Prevalencia de los trastornos de voz ocupacionales en los docentes de dos instituciones educativas de nivel superior en Colombia en el año 2013-2014

Resumen: En la población docente, el uso de la voz como principal herramienta del trabajo por su esfuerzo constante y prolongado constituye el principal factor de riesgo para padecer trastornos de la voz, concomitante con otros factores que inciden en la presentación de estas patologías. Objetivo: Determinar la prevalencia de los trastornos en la voz y sus factores asociados de la población docente de dos instituciones de educación superior (IES) en Colombia y los factores de riesgo asociados. Materiales y métodos: Se realizó un estudio descriptivo de tipo transversal, en el que participaron 149 docentes de dos IES (instituciones de educación superior) de dos ciudades de Colombia. Se aplicó un cuestionario sustentado en el Modelo de Técnicas Foniátricas para Prevenir la Disfonía en Profesores de Secundaria en Portugal y validado por la escuela de Medicina y Ciencias de la Salud, programa de fonoaudiología de la Universidad del Rosario con el trabajo denominado “La Voz como herramienta de trabajo” para Colombia; el cual indagaba los factores riesgo asociados al uso de la voz en el quehacer docente. Se realizó un análisis descriptivo de las variables cualitativas con frecuencias absolutas y porcentajes, medidas de tendencia central, promedio y mediana, de dispersión y desviación estándar. La información recolectada fue analizada con el software SPSS.PASW 18. La correlación entre las variables dependientes y las independientes, se realizaron con el coeficiente no-paramétrico de Spearman y la asociación con la prueba Ji-cuadrado de Pearson o el test exacto de Fisher (valores esperados < 5). Se evaluaron las distribuciones de las variables ordinales de las variables de problemas de la voz con el género, con la prueba no-paramétrica exacta de Mann Whitney. Las pruebas estadísticas se evaluaron a un nivel de significancia del 5% (p<0.05). Resultados: El promedio de edad fue de 36±11.7 años, con un rango que varió entre 25 y 68 años. El género más frecuente fue el masculino con 57,0% de participación. Los datos presentados se dan como resultado de las respuestas a tres preguntas indicativas de los trastornos de voz, las cuales no fueron respondidas por la totalidad de los docentes, por esta razón los datos se presentan así t= número total de personas que respondieron la pregunta y n= número de personas que respondieron afirmativamente. La prevalencia de alteración de voz fue del 63,4% (t=82; n=52), de disminución en el volumen de su voz de 57,3% (t=122; n=70) y cansancio laríngeo en el 76,8% (t=121; n=93). El cansancio laríngeo fue significativamente mayor en los hombres que en las mujeres (p=0.026, Test Mann Whitney exacto a una cola), con algunos hábitos de voz como el realizar esfuerzos en el cuello al hablar (rs = 0,461; p< 0,001) y con la dificultad para inhalar o exhalar aire al hablar (rs = 0,368; p<0.001), con el ruido de fondo (rs =0,361, p<0,001), al permanecer en ambientes contaminados con polvo y humedad (rs=0,311; p=0.001), con sufrir de estrés representado por dolor cervical en espalda y hombros (rs=0,349, p<0.001), y con los problemas familiares (rs= 0,397; p<0.001). Al analizar con la disminución del volumen de voz durante la práctica docente, las correlaciones más significativas mostradas fue estadísticamente mayor entre los hombres que en las mujeres (p=0.006, Test Mann Whitney exacto a una cola), con el esfuerzo cervical para hablar (rs =:0,596, p=<,001), y con el presentar dificultad para inhalar/exhalar aire al usar la voz (rs =0,508, p<,001), con la exposición a ruido de fondo (rs=0,204, p=0,030), ambientes contaminados con polvo y humedad (rs:=305, p<,001), con el estrés (rs =0,316, p=0,001), con los problemas familiares (rs =0,560, p<,001) y en las mujeres con la alteración de la voz en presencia de la menstruación (rs =0,751, p=0,000). Por último, se correlacionó con las alteraciones de voz durante la exposición laboral en la que se mostró mayor correlación en las mujeres que en los hombres (p=0.001, Test Mann Whitney exacto a una cola). Se mostró correlación directa con el no realizar pausas al hablar (rs=0,337, p<0,001), con toser para aclarar la voz (rs =0,349, p=0,001), y con el uso de la voz grave (rs =0,975; p=,004) ,con la presencia de ruido de fondo mientras se dicta clase (rs =0,370, p=0,001) con el permanecer en ambientes contaminados con polvo y humedad (rs =0,253,p=,023), con los síntomas cervicales asociados al estrés (rs=0,323, p=0,003), e inversa con los cambios en tono y volumen de la voz en presencia de menstruación en las mujeres (rs=-0,414,p=,017). Conclusiones: Con los hallazgos encontrados en este estudio es importante reconocer que en las características demográficas, se encontró que el género masculino refirió mayor cantidad de problemas de voz. Para las características laborales la antigüedad ocupacional es factor principal que incide en los problemas de voz; en el análisis de las características demográfico– laborales en las variables analizadas, el grupo etario que reporto cansancio laríngeo se encontraba entre los 36 a 45 años de edad, y los que referían un tiempo de exposición ocupacional mayor a 6 y menor a 15 años. En cuanto a los factores ambientales se identificó que la asociación más significativa está relacionada con estar sometido a cambios bruscos de temperatura, estar expuesto a ruido de fondo durante su labor y finalmente a permanecer en ambientes contaminados. Por ultimo al analizar las alteraciones de la voz con las características personales de los docentes, se observó que el estrés y los problemas familiares inciden de forma significativa en estas patologías. Con estos resultados se recomienda establecer un sistema de vigilancia epidemiológica en las IES, donde se capacite integralmente a los docentes en cuanto a los factores de riesgo personales y de hábitos de voz, además de supervisar y adecuar los factores ambientales que inciden en la presentación de trastornos de voz para evitar la presentación de estas patologías.

