Prevalência e fatores associados à alteração vocal em idosos institucionalizados com capacidade cognitiva preservada

Voice disorders (VD) in the elderly can interfere negatively in communication, emotional well-being and quality of life, conditions that correspond to greater exposure to illness and social isolation bringing consequent economic impact for the health system. It is assumed that institutionalized confinement, weakness and morbidity associated to nursing home (NH) contribute to transform VD an especially prevalent condition in institutionalized elderly, including those without cognitive impairment. Thus, the aim of this study was to determine the prevalence and associated factors of VD in NH elderly residents without cognitive impairment. There is no epidemiological diagnostic instruments of VD for elderly populations, so the first step of this study was dedicated to prepare and analyze the psychometric properties of a short, inexpensive and easy to use questionnaire named Screening for Voice Disorders in Older Adults (Rastreamento de Alterações Vocais em Idosos—RAVI). The methodological procedures of this step followed the guidelines of the Standards for Educational and Psychological Testing and contemplated validity evidence based on test content, based on response processes, based on internal structure and based on relations with other variables, as well as reliability analysis and clinical consistency. The result of the validation process showed that the RAVI final score generate valid and reliable interpretations for the epidemiological diagnosis of VD in the elderly, which endorsed the use of the questionnaire in the second stage of the study, performed in ten NH located in the city of Natal, Rio Grande do Norte. At this stage, data from socioeconomic and demographic variables, lifestyle, general health conditions and characterization of the institution were collected. It was performed a bivariate analysis and it was calculated the prevalence ratio as a magnitude association measure, with a confidence interval of 95%. The variables with p-value less than 0.20 were included in the multiple logistic regression model that followed the Forward selection method. The odds ratio found in the multivariate model was converted into prevalence ratio and the level of significance was 5%. The sample consisted of 117 subjects with predominance of females and average of 79.68 (± 7.92) years old. The prevalence of VD was 39.3% (95% CI: 30.4-48.1%). The multivariate model showed statistically significant association between VD and depressive symptoms, smoking for a year or more and selfreported hearing loss. In conclusion, VD is a prevalent health condition in NH elderly residents without cognitive impairment and is associated with factors involving psychosocial, lifestyle and communicative disability that require attention of managers and professionals involved with NH environment. Strategies to encourage communication and social integration, actions to combat smoking and minimizing the effects of hearing loss could stimulate the physical well-being, emotional and mental health of institutionalized elderly population, contributing to the vocal and communicative maintenance, a more effective social inclusion and better overall health condition.

O ator que canta um conto: a manipulação de parâmetros musicais na voz do ator

This research started with an investigation about the theatrical speaking. Through an empirical methodology that analyzed a practical experience of creating a play and bibliographical research, the actress/researcher investigated ways to manipulate musical parameters as tools in the creation process of the actor s voice. The actress/researcher attempted to connect theory and practice, moved by the desire to find a vocal expression in theater that unfolds as living and transforming movement. This dissertation also contains the report of pedagogical experiences, in which the actress/researcher explored strategies to teach the appropriation of musical parameters in the construction of the vocal work of the actor. Considering that speaking in theater is closer to singing than everyday speech, she concluded that the actor may compose music as a music composer does in the elaborating process of building vocal scores. Therefore, she demonstrated that it is of fundamental importance a musical training in the development of the actor.

