Wind instrumentalists' work-related vocal tract discomfort.

BACKGROUND: Wind instrumentalist use the vocal tract intensively in their professional activities, which can lead to the development work-related voice disorders. OBJECTIVE: To analyze the perception of vocal tract discomfort (VTD) by wind instrumentalists from Natal, Brazil. METHOD: Cross-sectional study with 117 professional musicians and music students from six official bands/orchestras in the city of Natal. Both the Vocal Tract Discomfort Scale and a sample characterization questionnaire were applied. The Chi-square test, Fisher's exact test, and Mann-Whitney U test were applied in the statistical analysis of the variables. RESULTS: The most frequent and intense symptoms of VTD were sensitive throat and sore throat. There was a significant difference between the values of frequency and intensity of all symptoms both before and after playing the instrument. Dryness was the most intense symptom felt after playing the instrument. Musicians who report muscle pain and gastroesophageal reflux showed more VTD symptoms. CONCLUSION: Symptoms of VTD are experienced by wind instrumentalists and can be work-related since there was a difference in their perception after playing their instruments. There was also a relationship with gastroesophageal reflux and muscle pain, indicating that, in addition to collective issues, the individual musicians' health should be taken into account.

Mental health services accessibility for women and men: A protocol for a systematic review and meta-analysis.

INTRODUCTION: Mental and behavioral disorders constitute a serious public health problem and require adequate access among women and men for promotion, prevention and treatment of mental illness. METHODS AND ANALYSIS: For the writing of this protocol we will use the guidelines of the PRISMA-P Checklist (Main Items for Reporting Systematic Reviews and Meta-analyzes). This protocol was registered under the number: CRD42021243263. To this end, research will be conducted in the PubMed, Web of Science, Scopus, CINAHL and ScienceDirect databases in search of cross-sectional studies that assess the prevalence of access to mental health services among women and men. All cross-sectional studies that examined the prevalence of mental health services accessibility among women and men will be included. The search will be conducted by two independent researchers who will identify the articles; they will exclude duplicate studies. Through a blinded assessment, they will select articles using the Rayyan QCRI application. The methodological quality of the included studies will be assessed by the Joanna Briggs Institute Checklist for Analytical Cross-Sectional Studies. Meta-analyses will be performed according to the conditions of the included data. ETHICS AND DISCLOSURE: For the development of this study, there is no need for ethical review, as this is a systematic review that will use secondary studies. The conclusions of this study will be disseminated through peer-reviewed publications, conference presentations and condensed abstracts to key stakeholders and partners in the field. The database search is scheduled to start on May 10th, 2021. The entire review process is expected to be completed by August 30th, 2021.

Frequency of Vitamin a Deficiency in Children Hospitalized for Pneumonia: An Integrative Review.

Objective: To identify the frequency of vitamin A deficiency in children aged 6 months to 5 years hospitalized for pneumonia. Methods: An integrative literature review was carried out, where searches were made by two independent researchers, with no language limits or publication time in the databases PubMed, LILACS, Web of Science, Scopus and CINAHL, and in the gray literature-OpenGrey, Proquest and Google Scholar. In the eligibility phase, the screened studies were read in full and those that did not answer the research question were excluded. Methodological quality was assessed using the Downs & Black (1998) checklist. Results: 1642 articles were identified, after all stages of screening and selection, 10 studies were included, of which 5 were longitudinal, 4 were intervention and 1 transversal. All studies identified subclinical vitamin A deficiency in children hospitalized with pneumonia; the highest frequency of subclinical vitamin A deficiency was 93.2%. All studies evaluated showed frequencies of subclinical vitamin A deficiency >20%. Conclusion: There is a high frequency of subclinical vitamin A deficiency in children with pneumonia; these data need to be further explored in terms of their associations. For this reason, new studies that evaluate this topic are of fundamental importance.

Factors Associated with Suicidal Behavior in Farmers: A Systematic Review.