Probabilistic simulations of crop yield over western India using the DEMETER seasonal hindcast ensembles

Process-based integrated modelling of weather and crop yield over large areas is becoming an important research topic. The production of the DEMETER ensemble hindcasts of weather allows this work to be carried out in a probabilistic framework. In this study, ensembles of crop yield (groundnut, Arachis hypogaea L.) were produced for 10 2.5 degrees x 2.5 degrees grid cells in western India using the DEMETER ensembles and the general large-area model (GLAM) for annual crops. Four key issues are addressed by this study. First, crop model calibration methods for use with weather ensemble data are assessed. Calibration using yield ensembles was more successful than calibration using reanalysis data (the European Centre for Medium-Range Weather Forecasts 40-yr reanalysis, ERA40). Secondly, the potential for probabilistic forecasting of crop failure is examined. The hindcasts show skill in the prediction of crop failure, with more severe failures being more predictable. Thirdly, the use of yield ensemble means to predict interannual variability in crop yield is examined and their skill assessed relative to baseline simulations using ERA40. The accuracy of multi-model yield ensemble means is equal to or greater than the accuracy using ERA40. Fourthly, the impact of two key uncertainties, sowing window and spatial scale, is briefly examined. The impact of uncertainty in the sowing window is greater with ERA40 than with the multi-model yield ensemble mean. Subgrid heterogeneity affects model accuracy: where correlations are low on the grid scale, they may be significantly positive on the subgrid scale. The implications of the results of this study for yield forecasting on seasonal time-scales are as follows. (i) There is the potential for probabilistic forecasting of crop failure (defined by a threshold yield value); forecasting of yield terciles shows less potential. (ii) Any improvement in the skill of climate models has the potential to translate into improved deterministic yield prediction. (iii) Whilst model input uncertainties are important, uncertainty in the sowing window may not require specific modelling. The implications of the results of this study for yield forecasting on multidecadal (climate change) time-scales are as follows. (i) The skill in the ensemble mean suggests that the perturbation, within uncertainty bounds, of crop and climate parameters, could potentially average out some of the errors associated with mean yield prediction. (ii) For a given technology trend, decadal fluctuations in the yield-gap parameter used by GLAM may be relatively small, implying some predictability on those time-scales.

