Speech perception in adolescents with pre-lingual hearing impairment with cochlear implants

Profound hearing loss is a disability that affects personality and when it involves teenagers before language acquisition, these bio-psychosocial conflicts can be exacerbated, requiring careful evaluation and choice of them for cochlear implant. Aim: To evaluate speech perception by adolescents with profound hearing loss, users of cochlear Implants. Study Design: Prospective. Materials and Methods: Twenty-five individuals with severe or profound pre-lingual hearing loss who underwent cochlear implantation during adolescence, between 10 to 17 years and 11 months, who went through speech perception tests before the implant and 2 years after device activation. For comparison and analysis we used the results from tests of four choice, recognition of vowels and recognition of sentences in a closed setting and the open environment. Results: The average percentage of correct answers in the four choice test before the implant was 46.9% and after 24 months of device use, this value went up to 86.1% in the vowels recognition test, the average difference was 45.13% to 83.13% and the sentences recognition test together in closed and open settings was 19.3% to 60.6% and 1.08% to 20.47% respectively. Conclusion: All patients, although with mixed results, achieved statistical improvement in all speech tests that were employed.

Importância do fonoaudiólogo no acompanhamento de indivíduos com hipotireoidismo congênito

TEMA: o hipotireoidismo congênito é uma alteração metabólica que traz conseqüência graves para indivíduos não tratados e mesmo as crianças que realizam o tratamento podem apresentar distúrbios do desenvolvimento. O Programa Nacional de Triagem Neonatal, instituído pelo Ministério da Saúde, prevê o acompanhamento longitudinal de indivíduos com equipe multidisciplinar. Entretanto, a Fonoaudiologia não é incluída nesta equipe. Deste modo, considerando a ocorrência de distúrbios da comunicação nestes indivíduos, realizou-se levantamento bibliográfico nas bases de dados Lilacs, MedLine e PubMed, no período de 1987 a 2007, referente às alterações em habilidades do desenvolvimento decorrentes do hipotireoidismo congênito. OBJETIVO: verificar, na literatura científica, presença de alterações do desenvolvimento em indivíduos com hipotireoidismo congênito e refletir sobre a importância da atuação fonoaudiológica, em conjunto com equipe multidisciplinar especializada, no acompanhamento dos mesmos. CONCLUSÃO: a literatura relata alterações nas habilidades do desenvolvimento (motoras, cognitivas, lingüísticas e de autocuidados) e destaca que crianças com hipotireoidismo congênito são de risco para alterações no desenvolvimento lingüístico e, portanto, necessitam do acompanhamento longitudinal do desenvolvimento comunicativo. Torna-se evidente a importância da atuação do fonoaudiólogo nos Programas de Triagem Neonatal credenciados pelo Ministério da Saúde. Ressalta-se ainda a necessidade de investigações referentes às outras alterações metabólicas contempladas nestes programas, nas quais o fonoaudiólogo pode atuar de modo a prevenir, habilitar e reabilitar os distúrbios da comunicação, contribuindo para o trabalho em equipe, promovendo saúde nesta população.

Terapêutica interdisciplinar para fratura cominutiva de côndilo por projétil de arma de fogo: enfoque miofuncional

TEMA: ferimentos causados por projéteis de arma de fogo apresentam alta incidência na região da cabeça e face. A articulação temporomandibular pode estar envolvida, além de estruturas anatômicas importantes como o nervo facial, necessitando de equipe multidisciplinar para efetuar tratamento adequado. PROCEDIMENTOS: apresentação de caso clínico de fratura condilar cominutiva causada por projétil de arma de fogo tratado de forma não-cirúrgica associado à terapia miofuncional orofacial. Paciente encaminhado para avaliação e procedimentos fonoaudiológicos após conduta da equipe de cirurgia bucomaxilofacial, sem remoção do projétil, alojado superficialmente, próximo da origem do músculo esternocleidomastóideo à direita, com fratura condilar cominutiva e lesão do nervo facial. Foram aspectos observados em avaliação: mordida aberta anterior, importante redução da amplitude dos movimentos mandibulares com desvios para o lado acometido, ausência de lateralidade contralateral, dor muscular, paralisia e parestesia em terço médio e superior da hemiface direita. Realizadas sessões de terapia miofuncional seguindo protocolo específico para traumas de face constando de: drenagem de edema; manipulações na musculatura levantadora da mandíbula ipsilateral; ampliação e correção dos movimentos mandibulares; procedimentos específicos referentes à paralisia facial e reorganização funcional direcionada. RESULTADOS: após oito semanas de terapia os resultados obtidos mostram restabelecimento de amplitude e da simetria dos movimentos mandibulares, reorganização da mastigação, adequação da deglutição e fala, remissão da sintomatologia dolorosa e remissão da paralisia do terço médio. CONCLUSÃO: o tratamento conservador da fratura por meio da terapia miofuncional orofacial resultou na reabilitação funcional da mandíbula e face dirigindo os movimentos e estimulando a adequação das funções estomatognáticas.