Perfil epidemiológico dos distúrbios hipertensivos na gravidez

The preeclampsia is a disease that evolves to high death rate for the mother and for the fetus. The incidence of this disease in the world is variable and there are no data of this disturb in the Brazilian population. This paper had the objective to determine the incidence and risk factors for development of hypertensive disorders of pregnancy in a neighborhood in Natal, RN, Brazil, taking place a prospective study, cohort type, with the objective of evaluating the entire pregnancy of 242 women that got pregnant between 2004-2007. The incidence of hypertensive disorders was of 17%, while the incidence of preeclampsia was of 13.8%. The age average of women that developed the hypertensive disorders was of 27.4 years (SD±.9), whilst those that developed preeclampsia was of 26.6 (SD ±7.8) years and the normotensive was of 23.9 (SD±5.8) (p=0.002). It is noted a significant increase of the hypertensive disorder with age (p=0.0265). The gestational age for those who developed preeclampsia was lower than the women that developed normotensive pregnancy (p=0.0002). The body mass index (BMI) of the group of women that developed the hypertensive disorder was of 25.8 (SD±3.9), significantly higher than the group of normotensive women with 23.5 (SD±3.7) (p=0.02). The levels of triglycerides and cholesterol tended to be higher on women with preeclampsia than on normotensive, p=0.0502 and p=0.0566, respectively. Six (6) women presented with severe preeclampsia and one (1) developed HELLP Syndrome. The resolution of the pregnancy was performed by cesarean section in 70% of women that developed hypertensive disorders, whilst the normotensive was of 23.6% (p<0.0001). A subgroup of the studied subjects was reassessed one year after labor, revealing that 50% of the patients were still hypertensive. There were no larger complications nor mother death during labor. The incidence of hypertensive disorders are above the levels noted in other studies and 30% of the women were within the poles of greater risk for the hypertensive disorders; the elevated BMI in the beginning of the pregnancy is a risk factor for hypertensive disorder. The risk of severe complication in preeclampsia is high, with imminence of eclampsia occurring in 20.1% of women who developed hypertensive disorder of pregnancy. The adequate prenatal care and the opportune labor assistance may minimize the complications of the pregnancy hypertension and avoid mother death, although the risk of women remaining hypertensive is elevated

Distúrbios do sono em pacientes com transtorno depressivo

To evaluate sleep disorder complaints in outpatients with depressive disorder from a general hospital. Methods: An observational, cross-sectional study was carried out with a study sample composed of 70 patients (44 women and 26 men) with diagnosis of depressive disorder, according to the DSM-IV criteria. The patients were interviewed and evaluated by the Identification Questionnaire, the Sleep Habits Questionnaire and the Beck Depression Inventory (BDI). Results: In this study, 50 (71.3%) patients had recurrence of sleep disorder complaints. Mean BDI score was 35.83+8.85, with significant differences between patients with (38.50+8.70) and without (29.60+7.80) recurrence (p<0.05) and among patients with 1, 2, 3 and >3 episodes (p<0.05). In this study, 49 (70%) patients had insomnia and 21 (30%) had subjective excessive sleepiness. Significant differences were observed between the mean duration in months of the sleep disorders (7.16+2.10) and the depressive disorder (6.12+1.90) (p<0.05). Discussion: In the study sample, recurrence of sleep disorder complaints was high and significantly associated with severe depression. Insomnia was prevalent and the mean duration of sleep disorders was higher in relation to depressive disorder

Programas de exercícios físicos e níveis de biomarcadores inflamatórios em mulheres com distúrbios metabólicos: uma revisão sistemática

Uma grande quantidade de informações dá suporte à relação existente entre inatividade física e processos inflamatórios latentes em distúrbios metabólicos. O objetivo deste trabalho foi acessar criticamente o corpo de evidências existentes na literatura sobre a associação entre programas de exercícios físicos e os níveis de biomarcadores inflamatórios em mulheres entre 18 e 82 anos de idade. Foram realizadas buscas bibliográficas sistemáticas usando as bases de dados PubMed Medline, Cochrane Central Register of Controlled Trials, Web of Science, LILACS e SciELO de publicações entre janeiro de 1993 e janeiro de 2012 usando os seguintes termos: inflamação, citocinas, exercícios, treinamento físico, treinamento aeróbico, treinamento cardiovascular, treinamento de força, treinamento contra resistência, treinamento intervalado, reabilitação cardíaca e gerenciamento/modificação terapêutica de estilo de vida. Do total de estudos incluídos na revisão, três deles reportaram mudanças não significativas nos níveis de biomarcadores inflamatórios, um estudo documentou um aumento nos biomarcadores e 12 estudos reportaram decréscimos nos níveis de biomarcadores inflamatórios associados com exercício. Características secundárias do estilo de vida, como trabalho físico extenuante e fumo, afetaram os níveis de biomarcadores inflamatórios. Intervenções integrativas incluindo dieta, exercício aeróbico moderado (60% a 80% da frequência cardíaca máxima ou 50% a 60% do VO2Máx), treinamento contra resistência em circuito (8 a 10 exercícios, 8 a 12 repetições), aconselhamento e educação voltados para a saúde, usados conjuntamente, se apresentaram como possíveis estratégias efetivas na melhoria nos níveis de biomarcadores inflamatórios em mulheres