Loss potentials associated with European windstorms under future climate conditions

Possible changes in the frequency and intensity of windstorms under future climate conditions during the 21st century are investigated based on an ECHAM5 GCM multi-scenario ensemble. The intensity of a storm is quantified by the associated estimated loss derived with using an empirical model. The geographical focus is ‘Core Europe’, which comprises countries of Western Europe. Possible changes of losses are analysed by comparing ECHAM5 GCM data for recent (20C, 1960 to 2000) and future climate conditions (B1, A1B, A2; 2060 to 2100), each with 3 ensemble members. Changes are quantified using both rank statistics and return periods (RP) estimated by fitting an extreme value distribution using the peak over threshold method to potential storm losses. The estimated losses for ECHAM5 20C and reanalysis events show similar statistical features in terms of return periods. Under future climate conditions, all climate scenarios show an increase in both frequency and magnitude of potential losses caused by windstorms for Core Europe. Future losses that are double the highest ECHAM5 20C loss are identified for some countries. While positive changes of ranking are significant for many countries and multiple scenarios, significantly shorter RPs are mostly found under the A2 scenario for return levels correspondent to 20 yr losses or less. The emergence time of the statistically significant changes in loss varies from 2027 to 2100. These results imply an increased risk of occurrence of windstorm-associated losses, which can be largely attributed to changes in the meteorological severity of the events. Additionally, factors such as changes in the cyclone paths and in the location of the wind signatures relative to highly populated areas are also important to explain the changes in estimated losses.

Enhancing consumer liking of low salt tomato soup over repeated exposure by herb and spice seasonings

There is strong evidence for the link between high dietary sodium and increased risk of cardiovascular disease which drives the need to reduce salt content in foods. In this study, herb and spice blends were used to enhance consumer acceptability of a low salt tomato soup (0.26% w/w). Subjects (n=148) scored their liking of tomato soup samples over five consecutive days. The first and last days were pre-and post-exposure visits where all participants rated three tomato soup samples; standard, low salt and low salt with added herbs and spices. The middle 3 days were the repeated exposure phase where participants were divided into three balanced groups; consuming the standard soup, the low salt soup, or the low salt soup with added herbs and spices. Reducing salt in the tomato soup led to a significant decline in consumer acceptability, and incorporating herbs and spices did not lead to an immediate enhancement in liking. However, inclusion of herbs and spices enhanced the perception of the salty taste of the low salt soup to the same level as the standard. Repeated exposure to the herbs and spice-modified soup led to a significant increase in the overall liking and liking of flavour, texture and aftertaste of the soup, whereas no changes in liking were observed for the standard and low salt tomato soups over repeated exposure. Moreover, a positive trend in increasing the post-exposure liking of the herbs and spices soup was observed. The findings suggest that the use of herbs and spices is a useful approach to reduce salt content in foods; however, herbs and spices should be chosen carefully to complement the food as large contrasts in flavour can polarise consumer liking.

Atypical processing of voice sounds in infants at risk for Autism Spectrum Disorder

Adults diagnosed with autism spectrum disorder (ASD) show a reduced sensitivity (degree of selective response) to social stimuli such as human voices. In order to determine whether this reduced sensitivity is a consequence of years of poor social interaction and communication or is present prior to significant experience, we used functional MRI to examine cortical sensitivity to auditory stimuli in infants at high familial risk for later emerging ASD (HR group, N = 15), and compared this to infants with no family history of ASD (LR group, N = 18). The infants (aged between 4 and 7 months) were presented with voice and environmental sounds while asleep in the scanner and their behaviour was also examined in the context of observed parent-infant interaction. Whereas LR infants showed early specialisation for human voice processing in right temporal and medial frontal regions, the HR infants did not. Similarly, LR infants showed stronger sensitivity than HR infants to sad vocalisations in the right fusiform gyrus and left hippocampus. Also, in the HR group only, there was an association between each infant's degree of engagement during social interaction and the degree of voice sensitivity in key cortical regions. These results suggest that at least some infants at high-risk for ASD have atypical neural responses to human voice with and without emotional valence. Further exploration of the relationship between behaviour during social interaction and voice processing may help better understand the mechanisms that lead to different outcomes in at risk populations.