This review aimed to investigate the factors associated with suicidal behavior in farmers in the scientific literature. Two researchers participated independently in searching databases, specifically PubMed/MEDLINE, LILACS, Web of Science, Scopus, PsycINFO, and SciELO. Only observational studies were included. The quality of the selected studies was assessed with a critical assessment checklist for cross-sectional analytical and case-control studies, prepared by the Joanna Briggs Institute. Data related to the publication were collected (author and year; city/country); methodological design; sample/population (gender; average age), outcome, measuring instrument and factors associated with suicidal behavior. A total of 14 studies were included in the systematic review, and factors associated with farmers' behavior in mental health (depression), seasonal impacts (drought), and work exposures (herbicides and insecticides) were identified. However, heterogeneity was found in terms of the method, measurement of suicidal behavior, and associated factors, which indicates the need for further studies.

Prevalence of COVID-19 infection in black people in primary health care, hospital units and intensive care units: a protocol for a systematic review and meta-analysis.

INTRODUCTION: COVID-19 pandemic has affected people all over the world. In this context, health disparities are already evident in becoming ill and dying from this condition, further accentuating historical racial inequalities. METHODS AND ANALYSIS: This protocol will be developed based on the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. For this, searches will be carried out in PubMed, Web of Science, Scopus, Lilacs and ScienceDirect databases searching for cross-sectional studies that assessed the prevalence of black people with COVID-19 at different levels of complexity. All cross-sectional studies that analysed the prevalence of COVID-19 in black people assisted in primary care, hospital wards and intensive care units will be included. The research will be carried out by two independent researchers who will identify the articles; they will exclude duplicate studies. Through blind evaluation, they will select the articles using the Rayyan QCRI application. The instrument proposed by Downs and Black will be used to assess the risk of bias. The meta-analyses will be performed according to the data conditions included. ETHICS AND DISSEMINATION: For this study's development, there is no need for an ethical appraisal considering that it is a systematic review that will use secondary studies. This study's findings will be disseminated through peer-reviewed publications, conference presentations and condensed summaries for main stakeholders and partners in the field. The database search is expected to begin on 1 February 2021. It is expected to complete the entire review process by 30 October 2021 TRIAL REGISTRATION NUMBER: CRD42020209079.

Uma análise das teleconsultorias assíncronas em saúde auditiva do Núcleo de Telessaúde do Rio Grande do Norte / An analysis of asynchronous hearing health teleconsulting at the Rio Grande do Norte Telehealth Center

RESUMO Objetivo identificar o perfil das teleconsultorias assíncronas na área da saúde auditiva do Núcleo Técnico Científico de Telessaúde do Rio Grande do Norte (RN). Métodos este estudo é retrospectivo e descritivo. Foram analisados os registros das teleconsultorias de janeiro de 2015 a dezembro de 2019 na plataforma de teleconsultoria do Núcleo de Telessaúde do RN. As teleconsultorias foram filtradas e categorizadas por dois fonoaudiólogos quanto a estado de origem, gênero e profissão do solicitante, tema e objetivo da questão. Resultados entre as teleconsultorias realizadas no período, foram incluídas, neste estudo, as teleconsultorias na área da saúde auditiva. Em ordem decrescente de frequência, os profissionais solicitantes foram: agentes comunitários de saúde, fonoaudiólogos, agentes de combate a endemias, médicos, enfermeiros, agentes de saúde pública, técnicos e auxiliares de enfermagem e outros. Quanto aos objetivos das teleconsultorias, de maior a menor frequência, foram constatadas perguntas sobre condutas, avaliação, tratamento, relações entre fatores, etiologias, prevenção, sintomas, implantação, acesso ao sistema de saúde e outras. Em relação às temáticas, em ordem descendente, foram observadas perguntas sobre hipoacusia, dispositivos auxiliares de audição, zumbido, otite, programa saúde na escola, emissões otoacústicas, otalgia, labirintite e perfuração timpânica. Conclusão as teleconsultorias assíncronas sobre saúde auditiva tiveram maior frequência por solicitantes do gênero feminino, agentes comunitários de saúde e fonoaudiólogos, sobre a temática da hipoacusia e de dispositivos auxiliares de audição, com objetivo de tomada de decisões para condutas e avaliação na área da saúde auditiva.