Poéticas de um saber brincar: a vez e a voz do fandango

The present thesis aims to get to know and to analyze the elements which make up the poetical performance of the Fandango from Canguaretama confirming/corroborating an eminently theatrical model. It still highlights the producers´ history, its asset production and its insertion in community where we had contact with two other types of performances: the daily and the ritualistic. Such actions both combine and present different meanings and objectives, promoting distinct readings and experiences. Looking at these three ways of performances poetic, daily, and ritual enabled to go deeper in cultural aspects of the studied community and, thus, check over what is going on in these events, how they accord with and conceive a popular performance context. The research could substantiate the existence of a theatrical model whose performance by means of the voice and active presence of playful bodies, implied in getting to know the consolidation of a cultural patrimony which reveals us the past, but, especially, the present, its people and its place

Gritos de silêncio: na voz dos familiares cuidadores de portadores da doença de Alzheimer

This work is an investigation related to issues of those who take home care of people who suffer from Alzheimer disease (AD). Thus, it is justified by the need to acknowledge how these relatives perform this task and in which ways they do this. The study has is analytical and qualitative methodology with the use of a thematic oral history approach. The subjects of the research were nine relatives of those who suffer from AD that participate in the home care group in the Candelária neighborhood in the city of Natal in Rio Grande do Norte-Brazil. The data was collected using a semi-structured questionnaire and interview that was booked in advance and had full support from the care takers. After information collection, three thematic axles were defined. After this procedure, three analisys subcategories were also defined. The first thematic axle emphasizes the so called movement of rite of passage, when the relative becomes a care taker of a person with AD. The second category deals with the care takers strategies, either related to their own behalf or on their relative. It is possible to infer that amongst other forms of help, the care taker needs to rely on a support network, such as health services, groups composed by multiprofessionals that enable better articulation between family and collaborators. The dimension related to faith and spirituality was also observed and pointed out as an important aspect in the emotional support process for these relatives. In the third axle the perspectives of struggle, conquests of the right to health and life quality of those who suffer from AD as well as their relatives was observed. These also deal with dreams and hope

Doenças sem doentes: Ocorrência de Distúrbios Osteomusculares Relacionados ao Trabalho DORT nos operadores de caixa de um banco

The changes incurred in the financial system with the introduction of new technologies and new forms of administration of banks has caused impact on the health of workers. These changes, which passed in the process of work, generate a combined share of the risk factors that result in numerous injuries and illnesses among banks, notably between the operators of banks tellers. The Work-Related Musculoskeletal Disordes - WRMD represent a group of occupational diseases always present among these workers. Because of its high incidence and the amount of financial resour envolved to manage the problem has been the object of constant study. This paper aims to analyze the bank teller activity; search the occurrence of WRMD in the activity, identifying the factors determining the occurrence of WRMD in the activity and determine the real number of touchs on a keyboard made by the operator and propose solutions that influence the reduction of illness in the workplace of the bank teller. Methodological tools of ergonomics are used to provide a broad knowledge of aspects of work that have been studied and influential in the generation of occupational diseases studied. It was found that activity put workers to serious risk of occupational diseases. As the main contributory factors and determinants for this illness: the requirements and control the numbers daily endorsements; evaluation system based on performance targets for productivity; management system at time of service to customers; work with stressful factors (broken box); excess of time worked; furniture of workstations with ergonomic inadequacies and policy for the prevention of occupational diseases inefficient. They have also noted cases of illness for DORT workers without fulfilling the legal requirement of the issuance of the communication of labour accident and without the removal of the employee of the workplace

Classificação de distúrbios na rede elétrica usando redes neurais e wavelets

Post dispatch analysis of signals obtained from digital disturbances registers provide important information to identify and classify disturbances in systems, looking for a more efficient management of the supply. In order to enhance the task of identifying and classifying the disturbances - providing an automatic assessment - techniques of digital signal processing can be helpful. The Wavelet Transform has become a very efficient tool for the analysis of voltage or current signals, obtained immediately after disturbance s occurrences in the network. This work presents a methodology based on the Discrete Wavelet Transform to implement this process. It uses a comparison between distribution curves of signals energy, with and without disturbance. This is done for different resolution levels of its decomposition in order to obtain descriptors that permit its classification, using artificial neural networks