Formação de profissionais de saúde no Brasil: uma análise no período de 1991 a 2008

Estudo conduzido com o objetivo de contribuir para o planejamento e implementação de políticas de qualificação profissional no campo da saúde. Foram analisados 14 cursos de graduação da área da saúde: biomedicina, ciências biológicas, educação física, enfermagem, farmácia, fisioterapia, fonoaudiologia, medicina, medicina veterinária, nutrição, odontologia, psicologia, serviço social e terapia ocupacional, no período de 1991 a 2008. Dados sobre número de ingressantes, taxa de ocupação de vagas, distribuição de concluintes por habitante, gênero e renda familiar foram coletados a partir dos bancos do Ministério da Educação. Para o curso de medicina, a relação foi de 40 candidatos por vaga nas instituições públicas contra 10 nas privadas. A maioria dos ingressantes era composta por mulheres. A região Sudeste concentrou 57% dos concluintes, corroborando o desequilíbrio de distribuição regional das oportunidades de formação de profissionais de saúde e indicando a necessidade de políticas de incentivo à redução dessas desigualdades.

Migração e referenciais identificatórios: linguagem e preconceito

A ausência de diálogos no mundo massificado impõe um discurso padronizado. Tenta-se eliminar as diferenças e os limites que estruturam as identidades são ameaçados. A violência desse mundo joga para a periferia grandes segmentos da população, condenados a viver em condições desumanas. Migrantes e imigrantes, desenraizados dos fundamentos de suas identidades, constituem parte expressiva dessa população. Grandes metrópoles, como São Paulo, são verdadeiros lócus do embate intercultural que os ameaça. Nossa discussão se apóia em trabalho de pesquisa anterior com crianças nordestinas em escolas paulistas - pudemos constatar o preconceito, a humilhação que atingem essa população. O ponto de partida para a humilhação é, quase sempre, sua linguagem regional, vista como errada e inadequada. A lingüística e a sociolingüística nos mostram o contrário. Entretanto, tudo que enraíza e fortalece a identidade é negado. A “barbárie civilizada” destrói desejo, sonhos, esperança, alteridade.

Health Related Quality of Life Assessment questionnaire for children aged 5 to 11 years with HIV/AIDS: cross-cultural adaptation for the Portuguese language

The objective of this study is to describe preliminary results from the cross-cultural adaptation of the Quality of Life Assessment Questionnaire, used to measure health related quality of life (HRQL) in Brazilian children aged between 5 and 11 with HIV/AIDS. The cross-cultural model evaluated the Concept, Item, Semantic and Measurement Equivalences (internal consistency and intra-observer reliability). Evaluation of the conceptual, item, semantic equivalences showed that the Portuguese version is pertinent for the Brazilian context. Four of seven domains showed internal consistency above 0.70 (α: 0.76-0.90) and five of seven revealed intra-observer reliability (ricc: 0.41-0.70). This first Portuguese version of the HRQL questionnaire can be understood as a valuable tool for assessing children's HRQL, but further studies with large samples and more robust analyses are recommended before use in the Brazilian context.