An Ensemble Kalman Smoother for Nonlinear Dynamics

It is for mally proved that the general smoother for nonlinear dynamics can be for mulated as a sequential method, that is, obser vations can be assimilated sequentially during a for ward integration. The general filter can be derived from the smoother and it is shown that the general smoother and filter solutions at the final time become identical, as is expected from linear theor y. Then, a new smoother algorithm based on ensemble statistics is presented and examined in an example with the Lorenz equations. The new smoother can be computed as a sequential algorithm using only for ward-in-time model integrations. It bears a strong resemblance with the ensemble Kalman filter . The difference is that ever y time a new dataset is available during the for ward integration, an analysis is computed for all previous times up to this time. Thus, the first guess for the smoother is the ensemble Kalman filter solution, and the smoother estimate provides an improvement of this, as one would expect a smoother to do. The method is demonstrated in this paper in an intercomparison with the ensemble Kalman filter and the ensemble smoother introduced by van Leeuwen and Evensen, and it is shown to be superior in an application with the Lorenz equations. Finally , a discussion is given regarding the properties of the analysis schemes when strongly non-Gaussian distributions are used. It is shown that in these cases more sophisticated analysis schemes based on Bayesian statistics must be used.

Fabrication and integration of planar electrodes for contactless conductivity detection on polyester-toner electrophoresis microchips

In this report, we describe the microfabrication and integration of planar electrodes for contactless conductivity detection on polyester-toner (PT) electrophoresis microchips using toner masks. Planar electrodes were fabricated by three simple steps: (i) drawing and laser-printing the electrode geometry on polyester films, (ii) sputtering deposition onto substrates, and (iii) removal of toner layer by a lift-off process. The polyester film with anchored electrodes was integrated to PT electrophoresis microchannels by lamination at 120 degrees C in less than 1 min. The electrodes were designed in an antiparallel configuration with 750 mu m width and 750 gm gap between them. The best results were recorded with a frequency of 400 kHz and 10 V-PP using a sinusoidal wave. The analytical performance of the proposed microchip was evaluated by electrophoretic separation of potassium, sodium and lithium in 150 mu m wide x 6 mu m deep microchannels. Under an electric field of 250 V/cm the analytes were successfully separated in less than 90 s with efficiencies ranging from 7000 to 13 000 plates. The detection limits (S/N = 3) found for K+, Na+, and Li+ were 3.1, 4.3, and 7.2 mu mol/L, respectively. Besides the low-cost and instrumental simplicity, the integrated PT chip eliminates the problem of manual alignment and gluing of the electrodes, permitting more robustness and better reproducibility, therefore, more suitable for mass production of electrophoresis microchips.

Lymphocyte transformation assay for C neoformans antigen is not reliable for detecting cellular impairment in patients with Neurocryptococcosis

Background: Cryptococcus neoformans causes meningitis and disseminated infection in healthy individuals, but more commonly in hosts with defective immune responses. Cell-mediated immunity is an important component of the immune response to a great variety of infections, including yeast infections. We aimed to evaluate a specific lymphocyte transformation assay to Cryptococcus neoformans in order to identify immunodeficiency associated to neurocryptococcosis (NCC) as primary cause of the mycosis.Methods: Healthy volunteers, poultry growers, and HIV-seronegative patients with neurocryptococcosis were tested for cellular immune response. Cryptococcal meningitis was diagnosed by India ink staining of cerebrospinal fluid and cryptococcal antigen test (Immunomycol-Inc, SP, Brazil). Isolated peripheral blood mononuclear cells were stimulated with C. neoformans antigen, C. albicans antigen, and pokeweed mitogen. The amount of H-3-thymidine incorporated was assessed, and the results were expressed as stimulation index (SI) and log SI, sensitivity, specificity, and cut-off value (receiver operating characteristics curve). We applied unpaired Student t tests to compare data and considered significant differences for p<0.05.Results: The lymphotoxin alpha showed a low capacity with all the stimuli for classifying patients as responders and non-responders. Lymphotoxin alpha stimulated by heated-killed antigen from patients with neurocryptococcosis was not affected by TCD4+ cell count, and the intensity of response did not correlate with the clinical evolution of neurocryptococcosis.Conclusion: Response to lymphocyte transformation assay should be analyzed based on a normal range and using more than one stimulator. The use of a cut-off value to classify patients with neurocryptococcosis is inadequate. Statistical analysis should be based on the log transformation of SI. A more purified antigen for evaluating specific response to C. neoformans is needed.