Reconhecimento de voz através de unidades menores do que a palavra, utilizando Wavelet Packet e SVM, em uma nova estrutura hierárquica de decisão

The automatic speech recognition by machine has been the target of researchers in the past five decades. In this period have been numerous advances, such as in the field of recognition of isolated words (commands), which has very high rates of recognition, currently. However, we are still far from developing a system that could have a performance similar to the human being (automatic continuous speech recognition). One of the great challenges of searches for continuous speech recognition is the large amount of pattern. The modern languages such as English, French, Spanish and Portuguese have approximately 500,000 words or patterns to be identified. The purpose of this study is to use smaller units than the word such as phonemes, syllables and difones units as the basis for the speech recognition, aiming to recognize any words without necessarily using them. The main goal is to reduce the restriction imposed by the excessive amount of patterns. In order to validate this proposal, the system was tested in the isolated word recognition in dependent-case. The phonemes characteristics of the Brazil s Portuguese language were used to developed the hierarchy decision system. These decisions are made through the use of neural networks SVM (Support Vector Machines). The main speech features used were obtained from the Wavelet Packet Transform. The descriptors MFCC (Mel-Frequency Cepstral Coefficient) are also used in this work. It was concluded that the method proposed in this work, showed good results in the steps of recognition of vowels, consonants (syllables) and words when compared with other existing methods in literature

Avaliação clínica da relação entre o índice de placa, índice gengival, alinhamento dental, mucosa ceratinizada, tipo de periodonto e distúrbios oclusais com a ocorrência de recessão gengival

This study clinically evaluated the relationship of gingival recessions with the periodontal index of gingival and plaque, dental alignment, keratinized mocous, type of periodontal, and occlusal disorders. Study participants were individuals aged between 19 and 33 years. The evaluations were performed by using questionnaires and clinical examinations. In subjects examined, the teeth were assessed and divided into groups (Molars, premolars, canines and incisors). The gingival recession were measured in the central region of the teeth and individuals were subject to disclosure to the plate and observing the poll of plaque and gingival index, respectively. 558 teeth were examined, with 24.1%, 135 had gingival recession greater than or equal to 1mm. Through the combination of tests used to evaluate the average of the recession and its relationship with the variables studied, we observed that the degree of recession of the elements assessed dental showed, almost for the most part, when higher values associated with the index plaque (p = 0.101), Gingival Index (p = 0.053), dental alignment (p = 0.962), width of keratinized mocous (p = 0.004) and type of periodontium (p = 0.033), however statistically significant difference could only be considered when related the recessions in the keratinized mocous and the type of the periodontium. Although we identify, when we evaluate the whole set of teeth that occlusal disturbances (p = 0.002) were more strongly associated with cases of gum recession that the gingival index (p = 0.006), however, these two conditions were correlated with the cases of recession, contributing to its occurrence

O princípio da eficiência administrativa na regulação da prestação do serviço de voz sobre internet - VoIP

The present work aims to demonstrate the link of the principle of efficiency - as expressed in the Constitution of 1988, by Constitutional Amendment No. 19 - with regulatory agencies, more specifically the ANATEL (National Telecommunications Agency). It also includes this principle’s importance to regulation - to monitor and manage public services - as well as when an activity will be considered efficient, keeping in mind that agencies are subjected to other principles of public administration. The increasing use of telephony has enabled further development of technologies that provide improvements in the provision of this service. The VoIP (Voice over IP), is nothing more than a technological breakthrough that directly targets the providers of conventional telephone service, both by modifying the business working for a long time with the same technology as the amount of new competitors’ dispute on market share. It also analyses the difficulty of understanding and definition of what is VoIP telephony, its growth and the threats that the traditional and mostly which is ANATEL’s role concerning this telephony technology. As regulator of the telecommunications service, ANATEL not yet regulated the voice telephony service using the IP protocol. What looks over the years is that ANATEL exercise its regulatory function to provide better conditions for competition among providers of VoIP and traditional telephone companies, obviously some difficulties are expected, given that VoIP is a technology that provides two services, through conventional telephony and using the internet.