ABSTRACT Objective To identify the profile of asynchronous hearing health teleconsulting ​​ at the Scientific-Technical Center for Telehealth in Rio Grande do Norte (RN). Methods This study is retrospective and descriptive. Teleconsulting records from January 2015 to December 2019 on the telehealth platform of the Telehealth Center of RN were analyzed. The teleconsultations were filtered and categorized by two speech-language therapists regarding the applicant's state of origin, gender and profession, theme and objective of the question. Results Among the teleconsultations carried out in the period, the ones regarding the hearing health area were included in this study. In decreasing order of frequency, the requesting professionals were: community health agents, speech-language therapists, endemic disease control agents, doctors, nurses, public health agents, nursing technicians and assistants and others. As for the objectives of teleconsulting, from higher to lower frequency, were identified questions about: conduct, evaluation, treatment, relations among factors, etiologies, prevention, symptoms, implementation, access to the health system and others. Concerning the themes, in descending order, were observed questions about hearing loss, hearing aid devices, tinnitus, otitis, school health program, otoacoustic emissions, otalgia, labyrinthitis and tympanic perforation. Conclusion Asynchronous teleconsulting on hearing health was more frequent on female applicants, community health agents and speech-language therapists, concerning the theme of hearing loss and hearing aid devices, to make decisions for conducts and evaluation in the health area hearing.

Teste de dígitos no ruído baseado em software para português brasileiro em crianças com transtorno do processamento auditivo central / Software-based digits-in-noise test for Brazilian Portuguese in children0ith central auditory processing disorder / Prueba de dígitos en ruido basado en software para portugués brasileño en niños con trastorno del central procesamiento auditivo

Introdução: Nas situações da vida diária, frequentemente, é necessário reconhecer a fala em ambientes com ruído competitivo, sendo que dificuldades neste reconhecimento é uma queixa comum de pessoas com transtornos do processamento auditivo central (TPAC). O Teste de Dígitos no Ruído (TDR), desenvolvido para triagem de perdas auditivas em adultos e idosos, apresenta vantagens que o tornam promissor para triagem em crianças com TPAC. Objetivo: Verificar o desempenho de crianças com TPAC no TDR baseado em software para o Português brasileiro. Método: A amostra de conveniência foi constituída por 31 crianças (8-12 anos), sendo 23 com TPAC, alocadas no G1, e oito sem o transtorno, que compuseram o G2. Todas realizaram avaliação audiológica básica, timpanometria, reconhecimento numérico visual e aleatório, aplicação do TDR e avaliação comportamental do processamento auditivo central (PAC) para determinar presença ou não do TPAC. Na análise foi utilizado Teste de Mann-Whitney no comparativo entre G1 e G2 e correlação de Sperman entre os testes de PAC e a média da relação S/R (RSR) do TDR. Resultados: G1 e G2 apresentaram desempenhos significativamente diferentes nos testes fala filtrada (orelha direita), dicótico de dígitos (orelha esquerda), fusão binaural e gaps-in-noise de ambas as orelhas e no teste de padrões de frequência. A média da relação sinal/ruído (RSR) do TDR foi de -7,29 dB (dp ± 4,76) nos sujeitos do G1 e de -8,42 dB (dp ± 2,93) no G2. Não houve diferença estatisticamente significante entre G1 e G2 no comparativo das médias de RSR final (p = 0,227). Não foi evidenciada correlação na maior parte dos testes de PAC e o TDR, exceto correlação negativa no FBOE e DDIOD. Conclusão: O desempenho das crianças com TPAC é similar ao de crianças sem TPAC no teste de dígitos no ruído em Português Brasileiro.