Biologically Plausible Connectionist Prediction of Natural Language Thematic Relations

In Natural Language Processing (NLP) symbolic systems, several linguistic phenomena, for instance, the thematic role relationships between sentence constituents, such as AGENT, PATIENT, and LOCATION, can be accounted for by the employment of a rule-based grammar. Another approach to NLP concerns the use of the connectionist model, which has the benefits of learning, generalization and fault tolerance, among others. A third option merges the two previous approaches into a hybrid one: a symbolic thematic theory is used to supply the connectionist network with initial knowledge. Inspired on neuroscience, it is proposed a symbolic-connectionist hybrid system called BIO theta PRED (BIOlogically plausible thematic (theta) symbolic-connectionist PREDictor), designed to reveal the thematic grid assigned to a sentence. Its connectionist architecture comprises, as input, a featural representation of the words (based on the verb/noun WordNet classification and on the classical semantic microfeature representation), and, as output, the thematic grid assigned to the sentence. BIO theta PRED is designed to ""predict"" thematic (semantic) roles assigned to words in a sentence context, employing biologically inspired training algorithm and architecture, and adopting a psycholinguistic view of thematic theory.

Noise reduction in biomedical speech signal processing based on time and frequency Kalman filtering combined with spectral subtraction

The goal of this paper is to study and propose a new technique for noise reduction used during the reconstruction of speech signals, particularly for biomedical applications. The proposed method is based on Kalman filtering in the time domain combined with spectral subtraction. Comparison with discrete Kalman filter in the frequency domain shows better performance of the proposed technique. The performance is evaluated by using the segmental signal-to-noise ratio and the Itakura-Saito`s distance. Results have shown that Kalman`s filter in time combined with spectral subtraction is more robust and efficient, improving the Itakura-Saito`s distance by up to four times. (C) 2007 Elsevier Ltd. All rights reserved.

Proposal of a High-Level Language for Writing Self Modifying Programs

This paper proposes a simple high-level programming language, endowed with resources that help encoding self-modifying programs. With this purpose, a conventional imperative language syntax (not explicitly stated in this paper) is incremented with special commands and statements forming an adaptive layer specially designed with focus on the dynamical changes to be applied to the code at run-time. The resulting language allows programmers to easily specify dynamic changes to their own program`s code. Such a language succeeds to allow programmers to effortless describe the dynamic logic of their adaptive applications. In this paper, we describe the most important aspects of the design and implementation of such a language. A small example is finally presented for illustration purposes.

MODELING THE UNVOICED COMPONENT IN THE CANONICAL REPRESENTATION OF SPEECH

The canonical representation of speech constitutes a perfect reconstruction (PR) analysis-synthesis system. Its parameters are the autoregressive (AR) model coefficients, the pitch period and the voiced and unvoiced components of the excitation represented as transform coefficients. Each set of parameters may be operated on independently. A time-frequency unvoiced excitation (TFUNEX) model is proposed that has high time resolution and selective frequency resolution. Improved time-frequency fit is obtained by using for antialiasing cancellation the clustering of pitch-synchronous transform tracks defined in the modulation transform domain. The TFUNEX model delivers high-quality speech while compressing the unvoiced excitation representation about 13 times over its raw transform coefficient representation for wideband speech.

Using Reverberation to Improve Range and Elevation Discrimination for Small Array Sound Source Localization

Sound source localization (SSL) is an essential task in many applications involving speech capture and enhancement. As such, speaker localization with microphone arrays has received significant research attention. Nevertheless, existing SSL algorithms for small arrays still have two significant limitations: lack of range resolution, and accuracy degradation with increasing reverberation. The latter is natural and expected, given that strong reflections can have amplitudes similar to that of the direct signal, but different directions of arrival. Therefore, correctly modeling the room and compensating for the reflections should reduce the degradation due to reverberation. In this paper, we show a stronger result. If modeled correctly, early reflections can be used to provide more information about the source location than would have been available in an anechoic scenario. The modeling not only compensates for the reverberation, but also significantly increases resolution for range and elevation. Thus, we show that under certain conditions and limitations, reverberation can be used to improve SSL performance. Prior attempts to compensate for reverberation tried to model the room impulse response (RIR). However, RIRs change quickly with speaker position, and are nearly impossible to track accurately. Instead, we build a 3-D model of the room, which we use to predict early reflections, which are then incorporated into the SSL estimation. Simulation results with real and synthetic data show that even a simplistic room model is sufficient to produce significant improvements in range and elevation estimation, tasks which would be very difficult when relying only on direct path signal components.

