Burnout is a syndrome that results from chronic stress at work, with several consequences to workers’ well-being and health. This systematic review aimed to summarize the evidence of the physical, psychological and occupational consequences of job burnout in prospective studies. The PubMed, Science Direct, PsycInfo, SciELO, LILACS and Web of Science databases were searched without language or date restrictions. The Transparent Reporting of Systematic Reviews and Meta-Analyses guidelines were followed. Prospective studies that analyzed burnout as the exposure condition were included. Among the 993 articles initially identified, 61 fulfilled the inclusion criteria, and 36 were analyzed because they met three criteria that must be followed in prospective studies. Burnout was a significant predictor of the following physical consequences: hypercholesterolemia, type 2 diabetes, coronary heart disease, hospitalization due to cardiovascular disorder, musculoskeletal pain, changes in pain experiences, prolonged fatigue, headaches, gastrointestinal issues, respiratory problems, severe injuries and mortality below the age of 45 years. The psychological effects were insomnia, depressive symptoms, use of psychotropic and antidepressant medications, hospitalization for mental disorders and psychological ill-health symptoms. Job dissatisfaction, absenteeism, new disability pension, job demands, job resources and presenteeism were identified as professional outcomes. Conflicting findings were observed. In conclusion, several prospective and high-quality studies showed physical, psychological and occupational consequences of job burnout. The individual and social impacts of burnout highlight the need for preventive interventions and early identification of this health condition in the work environment.

Resumo A Síndrome de Burnout resulta do estresse crônico no trabalho e é composta por três dimensões: exaustão emocional, despersonalização e realização profissional. Objetivou-se identificar, em professores da educação básica de Londrina, no Paraná, fatores associados a piores níveis nessas dimensões. Trata-se de estudo transversal realizado entre agosto de 2012 e junho de 2013. Foram pesquisadas características sociodemográficas, ocupacionais, relacionamentos na escola, violência contra o professor e Síndrome de Burnout por meio da escala Maslach Burnout Inventory (MBI). Pontuações > percentil 75 na MBI (exaustão emocional e despersonalização) ou < percentil 25 (realização profissional) foram consideradas como piores níveis. Foram realizadas análises bivariadas e múltiplas por regressão de Poisson. Participaram da pesquisa 804 professores. Após ajustes, relacionamento ruim/regular com alunos associou-se a piores níveis nas três dimensões da escala. Tempo insuficiente para família/lazer e relacionamento ruim/regular com pais permaneceram significativos para piores níveis de exaustão emocional e de despersonalização. Violência física, quantidade de alunos considerada ruim/regular e infraestrutura ruim da escola ainda se mantiveram associadas a piores níveis de despersonalização, enquanto oportunidade ruim/regular para expressar opiniões no trabalho associou-se à baixa realização profissional. Ambiente de trabalho hostil e outros fatores laborais devem ser priorizados por políticas de prevenção da Síndrome de Burnout em professores.

Resumo O objetivo deste trabalho foi estimar a prevalência da percepção de problemas vocais frequentes em professores da educação básica e investigar os fatores ocupacionais associados. Estudo transversal, realizado mediante entrevistas de 967 professores atuantes em 20 escolas estaduais de Londrina, Paraná, Brasil. A percepção de problemas vocais frequentes foi de 25,7%. Análises ajustadas mostraram associação desses problemas com características do vínculo de trabalho (≥ 40 horas/semana, percepção ruim da remuneração e dos benefícios de saúde), características do ambiente de trabalho (quantidade de alunos por sala, exposição a pó de giz e micro-organismos), aspectos psicológicos (menor realização profissional, baixa oportunidade de expressar opiniões, pior relacionamento com superiores e equilíbrio entre vida profissional e pessoal) e situações de violência (insultos e assédio moral). A percepção de transtornos vocais frequentes afeta um em cada quatro professores da educação básica e está associada a diversas características da atividade docente, tanto estruturais como referentes ao processo de trabalho.

Social and epidemiological aspects of dengue were evaluated in an important metropolitan area in southern Brazil, from August 2012 to September 2014. Demographic, clinical, serological data were collected from patients with acute dengue symptoms treated at public health system units (HSUs). A systematic approach to analyze the spatial and temporal distribution of cases was developed, considering the temporal cross-correlation between dengue and weather, and the spatial correlation between dengue and income over the city's census tracts. From the 878 patients with suggestive symptoms, 249 were diagnosed as positive dengue infection (28%). Considering the most statistically significant census tracts, a negative correlation was found between mean income and dengue (r = −0.65; p = 0.02; 95% CI: −0.03 to −0.91). The occurrence of dengue followed a seasonal distribution, and it was found to be three and four months delayed in relation to precipitation and temperature, respectively. Unexpectedly, the occurrence of symptomatic patients without dengue infection followed the same seasonal distribution, however its spatial distribution did not correlate with income. Through this methodology, we have found evidence that suggests a relation between dengue and poverty, which enriches the debate in the literature and sheds light on an extremely relevant socioeconomic and public health issue.

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This study aimed to identify associations between sociodemographic, workplace, and school environmental factors and the occurrence of physical violence against teachers at school. This was a cross-sectional study of teachers that had been working for at least a year in elementary or middle schools in the state school system in Londrina, Paraná State, Brazil. A convenience sample was taken of the 20 schools with the most teachers in the city of Londrina. Data were obtained through interviews and self-completed questionnaires in 2012 and 2013. Physical violence was defined as reports of attempted or actual physical aggression using cold steel weapons or firearms in the 12 months prior to the study. Structural equation models were used for the data analysis. Of the 937 teachers eligible for the study, 789 (84.2%) were interviewed. The physical violence victimization rate in schoolteachers was 8.4%. Work conditions (number of schools where the teachers worked and type of employment contract) showed a direct effect on physical violence (p = 0.032), as did having experienced previous situations of violence in the school (p = 0.059). Age (up to 40 years) was indirectly related to physical violence, correlating with worse work conditions. The results highlight the importance of improving teachers' work conditions and implementing measures to prevent violence both in schools and in society as a whole.

Our purpose was to identify individual and work-related factors that are associated with psychological violence (PV) and are related to a higher number of PV forms among teachers. This cross-sectional study included 789 elementary and high school teachers in a municipality in southern Brazil. Data were obtained through interviews and a self-administered questionnaire. PV was characterized by reports of insults from students, humiliation by colleagues or teachers, and threats in the 12 months preceding the study. Factors associated with the number of PV forms were also investigated. Poisson regression models were used for the analyses. More than half (64.1%) of the teachers reported at least one event of PV, 38.3% reported only one form, 21.5% reported two forms, and 4.3% reported all three surveyed forms. After adjustments, poor relationships with superiors or students and having suffered physical violence at school remained associated with at least one PV episode. The same variables were associated with the number of forms of PV, as were age (inverse relationship) and violence outside of school. The higher the number of aggregated factors, the more estimated forms of PV, particularly among the younger teachers. These results highlight the importance of adopting strategies that promote a nonviolent and safe school environment for teachers, which will in turn improve work conditions, the quality of education, and teachers' health.

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