Speech recognition on noise is an auditory processing skill, important for children in contexts with competitive noise and reverberation and can test their functional capacity. The Digits-in-Noise (DIN) Test, developed for hearing screening in adults and the elderly, has advantages that make it promising for screening children with central auditory processing disorders (CAPD). Objective: Verify the performance of children with central auditory processing disorder in a software-based DIN Test for Brazilian Portuguese. Methods: The convenience sample comprised 31 children (8 to 12 years), 23 with CAPD placed in G1, and eight without the disorder that composed G2. All children underwent basic audiological assessment and tympanometry, visual and random numerical recognition, use of DIN and auditory processing behavioral assessment to determine the presence or absence of APD. We used the Mann-Whitney test to compare G1 and G2. Results: G1 and G2 presented different performances in the filtered speech (right ear), dichotic digits (left ear), binaural fusion and gaps-in-noise tests of both ears and in the frequency pattern test. We observed that the average DIN signal-to-noise ratio (SNR) was -7.29 dB (SD ± 4.76) in G1 subjects, and -8.42 dB (SD ± 2.93) in G2 subjects. There was no statistically significant difference between G1 and G2 in comparison of average final SNR (p = 0.227). Conclusion: Considering the average values of the final SNR, we found that the children's performance in the DIN test was similar between both groups.

Introducción: Reconocimiento de habla en ruido es una habilidad del procesamiento auditivo, importante para chicos en contextos con ruido competitivo y reverberación, y puede ser evaluada para determinar su capacidad funcional. La Prueba de Dígitos en Ruido (PDR), desarrollada para detectar pérdida de audición en adultos y ancianos, presentado ventajas que lo hacen prometedor para detección en niños con trastorno del procesamiento auditivo central (TPAC). Objetivo: Verificar el rendimiento de niños conTPAC en PDR basado en software en portugués brasileño. Metodos: La muestra de conveniencia consistió en 31 niños entre 8-12 año, 23 chicos con TPAC, asignado en G1, y ocho sin trastorno, que componen G2. Todos realizaron evaluación audiológica básica, timpanometría, reconocimiento numérico visual y aleatorio, aplicación del PDR y evaluación comportamental del procesamiento auditivo, aplicación del PDR e del comportamiento del procesamiento auditivo para determinar la presencia o ausencia de TPAC. Se utilizó la prueba de Mann-Whitney para análisis entre G1 y G2. Resultados: G1 y G2 presentaron diferentes rendimientos en pruebas de habla filtrada (oído derecho), dígitos dicóticos (oído izquierdo), fusión binaural y gaps-in-noise en ambos oídos y en la prueba del patrón de frecuencia. La Relación Señal/Ruido (S/R) del PDR fue -7.29 dB (sd ± 4.76) en chicos del G1 y -8.42 dB (sd ± 2.93) en G2. No hubo diferencias estadísticamente significativas entre G1 y G2 al comparar las medias finales de RSR (p = 0.227). Conclusión: Teniendo en cuenta valores de la media S/R final, hubo similitud de rendimiento en PDR en ambos grupos.

Sensitivity and specificity of three hearing screening protocols in the school setting

ABSTRACT Objective: to evaluate the sensitivity and specificity of three hearing screening protocols: audiometry, tympanometry, and transient evoked otoacoustic emissions (TEOAE). Methods: a cross-sectional study comprising 70 schoolchildren aged 6-14 years old (9.9 ± 2). All participants underwent a complete audiological evaluation and screening procedures. Procedures were compared regarding sensitivity, specificity, and positive and negative predictive values. Results: sensitivity and specificity were, respectively, 64.71% and 66.04% for audiometry, 64.71% and 73.58% for tympanometry, and 66.67% and 78.85% for TEOAE. The positive and negative predictive values were 37.93% and 14.63% for audiometry, 44% and 13.33% for tympanometry, and 52.17% and 12.77% for TEOAE. Conclusions: in the school setting, TEOAE stands out from the two other screening protocols, in all measures regarding sensitivity, accuracy, and predictive values.

