850 resultados para CLINICIAN RATINGS OF VOICE QUALITY
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Objective: To analyze the association between sleep quality and quality of life of nursing professionals according to their work schedules. Methods: A prospective, cross-sectional, observational study was conducted between January and December 2010, with 264 nursing professionals, drawn from 989 subjects at Botucatu General Hospital and stratified by professional category. The Pittsburg Sleep Quality Index and the WHOQOL-bref were administered to evaluate sleep quality and quality of life, respectively. Self-reported demographic data were collected with a standard form. Continuous variables were reported as means and standard deviations, and categorical variables were expressed as proportions. Associations were evaluated using Spearman's correlation coefficient. The association of night-shift work and gender with sleep disturbance was evaluated by logistic regression analysis using a model adjusted for age and considering sleep disturbance the dependent variable. The level of significance was p < 0.05. Results: Night-shift work was associated with severe worsening of at least one component of sleep quality in the model adjusted for age (OR = 1.91; 95% CI 1.04; 3.50; p = 0.036). Female gender was associated with sleep disturbance (OR = 3.40; 95% CI 1.37; 8.40; p = 0.008). Quality of life and quality of sleep were closely correlated (R = -0.56; p < 0.001). Conclusions: Characteristics of the nursing profession affect sleep quality and quality of life, and these two variables are associated.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Considering the great importance of the Itupararanga Reservoir, Upper Alto Sorocaba basin/SP, this study aimed to report the variations of some parameters of water quality in the spatial and temporal gradients in this multipurpose res- ervoir. The eutrophication of this reservoir was checked using the Carlson Index Modified and the results indicate that the surface water were classified as eutrophic and mesotrophic in wet and dry periods, being characterized the better quality of water in wet period. In the vertical gradient the results showed a stratiphication in all parameters analyzed, except for the electrical conductivity, with good correlation between total phosphorous and chlorophyll-a, indicating that eutrophication of the reservoir changes the conditions of algal growth, mainly in its initial area. Immediate inter- ventions are needed, which must be directed to planning of land use, domestic effluents treatment, taking to an inte- grated management of this important watershed located in the São Paulo State.
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Introduction: In Brazil part of the production of ginger is of inadequate quality for export. The production of spirit from felt-over rhizomes is an alternative of great interest to producers of these rhizomes. Aim: Aiming to increase the value of felt-over rhizomes, this work aimed to study the use of ginger as a raw material for alcoholic beverage production. It was evaluated the effect of fermentation conditions on the components of fermented alcoholic, as well as, the quality of alcoholic distilled beverage of ginger. Methods: Dehydrated ginger passed by enzymatic hydrolysis-saccharification processes. The hydrolysate obtained was analyzed for sugar profile in HPLC. The alcoholic fermentation process followed the central composite rotational design for three factors: fermentation temperature (23 to 37ºC), time of fermentation (17 to 33 h) and concentration of inoculum (0.22 to 3.00%). The fermented alcoholic obtained was analyzed in HPLC for the contents of ethanol, methanol, glycerol and residual sugars. The distillated alcoholic beverage of ginger was analyzed for ethanol, methanol, acetaldehyde, ethyl acetate and higher alcohols in the gas chromatography (GC). In addition, copper content and acidity were analyzed Results: Sugar profile of the ginger hydrolysate revealed the presence of 77.8% of glucose. Data analysis of fermentation process showed influence of temperature on ethanol and methanol content of the fermented alcoholic of ginger. Time of fermentation had effect on glycerol content. All parameters of process had influence on residual sugars contents. The HPLC analysis has shown presence of methanol, ethyl acetate, aldehyde, acids, higher alcohols and esters in distilled alcoholic beverage of ginger. Conclusion: Fermented alcoholic of ginger with higher levels of ethanol can be obtained under the conditions of 1.5% w/w of inoculum, 30°C of temperature and 24 hours of fermentation time. In this condition of fermentation process the beverage of ginger had good quality.
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Este estudo teve como objetivo investigar o impacto das atividades antropogênicas da cidade de Belém pela comparação da qualidade da água e das comunidades de larvas de peixes em dois igarapés que desembocam no rio Guamá. Um dos igarapés atravessa um subúrbio pobre e populoso de Belém, enquanto o outro é localizado em uma ilha de Belém, declarada Área de Proteção Ambiental desde 1997. Dois pontos de coletas foram definidos em cada igarapé e monitorados durante oito horas, a cada três meses e durante um ano. O igarapé em região urbana apresentou fortes alterações na qualidade da água, durante o ano todo e em todas as marés, e isto deve se essencialmente a presença de um elevado número de coliformes termotolerantes. Poucas larvas foram encontradas. A água foi considerada imprópria para uso e atividades humanas, assim como para a vida aquática. O igarapé da ilha apresentou primeiros sinais de contaminação por nutrientes e bactéria durante o período chuvoso, parcialmente decorrente de fontes de poluição difusa. Em ambos os córregos, as comunidades larvais foram quase exclusivamente compostas de clupeiformes. Todos os estágios de desenvolvimento larval foram encontrados. Densidades e proporções mais elevadas de larvas recém eclodidas foram registradas durante a estação seca e associadas à presença de nitrato. Resultados apontam a necessidade de desenvolver um sistema de drenagem urbano para esgoto e água pluvial na maior brevidade, e recomenda um estudo de monitoramento integrado do igarapé na Área de Proteção Ambiental.
