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.

Efectos en las cualidades de la voz posteriores a la intervención con fonoterapia y lipoinyección en parálisis de pliegue vocal unilateral paramediana. Comparación de dos casos.

La temática del presente proyecto de investigación se centra en la descripción de los efectos en las cualidades de la voz, analizadas por el Multidimensional Voice Program (MDVP) de Kay - Elemetrics Corp. y el análisis de la estructura y dinámica de las cuerdas vocales a partir de la Videoestroboscopia Laríngea Computarizada (VELC), luego de la intervención en la Parálisis de Pliegue Vocal Unilateral en posición Paramediana (PPVUP), realizada a dos usuarios que consultaron la unidad de Laringe y Voz de la Clínica Avellaneda entre los años 2000 y 2003. En uno de los casos se utilizó la infiltración paracordal de grasa o lipoinyección y en el otro la fonoterapia o terapia vocal.

Education and literacy. 'Educación y alfabetización'.

Resumen tomado de la publicación.Monográfico : las condiciones de aprendizaje de la lengua escrita

Qualidade de vida do cuidador de enfermagem e sua relação com o cuidar; Quality of life of the nursing caregiver and its relationship with care

Objective:To identify aspects that affect the quality of life of nursing caregivers and their relationship with care in an Intensive Care Unit for Adults (A-ICU). Methods:This was a descriptive study with qualitative approach, taking as subjects 21 professionals who constitute the nursing staff of the A-ICU of a school hospital in Maringá-PR. Unstructured interview was used as a strategy to collect data, conducted between May and June 2009. Data analysis was based on the method of content analysis. The categories identified were: overlooking improvement in quality of life related to the resources in an A-ICU; the quality of life influencing the form of care; interpersonal relationships into the health team reflecting on the quality of life and care. Results:The analysis of caregivers’ speech and the results of the observation showed that there is correlation between the aspects they consider influential in their quality of life and the way of caring for patients in an A-ICU.Conclusion: The findings indicate that, among the influential aspects, the stressful factors overlap the enhancing ones. From this perspective, dealing with caregiver’s suffering might be the starting point for the improvement in quality of care in an A-ICU.

Memory and power : two movements

The institutions that work with the preservation and diffusion of cultural heritage - be them archive, libraries, museums, art galleries or cultural centres - present a certain discourse about reality. To understand this discourse, composed by sound and silence, by fullness and emptiness, by presence and absence, by remembrance and forgetting, an operation is implied, not only with the enunciation of speech and its gaps, but also the comprehension of that which causes to speak, of who is speaking and of the point whence one speaks. Preservation and destruction, or, in another way, conservation and loss, walk hand in hand in the arteries of life. As suggested by Nietzsche (1999, p.273), it is impossible to live without loss, it is entirely impossible to live avoiding destruction to play its game and drive the dynamics of life on. However, by means of a kind of tautological argument, one often justifies preservation by the imminence of loss and memory by the threat of forgetting. Thus, one ceases to consider that the game and the rules of the game between forgetting and memory are not fed by themselves and that preservation and destruction are not opposed in a deadly duel, but instead they complement one another and are always at the service of subjects that build themselves and are built through social practices. To indicate that memories and forgettings can be sown and cultivated corroborates the importance of working towards the denaturalisation of these concepts and towards the understanding that they result from a construction process also involving other forces, such as: power. Power is a sower, a promoter of memories and forgettings.

Investigation and literature review of unilateral hearing loss

Literature and research were gathered and analyzed to determine the impact UHL has on a child’s education, speech and language development. The effects of early intervention and amplification were also analyzed.

Respiration for life vs. respiration for speech

This paper examines the differences between respiration for life and respiration for speech and how it can help with teaching intelligible speech.

Campanian crustacean burrow system from Israel with brood and nursery chambers representing communal organization

Phosphorite-filled crustacean burrows associated with a Campanian-age omission surface in the north-western Negev are described. The phosphatic burrow casts weather out displaying scratches (bioglyphs) and two types of local swellings (chambers), which are flattened normal to the course of the burrow. The more abundant chamber type is a flattened spheroid (diameter 45-50 mm) or a flattened, highly prolate ellipsoid of larger dimensions, with bioglyphs. The other type is a flattened spheroid (diameter 45 mm), gently rounded on the upper side and flat on the base. Rings of elevations on the cast (representing moats) form interconnected circlets, each capped by about eight rounded hemispherical tubercles (4 x 4 mm) (pits on original), the whole forming a discrete network. The first type of chamber may have hosted the young (nursery chamber) and/or stored food. The second type of cast replicates a chamber with a pitted floor, which may have formed a brood chamber for 60-70 spherical eggs, each about 3 mm in diameter. Brood chambers in crustacean burrow systems were previously suspected, but only at burrow terminations. The interpreted K-type breeding strategy, brood care and associated functions require a high degree of social organization, none of which has been observed in extant crustaceans, but all occur within social insects.