Reprodutibilidade de testes de resolução temporal em adultos / Reproducibility of temporal resolution tests in adults / Reproducibilidad de pruebas de resolución temporal en adultos

O uso de testes comportamentais é uma prática clínica frequente na audiologia devido à sua grande contribuição ao diagnóstico e aos processos de intervenção fonoaudiológica. Objetivo: Verificar a reprodutibilidade dos protocolos de avaliação da resolução temporal em adultos. Método: Participaram da amostra 34 sujeitos, 22 do sexo feminino e 12 do masculino, com média de idade de 26,21 anos (20 a 52 anos; dp= 8,92) seguindo os critérios: ausência de histórico otológico e/ou audiológico e queixas escolares; normalidade no padrão audiológico e no teste dicótico de dígitos. Foram utilizados na pesquisa os testes Random Gap Detection Test e Gap in Noise, a 50 dB. Ambos foram aplicados em dois momentos, sendo a segunda aplicação com intervalo de uma semana da primeira. O teste Wilcoxon foi utilizado para análise do desempenho da amostra no teste GIN em função da orelha e Teste de Friedman para análise do RGDT em função da frequência testada nos dois momentos. Foi adotado o nível de significância de 5%. O coeficiente de correlação intraclasse foi utilizado na análise da concordância entre as aplicações teste(T1) e reteste (T2) pelo mesmo avaliador (reprodutibilidade). Resultados: Não houve diferença entre as frequências testadas no RGDT (média) no T1 e T2. Houve diferença no desempenho do GIN entre orelha direita e esquerda no T2. A reprodutibilidade de teste-reteste no RGDT (média) e GIN foi substancial conforme o coeficiente de correlação intraclasse. Conclusão: Há reprodutibilidade no teste RGDT quando comparada a média das frequências e no teste GIN bilateralmente.

The behavioral test is frequent clinical practice in audiology due to its contribution to the diagnosis and speech therapy intervention processes. Objective: To verify the reproducibility of temporal resolution assessment protocols in adults. Method: A total of 34 subjects, 22 females and 12 males, with an average age of 26.21 years (20 to 52 years old; dp = 8.92) were included, following the criteria: absence of otological and/or audiological history and school complaints; normality in the audiological pattern and in the dichotic test of digits. The Random Gap Detection and Gap in Noise tests, at 50 dB, were used. Both were applied in two moments; the second application with a one-week interval of the first. The Wilcoxon test was used to analyze the performance of the sample in the GIN test in the ear and Friedman test in order to analyze the RGDT as a function of the frequency tested in the two moments. The level of significance of 5% was adopted. The intraclass correlation coefficient was used in the analysis of the agreement between the test (T1) and retest (T2) applications by the same evaluator (reproducibility). Results: There was no difference between the frequencies tested in the RGDT (mean) in T1 and T2. There was a difference in GIN performance between the ears in T2. The test-retest reproducibility in the RGDT (mean) and GIN was substantial according to the intraclass correlation coefficient. Conclusion: There is reproducibility in the RGDT test when compared to the mean frequencies and in the GIN test bilaterally.

El uso de pruebas comportamentales es una práctica clínica frecuente debido a su contribución al diagnóstico y intervención del lenguaje y del habla. Objetivo: Verificar la reproducibilidad de los protocolos de evaluación de La resolución temporal en adultos. Método: Participaron de la amuestra 34 sujetos, 22 del sexo femenino y 12 del masculino, con un promedio de 26,21 años (20 a 52 años; dp= 8,92) siguiendo los criterios: ausencia de histórico otológico, audiológico y quejas escolares; normalidad del patrón audiológico y en la prueba dicótica de dígitos. Se utilizaron las pruebas Random Gap Detection Test y Gap in Noise, a 50dB. Ambos fueron aplicados en dos momentos, siendo la segunda aplicación con intervalo de una semana de la primera. La prueba Wilcoxon fue utilizada para analizar el rendimiento de la muestra en la prueba GIN en función de la oreja y la prueba de Friedman para el análisis del RGDT en función de la frecuencia probada en los dos momentos. Se adoptó el nivel de significancia del 5%. El coeficiente de correlación intraclase fue utilizado en el análisis de la concordancia entre las aplicaciones test(T1) y reprueba(T2) por el mismo evaluador. Resultados: No hubo diferencia entre las frecuencias probadas en el RGDT en el T1 y T2. Hubo diferencias en rendimiento del GIN entre las orejas en el T2. La reproducibilidad de prueba-reprueba en el RGDT y GIN fue sustancial conforme el coeficiente de correlación intraclase. Conclusión: Hay reproducibilidad en la prueba RGDT cuando se compara el promedio de las frecuencias y la prueba GIN bilateralmente.