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PURPOSE: To determine whether the improvement in intermediate vision after bilateral implantation of an aspheric multifocal intraocular lens (IOL) with a +3.00 diopter (D) addition (add) occurs at the expense of optical quality compared with the previous model with a +4.00 D add. SETTING: Department of Ophthalmology, University of Sao Paulo, Sao Paulo, Brazil. DESIGN: Prospective randomized double-masked comparative clinical trial. METHODS: One year after bilateral implantation of Acrysof Restor SN6AD1 +3.00 D IOLs or Acrysof Restor SN6AD3 +4.00 D IOLs, optical quality was evaluated by analyzing the in vivo modulation transfer function (MTF) and point-spread function (expressed as Strehl ratio). The Strehl ratio and MTF curve with a 4.0 pupil and a 6.0 mm pupil were measured by dynamic retinoscopy aberrometry. The uncorrected and corrected distance visual acuities at 4 m, uncorrected and distance-corrected near visual acuities at 40 cm, and uncorrected and distance-corrected intermediate visual acuities at 50 cm, 60 cm, and 70 cm were measured. RESULTS: Both IOL groups comprised 40 eyes of 20 patients. One year postoperatively, there were no statistically significant between-group differences in the MTF or Strehl ratio with either pupil size. There were no statistically significant between-group differences in distance or near visual acuity. Intermediate visual acuity was significantly better in the +3.00 D IOL group. CONCLUSION: Results indicate that the improvement in intermediate vision in eyes with the aspheric multifocal +3.00 D add IOL occurred without decreasing optical quality over that with the previous version IOL with a +4.00 D add.
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The study of the quality of life of individuals has become a prominent issue for contemporary society. However, research involving quality of life should consider that this is a complex issue that involves objective and subjective aspects, living conditions, lifestyles and multidimensional factors. There is a widespread idea in society that physical activity, exercise, sports and related activities can have a positive impact on improving the quality of life of the population. However, in several studies, this relationship is examined from the biological point of view, which considers only health indicators. Such practices are being studied in the area of Physical Education in various perspectives, such as biological, psychological, social, and cultural. Therefore, Physical Education should seek to produce knowledge that meets the scientific principles, and look for evidence that effectively clarifies the dynamics of this relationship. In this sense, methodological rigor, particularly the conceptual definition, is essential for a better understanding of the results and of which generalizations are actually likely to e proved. In addition, it is necessary to identify the possibilities and limitations of quantitative evaluations, qualitative evaluations and possible combinations.
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Background The aim of the present study was to investigate the efficacy and tolerability of acupuncture (AC), Tanacetum (TAN) or combined treatment on quality of life in women with chronic migraine (CM). Methods A total of 69 women volunteers were randomly divided into 3 groups: AC, acupuncture administered in 20 sessions over 10 weeks (n=22); TAN, at 150 mg/day (n=23); and AC+TAN (n=23). The primary outcome was Short-Form 36 (SF-36) quality of life assessment score. Secondary outcomes included the Migraine Disability Assessment (MIDAS) and visual analogue scale (VAS) score experienced after randomisation. Results AC+TAN was statistically significantly more effective than AC or TAN alone in overall health-related quality of life (SF-36; p<0.05), on MIDAS score (-35.1 (10.6) AC vs -24.8 (11.7) TAN vs -42.5 (9.8) AC+TAN; p<0.05) and in reducing the mean score of pain on VAS (-5.6 (2.4) AC vs -3.7 (2.1) TAN vs -6.4 (3.1) AC+TAN; p<0.05). Conclusions The present work shows an improvement of the quality of life and better analgesic effect of acupuncture combined with TAN treatment on migraine pain in women when compared with acupuncture or TAN alone.
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Background: Medical education can affect medical students' physical and mental health as well as their quality of life. The aim of this study was to assess medical students' perceptions of their quality of life and its relationship with medical education. Methods: First-to sixth-year students from six Brazilian medical schools were interviewed using focus groups to explore what medical student's lives are like, factors related to increases and decreases of their quality of life during medical school, and how they deal with the difficulties in their training. Results: Students reported a variety of difficulties and crises during medical school. Factors that were reported to decrease their quality of life included competition, unprepared teachers, excessive activities, and medical school schedules that demanded exclusive dedication. Contact with pain, death and suffering and harsh social realities influence their quality of life, as well as frustrations with the program and insecurity regarding their professional future. The scarcity of time for studying, leisure activities, relationships, and rest was considered the main factor of influence. Among factors that increase quality of life are good teachers, classes with good didactic approaches, active learning methodologies, contact with patients, and efficient time management. Students also reported that meaningful relationships with family members, friends, or teachers increase their quality of life. Conclusion: Quality of teachers, curricula, healthy lifestyles related to eating habits, sleep, and physical activity modify medical students' quality of life. Lack of time due to medical school obligations was a major impact factor. Students affirm their quality of life is influenced by their medical school experiences, but they also reframe their difficulties, herein represented by their poor quality of life, understood as necessary and inherent to the process of becoming doctors.
