friends increased suicide planning by 90% and 66%, respectively. Prevalence of suicide planning was two to three times greater among adolescents bullied by classmates or who reported feelings of loneliness or sadness. Adverse family relationships, aggressive interactions with classmates, and depressive symptoms increase the prevalence of suicide planning. Therefore, preventive measures should be developed in schools and should include the family.

Planejamento suicida entre adolescentes escolares: prevalência e fatores associados / Suicide planning among teenage students: prevalence and associated factors

Estudo transversal com objetivo de investigar a prevalência de planejamento suicida e fatores associados em amostra representativa de adolescentes escolares de um município da grande Porto Alegre, Rio Grande do Sul, Brasil, com idade entre 12 e 18 anos. Para a coleta de dados, utilizaram-se dois questionários auto-aplicáveis: um sobre uso de álcool, drogas, violência, sentimentos de solidão e tristeza, relacionamento familiar, planejamento suicida, comportamento na escola e com amigos, padronizado pela Organização Mundial da Saúde, e o Body Shape Questionnaire. A prevalência de planejamento suicida foi 6,3 por cento. A análise multivariada utilizando a regressão de Cox mostrou que o planejamento suicida é mais prevalente em meninas e jovens que referem problemas na relação com os pais. O uso de drogas pelos amigos e pequeno número de amigos próximos aumentaram em, respectivamente, 90 por cento e 66 por cento o planejamento suicida. Aqueles agredidos por colegas, os que referiram sentirem-se sozinhos e tristes apresentaram duas a três vezes mais prevalência de planejamento suicida. Assim, relações familiares adversas, contatos agressivos com colegas e sintomas depressivos aumentam a prevalência de planejamento suicida, necessitando de ações preventivas na escola, incluindo a família.

This cross-sectional study evaluated the prevalence of suicide planning and associated factors in a representative sample of 12- to-18-year-old students in Porto Alegre, Rio Grande do Sul State, Brazil. Two self-administered questionnaires were used to collect data: a questionnaire, standardized by the World Health Organization, about use of alcohol and drugs, violence, feelings of loneliness and sadness, family relationships, suicide planning, behavior in school, and relationships with friends; and the Body Shape Questionnaire. Prevalence of suicide planning was 6.3 percent. Multivariate analysis using Cox regression showed that the prevalence of suicide planning was higher among girls and among adolescents that reported problems in the relationships with their parents. Drug use by friends and having a small number of close friends increased suicide planning by 90 percent and 66 percent, respectively. Prevalence of suicide planning was two to three times greater among adolescents bullied by classmates or who reported feelings of loneliness or sadness. Adverse family relationships, aggressive interactions with classmates, and depressive symptoms increase the prevalence of suicide planning. Therefore, preventive measures should be developed in schools and should include the family.

[Physical violence and associated factors: a population-based study in Southern Brazil]. / Violência física e fatores associados: estudo de base populacional no sul do Brasil.

OBJECTIVE: To estimate the prevalence of physical violence and its association with sociodemographic aspects, stressful life events, and the use of health services due to emotional problems. METHODS: A cross-sectional population-based study was conducted with a sample of 1,954 14-year-old or older inhabitants of the city of Canoas (Southern Brazil). They were selected by means of conglomerate sampling according to a pre-established system. Data were obtained in visits to households by means of a confidential semi-structured questionnaire. A bivariate analysis was carried out through multinomial logistic regression, and the multivariate analysis by polytomous logistic regression, categorizing the outcome by age group. RESULTS: The findings show a prevalence of 9.7% (CI 95%: 8.37;11.03) and association with: women 20 years old and older (OR=2.74; CI 95%: 1.52;4.94); higher schooling rate (p<0.03); higher experience of stressful life events at 20 years of age or more (OR=6.61; CI 95%: 2.71;16.1); and doctors' appointments due to emotional problems as of 10 years of age (p>0.001). CONCLUSIONS: The prevalence of physical violence in the population was significant, resulting in important emotional consequences and impact on health services, requiring capacity building of the professionals in the field.