Prevalence of hearing impairment and associated factors in school-aged children and adolescents: a systematic review / Prevalência de deficiência auditiva e fatores associados em adolescentes e crianças em idade escolar: uma revisão sistemática

Abstract Introduction: Hearing impairment is one of the communication disorders of the 21st century, constituting a public health issue as it affects communication, academic success, and life quality of students. Most cases of hearing loss before 15 years of age are avoidable, and early detection can help prevent academic delays and minimize other consequences. Objective: This study researched scientific literature for the prevalence of hearing impairment in school-aged children and adolescents, with its associated factors. This was accomplished by asking the defining question: "What is the prevalence of hearing impairment and its associated factors in school-aged children and adolescents?" Methods: Research included the databases PubMed/MEDLINE, LILACS, Web of Science, Scopus and SciELO, and was carried out by two researchers, independently. The selected papers were analyzed on the basis of the checklist provided by the report Strengthening the Reporting of Observational Studies in Epidemiology. Results: From the 463 papers analyzed, 26 fulfilled the criteria and were included in the review presented herein. The detection methods, as well as prevalence and associated factors, varied across studies. The prevalence reported by the studies varied between 0.88% and 46.70%. Otologic and non-otologic factors were associated with hearing impairment, such as middle ear and air passage infections, neo- and post-natal icterus, accumulation of cerumen, family history, suspicion of parents, use of earphones, age and income. Conclusion: There is heterogeneity regarding methodology, normality criteria, and prevalence and risk factors of studies about hearing loss in adolescents and school-aged children. Nevertheless, the relevance of the subject and the necessity of early interventions are unanimous across studies.

Resumo Introdução: A deficiência auditiva é um dos distúrbios de comunicação do século XXI, constitui um problema de saúde pública, pois afeta a comunicação, o sucesso acadêmico e a qualidade de vida dos estudantes. A maioria dos casos de perda auditiva antes dos 15 anos é evitável e a detecção precoce pode ajudar a evitar atrasos acadêmicos e minimizar outras consequências. Objetivo: Este estudo investigou a literatura científica sobre a prevalência da deficiência auditiva em crianças e adolescentes em idade escolar, com seus fatores associados. Isso foi feito através da questão norteadora: "Qual a prevalência da deficiência auditiva e seus fatores associados em crianças e adolescentes em idade escolar?" Método: A pesquisa compreendeu as bases de dados PubMed/MEDLINE, LILACS, Web of Science, Scopus e SciELO e foi feita de forma independente por dois pesquisadores. Os artigos selecionados foram analisados com base na lista de verificação fornecida pelo relatório Strengthening the Reporting of Observational Studies in Epidemiology. Resultados: Dos 463 artigos analisados, 26 preencheram os critérios e foram incluídos na revisão aqui apresentada. Os métodos de detecção, assim como a prevalência e os fatores associados, variaram entre os estudos. A prevalência relatada pelos estudos variou entre 0,88% e 46,70%. Fatores otológicos e não otológicos foram associados à deficiência auditiva, como infecções da orelha média e das vias aéreas, icterícia neonatal e pós-natal, acúmulo de cerúmen, histórico familiar, suspeita dos pais, uso de fones de ouvido, idade e renda. Conclusão: Há heterogeneidade quanto à metodologia, aos critérios de normalidade e, consequentemente, à prevalência e aos fatores associados nos estudos sobre da perda auditiva em adolescentes e crianças em idade escolar. No entanto, a relevância do assunto e a necessidade de intervenções precoces são unânimes entre os estudos.