Mechanical removal of necrotic periodontal ligament by either Robinson bristle brush with pumice or scalpel blade. Histomorphometric analysis and scanning electron microscopy

One of the important factors accounting for successful delayed replantation of avulsed teeth is seemingly the type of root surface treatment. Removal of necrotic cemental periodontal ligament remnants may prevent the occurrence of external root resorption, which is the major cause of loss of teeth replanted in such conditions. The purpose of this study was to compare the efficacy of two mechanical techniques for removal of root-adhered periodontal ligament. Preservation or removal of the cementum layer concomitantly with these procedures was also assessed. Forty-five roots of healthy premolars extracted for orthodontic purposes were selected. After extraction, the teeth were kept dry at room temperature for 1 h and then immersed in saline for rehydration for an additional 10 min. Thereafter, the roots were assigned to three groups, as follows: group 1 (control) - the cemental periodontal ligament was preserved; group 2 - removal of the periodontal ligament by scraping root surface with a scalpel blade (SBS); group 3 - periodontal ligament remnants were removed using a Robinson bristle brush at low-speed with pumice/water slurry (RBP). The specimens were analysed histomorphometrically and examined by scanning electron microscopy. The quantitative and qualitative analyses of the results showed that the RBP technique was significantly more effective than the SBS technique for removal of the periodontal ligament remnants adhered to root surface. Both techniques preserved the cementum layer.

Collision of positronium with atoms, molecules and ions using a modified coupled-channel framework

Scattering of positronium (Ps) from atoms (H, He, Ne, Ar), molecule (H(2)) and ion (He(+)) have been investigated using a coupled-channel (CC) formalism with a regularised non-local exchange potential. The advantage of using such a regularized exchange potential in the close-coupling formalism and the normalizability aspect of the solution at low energies with a minimum effective coupling are discussed. Results for the elastic and total scattering cross-sections, resonance and binding energies in Ps-H, and pick-off annihilation results in Ps-He are found to be in excellent agreement with measurements and variational predictions. (C) 2000 Elsevier B.V. B.V. All rights reserved.

High sensitivity low cost capacitive strain gage

This paper describes a high senstivity low cost capacitive strain gage sensor. The theory, design, and sensor construction details are presented. It consists of eight capacitive sensors connected in two full bridges. The capacitive strain gage sensor structure was designed in order to produce high sensitivity and low dependence with temperature. By using a simple signal conditioning circuit constituted by a differential amplifier, a band-pass filter, and a precision rectifier the device can measure forces with resolution of 0.009 N and precision of 98.7%. It is rugged, presents linear response, and good repeatability. It presents sensitivity of 8.7 V/N and fall time of 12 ms.

A poesia, a música e a performance da canção: alma minha gentil - um estudo de caso na obra de Glauco Velásquez

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A periferia de “nosotros”. O debate sobre o documentarismo na América Latina: uma análise do filme La Hora de los hornos (1968)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Treatment of Atrophic Mandibular Fractures with the Pencilboneplate: Report of 2 Cases

The incidence of fractures of the atrophic edentulous mandible is still low, even with the increasing life expectancy. The reduced blood supply of the sclerotic bone, the diminished contact area between bone fragments and the patient’s systemic condition makes the treatment of those fractures a challenge for any professional. Treatment of atrophic mandibular fractures by means of miniplate osteosynthesis has not been the preferred method of fixa- tion by many authors. Yet, many surgeons have applied this type of fixation for the atrophied jaw sections. This paper reports 2 cases of fractured atrophic mandibles treated with the pencilboneplate, a monocortical 2.0 mm titanium, 8 or 10-hole hardware with reinforcement on its middle portion, highlighting important considerations of its use. The pencilboneplate appears to be a valuable option for the treatment of atrophic mandibular fractures, espe- cially by an intra-oral approach, and warrants further bio- mechanical and clinical studies.

As canções de Camargo Guarnieri e Suzanna de Campos: um estudo para a interpretação

Pós-graduação em Música - IA