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Various types of trill exercises have been used for a long time as a tool in the treatment and preparation of the voice. Although they are reported to produce vocal benefits in most subjects, their physiology has not yet been studied in depth. The aim of this study was to compare the mean and standard deviation of the closed quotient in exercises of lip and tongue trills with the sustained vowel /epsilon/ in opera singers. Ten professional classical (operatic) singers, reportedly in perfect laryngeal health, served as subjects for this study and underwent electroglottography. During the examination, the subjects were instructed to deliver the sustained vowel /epsilon/ and lip and tongue trills in a same preestablished frequency and intensity. The mean values and standard deviation of the closed quotient were obtained using the software developed for this purpose. The comparison of the results was intrasubjects; maximum intensities were compared only among them and so were minimum intensities. The means of closed quotient were statistically significant only in the strong intensities, and the lip trill was different from the tongue trill and the sustained vowel /epsilon/. The standard deviation of the closed quotient distinguished the sustained vowel /epsilon/ from the lip and tongue trills in the two intensities. We concluded that there is oscillation of the closed quotient during the exercises of tongue and lip trills, and the closed quotient is higher during the performance of exercises of the lip trill, when compared with the two other utterances, only in the strong intensities.
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This case-control study aimed to test the association between voice disorders and job stress among public schoolteachers in Sao Paulo, Brazil. The groups consisted of teachers with (n = 165) and without (n = 105) voice-related complaints. Both groups answered the questionnaires Conditions of Vocal Production and Job Stress Scale. Analysis of cases and controls showed comparable samples, differing only by vocal symptoms. There was a statistically significant difference between cases and controls in relation to job stress involving high strain (OR = 2.1;95%CI: 1.1-3.9), which places high demands combined with low job control. High strain in cases in this study represents the highest risk of physical and mental disorders for teachers. Loss of voice prevents teachers from continuing in their professional role, eliminates their professional identity, and jeopardizes their career.
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This study aimed to assess the sanitary quality of water, and wet and dry sand from three beaches located in the South Coast region of Sao Paulo State, Brazil, selected taking into account the frequency of tourists and the water quality (good, fair and poor). Thirty-six water samples each of wet and dry sand and seawater were collected monthly over a period of one year and analyzed for fecal indicator bacteria (FIB: thermotolerant coliforms, Escherichia coli, and enterococci), presumptive Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans and dermatophytes. The results revealed FIB concentrations more elevated in dry sand followed by wet sand and water. P. aeruginosa and presumptive S. aureus were detected with a similar frequency in water and sand samples, but maximum concentrations and geometric means were higher in dry sand. C. albicans was detected only in water samples whereas the dermatophyte Microsporum sp. was isolated exclusively from dry and wet sand samples. This evaluation showed also that the environment had a significant influence on P. aeruginosa but not on presumptive S. aureus concentrations. According to threshold values proposed in the literature for E. coli and enterococci dry sand densities, none of the beaches would be considered of sufficient quality for recreational activities.
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Strategic environmental assessment (SEA) has been applied throughout the world in different sectors and in various ways. This paper reports on results of a PhD research on SEA applied to tourism development planning, reflecting the situation in mid-2010. First, the extent of tourism specific SEA application world-wide is established. Then, based on a review of the quality of 10 selected SEA reports, good practice, as well as challenges, trends and opportunities for tourism specific SEA are identified. Shortcomings of SEA in tourism planning are established and implications for future research are outlined. (C) 2012 Elsevier Inc. All rights reserved.
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Background: The identification of useful quality indicators for nutrition therapy (QINTs) is of great interest and a challenge. This study attempted to identify the 10 QINTs that best suit the practice of quality control in nutrition therapy (NT) by evaluating the opinion of experts in NT with the use of psychometric techniques and statistical tools. Methods: Thirty-six QINTs available for clinical application in Brazil were assessed in 2 distinct phases. In phase 1, 26 nutrition experts ranked QINTs by scoring 4 attributes (utility, simplicity, objectivity, low cost) to assess each QINT on a 5-point Likert scale. The top 10 QINTs were identified from the 10 best scores obtained, and the reliability of expert opinion for each indicator was assessed by Cronbach's alpha. In phase 2, experts provided feedback regarding the selected top 10 QINTs by answering 2 closed questions. Results: The top 10 QINTs, in descending order, are the frequency of nutrition screening of hospitalized patients, diarrhea, involuntary withdrawal of enteral feeding tubes, feeding tube obstruction, fasting longer than 24 hours, glycemic dysfunction, estimated energy expenditure and protein needs, central venous catheter infection, compliance of NT indication, and frequency of application of subjective global assessment. Opinions were consistent among the interviewed experts. During feedback, 96% of experts were satisfied with the top 10 QINTs, and 100% had considered them in accordance with their previous opinion. Conclusion: The top 10 QINTs were identified according to their usefulness in clinical practice by obtaining adequate agreement and representativeness of opinion of nutrition experts. (Nutr Clin Pract. 2012;27:261-267)