Prevalence of hearing impairment and associated factors in school-aged children and adolescents: a systematic review.

INTRODUCTION: Hearing impairment is one of the communication disorders of the 21st century, constituting a public health issue as it affects communication, academic success, and life quality of students. Most cases of hearing loss before 15 years of age are avoidable, and early detection can help prevent academic delays and minimize other consequences. OBJECTIVE: This study researched scientific literature for the prevalence of hearing impairment in school-aged children and adolescents, with its associated factors. This was accomplished by asking the defining question: "What is the prevalence of hearing impairment and its associated factors in school-aged children and adolescents?" METHODS: Research included the databases PubMed/MEDLINE, LILACS, Web of Science, Scopus and SciELO, and was carried out by two researchers, independently. The selected papers were analyzed on the basis of the checklist provided by the report Strengthening the Reporting of Observational Studies in Epidemiology. RESULTS: From the 463 papers analyzed, 26 fulfilled the criteria and were included in the review presented herein. The detection methods, as well as prevalence and associated factors, varied across studies. The prevalence reported by the studies varied between 0.88% and 46.70%. Otologic and non-otologic factors were associated with hearing impairment, such as middle ear and air passage infections, neo- and post-natal icterus, accumulation of cerumen, family history, suspicion of parents, use of earphones, age and income. CONCLUSION: There is heterogeneity regarding methodology, normality criteria, and prevalence and risk factors of studies about hearing loss in adolescents and school-aged children. Nevertheless, the relevance of the subject and the necessity of early interventions are unanimous across studies.

Influence of the socieconomic level on the temporal resolution hearing skills in adults / Influência do nível socioeconômico na habilidade auditiva de resolução temporal em adultos

ABSTRACT Objective: to investigate the influence of the socioeconomic level on the temporal resolution auditory ability of adults. Methods: the sample consisted of 48 subjects aged 18 to 50 years, divided into three groups: G1, 11 subjects at level A; G2, 19 in B1 and B2 and G3, 18 in C1, C2, D and E. All subjects presented responses in 20 dB HL in frequencies of 500 to 4000 Hz, during audiometric screening, type A tympanometry, presence of contralateral and ipsilateral acoustic reflexes, no neurological, psychiatric and / or psychological changes diagnosed; without audiological and / or otological complaints and with performance above 95% in the dichotic digit test. The Random Gap Detection and Gap-in-noise tests were performed. The Shapiro-Wilk test for normality analysis and the Kruskall Wallis test for socioeconomic stratum analysis, were used, both with 5% significance. Results: there were statistically significant differences between the groups in the Random Gap Detection in the frequency of 500 Hz and in the average of the frequencies, as a function of the socioeconomic level, the same not being observed in the Gap-in-noise. Conclusions: it is suggested that the socioeconomic level be taken into account in the analysis of the Random Gap Detection test.

RESUMO Objetivo: investigar a influência do nível socioeconômico na habilidade auditiva de resolução temporal de adultos. Métodos: a amostra foi composta por 48 sujeitos na faixa-etária de 18 a 50 anos, (X = 25,40 ± 7,36) divididos por estratos socioeconômicos em três grupos: G1: 11 sujeitos no nível A; G2: 19 no B1 e B2 e G3: 18 no C1, C2, D e E. Todos os sujeitos apresentaram respostas em 20 dB NA nas frequências de 500 a 4000Hz durante a triagem audiométrica, timpanometria tipo A, presença de reflexos acústicos contra e ipsilaterais, não possuíam alterações neurológicas, psiquiátricas e/ou psicológicas diagnosticadas; sem queixas audiológicas e/ou otológicas e com desempenho superior a 95% no teste dicótico de dígitos. Foram realizados os testes Random Gap Detection e o Gap-in-noise. Utilizou-se o teste Shapiro-Wilk para análise de normalidade e o teste de Kruskall Wallis para análise do estrato socioeconômico, ambos com 5% de significância. Resultados: houve diferença estatisticamente significante entre os grupos no Random Gap Detection na frequência de 500 Hz e na média das frequências em função do nível socioeconômico, não sendo observado o mesmo no Gap-in-noise. Conclusões: sugere-se que o nível socioeconômico seja levado em consideração na análise do teste Random Gap Detection.