A "voz das ruas" e a rearticulação da ideologia conservadora

The aim of this paper is to analyze the street demonstrations occurred last June and July 2013, which appear as samples of the hegemonic fights in course in Brazil, during the so-called Big Wave of the social groups in conflict nowadays in the country. Among other questions, this study tries to explain how the varied stages of these fighting groups influenced their late ones. For that, it takes into consideration the bibliography available not only on these groups, but also on the social and political contemporary Brazil. That is why it evaluates political documents, as well as opinion pieces, news and others disseminated by the press or by political groups. Speeches made by political leaderships, as, for example, that one the President Dilma Roussef made on 21 July 2013, deserves close analysis. This also applies to contributions made by secondary data, poll institutions and IBGE’s socio-economic data. Categories and concepts of Antonio Gramsci’s political sociology are used here as theoretic bases. In fact, it favors the hypothesis that, during the dispute for the intellectual and moral command of demonstrations on July 2013, a certain middle-class conservative ideology emerged on scene. This group conquered the agreement of hegemonic mass media acting now as a political party, here designated as media party. These media resorted to platforms preexistent to the demonstration movements, especially their rejection to political organizations and programs in order to ascend as the demonstrations’ leaders along a certain period in which corruption appeared as the central theme of these efforts, while the government tried to get control of the situation. In view of the several forces and issues at stake, the present study contributes to the discussion about the current reality in Brazil and its perspectives, without losing sight of the centrality of the June Movements as political and ideological milestones

Estudos de distúrbios ionosféricos propagantes de larga escala (LSTID’S) na região equatorial durante grandes tempestades magnéticas: estudo de casos

The Ionospheric Disturbances – TIDs – are irregularities on the ionospheric plasma propagating in speeds in the order of tens to a few hundreds of meters per second. This present study detected and characterized the TIDs of LSTIDs (Large Scale Travelling Ionospheric Disturbance) type at low latitudes during intense geomagnetic storms and its propagation over the Brazilian sector. This work also shows as being the first to report systematically propagation of gravity waves over Natal. For this purpose, we used ionospheric records obtained from type of digisonde CADI (Canadiam Advanced Digital Ionosonde) located in Natal and the type DSP (Digisonde Portable Souder) located in Cachoeira Paulista, Fortaleza and São Luis, whereupon we used a dataset of 12 years collected by INPE (National Institute of Space Research). In this study, both calm days, that preceded the storms, and the geomagnetically disturbed days were related during the years 2000 and 1012, which cover a period of maximum and minimum solar activity. And it is presented the variations that happened in the electron density from region F of the ionosphere over the Brazilian sector, especially near the Equator (Natal, Fortaleza and São Luis), caused by ionospheric disturbances in the equatorial region during intense geomagnetic storms, because, as we know of the literature in this area, this phenomenon contributes positively to the emergence of LSTIDs in the auroral region, which may move to the equatorial region where a few cases have been documented and studied systematically. From the observation of signatures if TIDs in ionogram records, a study of the morphology of these events was performed and compared with the main characteristics of the wave of this phenomenon during great magnetic storms, i.e., DST <(-200 nT) and KP > 6. Thus, we obtained the main characteristics of TIDs over our region, i.e., period, vertical wavelength, phase and propagation speed, as well as the delay of these disturbances compared to the beginning of the magnetic storms to the Brazilian Sector.

Topologia de gerador de distúrbios elétricos baseada em conversores de potência

Electrical disturbances such as voltage sags, interruptions and voltage unbalances might cause serious problems for the end-user and for the companies of generation and transmission of energy. Few years ago, those companies have been using methods and equipments of protection to avoid the disturbances’ presence or to mitigate their effects on the power system. Disturbances generators are used to analyse the behavior of electrical and electronic equipments affected by disturbances. The analysis of those failures allows the development of appropriated protection equipments. In this paper, the development of a disturbances generator based on power converters is presented. The disturbance generator developed is able to generate some symmetrical disturbances, such as: voltage sags, voltage swells and harmonic distortion. The control strategy used in the disturbance generator is based on discrete and repetitive control. The steps of the design of the control and of the filter used for reducing harmonic in the output, are detailed in the text. Are presented the obtained results on computational simulations and the obtained results on laboratory tests.