Reliability of nasal auscultation and their relation to middle ear condition – a clinical interest to pediatrics respiratory physiotherapy

Background: Acute respiratory infections are usual in children under three years old occurring in upper respiratory tract, having an impact on child and caregiver’s quality of life predisposing to otitis media or bronchiolitis. There are few valid and reliable measures to determine the child’s respiratory condition and to guide the physiotherapy intervention. Aim: To assess the intra and inter rater reliability of nasal auscultation, to analyze the relation between sounds’ classification and middle ear’s pressure and compliance as well as with the Clinical Severity Score. Methods: A cross-sectional observational study was composed by 125 nursery children aged up to three years old. Tympanometry, pulmonary and nasal auscultation and application of Clinical Severity Score were performed to each child. Nasal auscultation sounds’ were recorded and sent to 3 blinded experts, that classified, as “obstructed” and “unobstructed”, with a 48 hours interval, in order to analyze inter and intra rater reliability. Results: Nasal auscultation revealed a substantial inter and intra rater reliability (=0,749 and evaluator A - K= 0,691; evaluator B - K= 0,605 and evaluator C - K= 0,724, respectively). Both ears’ pressure was significantly lower in children with an "unobstructed" nasal sound when compared with an “obstructed” nasal sound (t=-3,599, p<0,001 in left ear; t=-2,258, p=0,026 in right ear). Compliance in both ears was significantly lower in children with an "obstructed" nasal sound when compared with “unobstructed” nasal sound (t=-2,728, p=0,007 in left ear; t=-3,830, p<0,001 in right ear). There was a statistically significant association between sounds’ classification and tympanograms types in both ear’s (=11,437, p=0,003 in left ear; =13,535, p=0,001 in right ear). There was a trend to children with an "unobstructed" nasal sound that had a lower clinical severity score when compared with “obstructed” children. Conclusion: It was observed a good intra and substantial inter reliability for nasal auscultation. Nasal auscultation sounds’ classification was related to middle ears’ pressure and compliance.

Wuthering heights on the screen: exploring the relations between film adaptation and subtitling

This essay aims to confront the literary text Wuthering Heights by Emily Brontë with five of its screen adaptations and Portuguese subtitles. Owing to the scope of the study, it will necessarily afford merely a bird‘s eye view of the issues and serve as a starting point for further research. Accordingly, the following questions are used as guidelines: What transformations occur in the process of adapting the original text to the screen? Do subtitles update the film dialogues to the target audience‘s cultural and linguistic context? Are subtitles influenced more by oral speech than by written literary discourse? Shouldn‘t subtitles in fact reflect the poetic function prevalent in screen adaptations of literary texts? Rather than attempt to answer these questions, we focus on the objects as phenomena. Our interdisciplinary undertaking clearly involves a semio-pragmatic stance, at this stage trying to avoid theoretical backdrops that may affect our apprehension of the objects as to their qualities, singularities, and conventional traits, based on Lucia Santaella‘s interpretation of Charles S. Peirce‘s phaneroscopy. From an empirical standpoint, we gather features and describe peculiarities, under the presumption that there are substrata in subtitling that point or should point to the literary source text, albeit through the mediation of a film script and a particular cinematic style. Therefore, we consider how the subtitling process may be influenced by the literary intertext, the idiosyncrasies of a particular film adaptation, as well as the socio-cultural context of the subtitler and target audience. First, we isolate one of the novel‘s most poignant scenes – ‗I am Heathcliff‘ – taking into account its symbolic play and significance in relation to character and plot construction. Secondly, we study American, English, French, and Mexican adaptations of the excerpt into film in terms of intersemiotic transformations. Then we analyze differences between the film dialogues and their Portuguese subtitles.