The Soil: Nature, Sustainable Use, Management, and Protection - An Overview

Soil forms the outer skin of the earth's land surface. Often less than a metre in depth, it is essential to sustain natural terrestrial ecosystems and human life. Soils result from the interactions over time between climate, parent material, topography, vegetation, and biota. They vary from place to place. Mineral soils are composed of mineral matter, organic matter, and gas- or liquid-filled pores in varying proportions. Soils perform a wide range of functions and provide many ecosystem or environmental services; with the climate problem, the soil is increasingly being recognised as a potential sink for carbon from the atmosphere. In part because of humankind's (over)use of soils and in part because of natural and human-induced environmental change, there is a widespread decline in soil quality and an increasing number of threats to soil, which jeopardise both the soil's natural functions and its use by humans. As a limited resource, soils must be used sustainably. Soil protection strategies have been indirectly embodied in a number of United Nations conventions, and there are now national and supranational developments towards specific regulations and legislation to protect soils and their functions.

Genomic and genetic analyses of diversity and plant interactions of Pseudomonas fluorescens

Background: Pseudomonas fluorescens are common soil bacteria that can improve plant health through nutrient cycling, pathogen antagonism and induction of plant defenses. The genome sequences of strains SBW25 and Pf0-1 were determined and compared to each other and with P. fluorescens Pf-5. A functional genomic in vivo expression technology (IVET) screen provided insight into genes used by P. fluorescens in its natural environment and an improved understanding of the ecological significance of diversity within this species. Results: Comparisons of three P. fluorescens genomes (SBW25, Pf0-1, Pf-5) revealed considerable divergence: 61% of genes are shared, the majority located near the replication origin. Phylogenetic and average amino acid identity analyses showed a low overall relationship. A functional screen of SBW25 defined 125 plant-induced genes including a range of functions specific to the plant environment. Orthologues of 83 of these exist in Pf0-1 and Pf-5, with 73 shared by both strains. The P. fluorescens genomes carry numerous complex repetitive DNA sequences, some resembling Miniature Inverted-repeat Transposable Elements (MITEs). In SBW25, repeat density and distribution revealed 'repeat deserts' lacking repeats, covering approximately 40% of the genome. Conclusions: P. fluorescens genomes are highly diverse. Strain-specific regions around the replication terminus suggest genome compartmentalization. The genomic heterogeneity among the three strains is reminiscent of a species complex rather than a single species. That 42% of plant-inducible genes were not shared by all strains reinforces this conclusion and shows that ecological success requires specialized and core functions. The diversity also indicates the significant size of genetic information within the Pseudomonas pan genome.

Annual CREMRU-JCI survey of corporate real estate practices in Europe and North America: 1993-2002

The annual survey of corporate real estate practices has been conducted by CREMRU since 1993 and in collaboration with Johnsons Controls Inc. since 1997. This year the survey forms the first stage of a broader research project: International Survey of Corporate Real Estate Practices: longitudinal study 1993-2002, being undertaken for the Innovative Construction Research Centre at the University of Reading, funded by the Engineering and Physical Sciences Research Council. The survey has been endorsed by CoreNet, the leading professional association concerned with corporate real estate, which opened it to a wider audience. This summary of the ten annual surveys focuses on the incidence of corporate real estate management (CREM) policies, functions and activities, as well as the assessment of knowledge or skills relevant to the CREM function in the future. Both are of vital interest to educational institutions concerned with this field, as well as the personnel and training functions within organisations concerned with better management of their property.

Inspecting the teaching of singing in the teacher training colleges of England, Wales and Scotland 1883-1899

This paper investigates the links between the teaching of singing, training and inspection during the late Victorian era. It utilises as a primary source the annual inspection reports of the music inspector, Sir John Stainer. More specifically it focuses upon the musical background of the students in the training colleges of England, Wales and Scotland, the methods employed to teach sight singing and voice production, the vocal repertoire and preparation for the teaching of singing in schools. Finally, some comparison is made with the present day and the relationship between the teaching of singing, training and inspection.