Language, discourse and politics

After discussing the meaning of the word politics, this paper shows that there are four possible approaches to the issue of the relationships between language, discourse and politics: a) the intrinsic political nature of language; b) the relations of power between discourses and their political dimension; c) the relations of power between languages and the political dimension of their usage and; d) linguistic policies. This paper addresses only the first two of these items. Languages have an intrinsically political nature because they subject their speakers to their order. The acts of silencing operationalized in discourse manifest a relation of power. The spread of discourses in the social space is also subject to the order of power. The use of language may be the space of pertinence, but is also that of exclusion, separation and even the elimination of the other. Therefore, language is not a neutral communication tool, but it is permeated by politics, by power. Because of the dislocations that it produces, literature is a form of swindling language, unveiling the powers that are imprinted on it.

Language and interdisciplinarity

Since language is multifaceted and heterogeneous, interdisciplinarity is natural to linguistic studies. In this article, after demonstrating that, I present two basic ways of doing science. One is ruled by the principle of exclusion, whereas the other is ruled by the principle of participation. The former leads to specialization, whereas the latter leads to the surpassing of specialization. From that, I discuss the advantages and problems of disciplinarity, and present the reasons why nowadays interdisciplinarity is a positive universal in scientific and pedagogical discourses. Also, based on etymology, I discuss the concepts of interdisciplinarity, multidisciplinarity, pluridisciplinarity and transdisciplinarity. Finally, I examine the bonds between linguistics and other sciences, by drawing a brief history of the relations between linguistics and literature in Brazil.

Otolaryngology and Speech Therapy evaluation in the assessment of oropharyngeal dysphagia: a combined protocol proposal

Dysphagia is a symptom associated with an array of anatomical and functional changes which must be assessed by a multidisciplinary team to guarantee optimal evaluation and treatment, preventing potential complications. Aim: The aim of the present study is to present the combined protocol of clinical and swallowing videoendoscopy carried by ENT doctors and speech therapists in the Dysphagia Group of the ENT Department - University Hospital. Materials and Methods: Retrospective study concerning the use of a protocol made up of patient interview and clinical examination, followed by an objective evaluation with swallowing videoendoscopy. The exam was performed in 1,332 patients from May 2001 to December 2008. There were 726 (54.50%) males and 606 (45.50%) females, between 22 days and 99 years old. Results: We found: 427 (32.08%) cases of normal swallowing, 273 (20.48%) mild dysphagia, 224 (16.81%) moderate dysphagia, 373 (27.99%) severe dysphagia and 35 (2.64%) inconclusive exams. Conclusion: The combined protocol (Otolaryngology and Speech Therapy), is a good way to approach the dysphagic patient, helping to achieve early and safe deglutition diagnosis as far as disorder severity and treatment are concerned.

Peptides containing T cell epitopes, derived from Sm14, but not from paramyosin, induce a Th1 type of immune response, reduction in liver pathology and partial protection against Schistosoma mansoni infection in mice

Sm14 and paramyosin are two major Schistosoma mansoni vaccine candidate antigens. Recently, we have identified Sm14 and paramyosin epitopes that are recognized by T cells of resistant individuals living in endemic areas for schistosomiasis. Herein, mice were immunized with these peptides separately or in association in order to evaluate their vaccine potential. Immunization of mice with Sm14 peptides alone or mixed with paramyosin peptides was able to induce 26%-36.7% or 28%-29.2% of worm burden reduction, 67% or 46% of intestinal eggs reduction and also 54%-61% or 43%-52% of liver pathology reduction, respectively. Protection was associated with a Th1 type of immune response induced by Sm14 peptide immunization. In contrast, paramyosin peptide vaccination did not engender protective immunity or liver pathology reduction and immunization was associated with a Th2 type of immune response. (C) 2008 Elsevier B.V. All rights reserved.