The role of drama in the teaching of speaking and listening as the basis for social capital

This paper explores how the concept of 'social capital' relates to the teaching of speaking and listening. The argument draws on Bourdieu's notion that a common language is an illusion but posits that an understanding of the grammar of speech can be productive in the development of both an understanding of what constitutes effective speech and the development of competence in speaking. It is argued that applying structuralist notions of written grammar is an inadequate approach to understanding speech acts or enhancing the creative use of speech. An analysis is made of how typical features of speech relate to dramatic dialogue and how the meaning of what is said is contingent upon aural and visual signifiers. On this basis a competent speaker is seen as being one who produces expressions appropriate for a range of situations by intentionally employing such signifiers. The paper draws on research into the way drama teachers make explicit reference to and use of semiotics and dramatic effectiveness in order to improve students' performance and by so doing empower them to increase their social capital. Ultimately, it is concluded that helping students identify, analyse and employ the aural, visual and verbal grammar of spoken English is not an adjunct to the subject of drama, but an intrinsic part of understanding the art form. What is called for is a re-appraisal by drama teachers of their own understanding of concepts relating to speech acts in order to enhance this area of their work.

Relation between the fatty acid composition of peripheral blood mononuclear cells and measures of immune cell function in health free-living subjects aged 25-72 y

Background: There is little information about the relation between the fatty acid composition of human immune cells and the function of those cells over the habitual range of fatty acid intakes. Objective: The objective of the study was to determine the relation between the fatty acid composition of human peripheral blood mononuclear cell (PBMC) phospholipids and the functions of human immune cells. Design: One hundred fifty healthy adult subjects provided a fasting blood sample. The phagocytic and oxidative burst activities of monocytes and neutrophils were measured in whole blood. PBMCs were isolated and used to measure lymphocyte proliferation in response to the T cell mitogen concanavalin A and the production of cytokines in response to concanavalin A or bacterial lipopolysaccharide. The fatty acid composition of plasma and PBMC phospholipids was determined. Results: Wide variations in fatty acid composition of PBMC phospholipids and immune cell functions were identified among the subjects. The proportions of total Polyunsaturated fatty acids (PUFAs), of total n-6 and n-3 PUFAs, and of several individual PUFAs in PBMC phospholipids were positively correlated with phagocytosis by neutrophils and monocytes, neutrophil oxidative burst, lymphocyte proliferation, and interferon gamma production. The ratios of saturated fatty acids to PUFAs and of n-6 to n-3 PUFAs were negatively correlated with these same immune functions. The relation of PBMC fatty acid composition to monocyte oxidative burst was the reverse of its relation to monocyte phagocytosis and neutrophil oxidative burst. Conclusion: Variations in the fatty acid composition of PBMC phospholipids account for some of the variability in immune cell functions among healthy adults.

The neural response to emotional prosody, as revealed by functional magnetic resonance imaging

Prosody is an important feature of language, comprising intonation, loudness, and tempo. Emotional prosodic processing forms an integral part of our social interactions. The main aim of this study was to use bold contrast fMRI to clarify the normal functional neuroanatomy of emotional prosody, in passive and active contexts. Subjects performed six separate scanning studies, within which two different conditions were contrasted: (1) "pure" emotional prosody versus rest; (2) congruent emotional prosody versus 'neutral' sentences; (3) congruent emotional prosody versus rest; (4) incongruent emotional prosody versus rest; (5) congruent versus incongruent emotional prosody; and (6) an active experiment in which subjects were instructed to either attend to the emotion conveyed by semantic content or that conveyed by tone of voice. Data resulting from these contrasts were analysed using SPM99. Passive listening to emotional prosody consistently activated the lateral temporal lobe (superior and/or middle temporal gyri). This temporal lobe response was relatively right-lateralised with or without semantic information. Both the separate and direct comparisons of congruent and incongruent emotional prosody revealed that subjects used fewer brain regions to process incongruent emotional prosody than congruent. The neural response to attention to semantics, was left lateralised, and recruited an extensive network not activated by attention to emotional prosody. Attention to emotional prosody modulated the response to speech, and induced right-lateralised activity, including the middle temporal gyrus. In confirming the results of lesion and neuropsychological studies, the current study emphasises the importance of the right hemisphere in the processing of emotional prosody, specifically the lateral temporal lobes. (C) 2003 Elsevier Science Ltd. All rights reserved.