Prevalência de perda auditiva e fatores associados em escolares da rede pública municipal de Natal/RN / Prevalence of hearing loss and associated factors in students from the municipal public network of Natal/RN

Introdução: A audição é fundamental para o desenvolvimento da linguagem e aprendizagem, interação social, aquisição de conhecimentos e torna possível ao indivíduo transmitir pensamento e sentimentos. A prevenção, identificação e intervenção precoces das alterações auditivas são essenciais, por sua relevância para os aspectos de linguagem e aprendizagem e por reduzir os custos com as consequências da perda auditiva. Objetivo: Analisar a prevalência de perda auditiva em escolares do município de Natal/RN e seus fatores associados. Metodologia: Trata-se de um estudo transversal que analisou 238 crianças e adolescentes do ensino fundamental I e II, dos sexos feminino e masculino, matriculados em escolas públicas do município de Natal-RN, avaliados pela meatoscopia, triagem audiométrica com Audiômetro Telessaúde e avaliação autorreferida de dificuldade auditiva e dor de ouvido. Para identificação dos fatores associados à perda auditiva foi utilizada a análise bivariada através dos testes do Qui-quadrado, Exato de Fisher e Razão de Prevalência, considerando a significância de 5%. A Regressão de Poisson utilizando o teste de Wald com estimação robusta foi realizada para fatores avaliados na análise multivariada. Foi realizada análise de concordância, Kappa (IC95%) entre o resultado da avaliação, perda auditiva referida pelos pais, pelos escolares e resultado da meatoscopia. Os dados foram analisados no SPSS 23. Resultados: A prevalência de perda auditiva entre os escolares de 6 a 17 anos (10,76 ± 2,81) foi de 16% (11,7%-21,4%); 16% referiram não ouvir bem, 18,9% sentiam dor de ouvido e 26,1% apresentaram meatoscopia alterada. 71,26% dos participantes pertenciam às classes econômicas A-B-C. A prevalência de perda auditiva foi maior entre os escolares que referiram dificuldade auditiva e dor de ouvido, entre crianças de 6 a 12 anos e por tipo de infecções de vias aéreas (p<0,05). A Infecção de vias aéreas (RP=3,37 IC95% 1,48-7,68) foi encontrada como fator de risco associado à perda auditiva, permanecendo significativa no modelo multivariado (RP=6,79 IC95% 1,98-23,26 pvalor=0,002). O índice Kappa indicou concordância consistente nas situações avaliadas. Conclusões: A prevalência de perda auditiva em escolares no município de Natal está acima da referida em outros estudos realizados no Brasil para esta faixa etária, o que mostra a necessidade da atenção fonoaudiológica vinculada ao Programa Saúde na Escola, a fim de que sejam sistematizadas ações de promoção da saúde auditiva para esta população no município de NatalRN (AU).

Introduction: Hearing is fundamental for the development of language and learning, social interaction, acquisition of knowledge and makes it possible for the individual to transmit thoughts and feelings. Early prevention, identification and intervention of auditory changes are essential because of their relevance to language and learning aspects and to reduce costs with the consequences of hearing impairment. Objective: To analyze the prevalence of hearing impairment in schoolchildren in the city of Natal / RN and its associated factors. Methods: This is a cross-sectional study of the analysis of children and adolescents of primary and secondary education, male and female, enrolled in public schools in the city of Natal-RN, with evaluation by meatoscopy, audiometric screening with audiometry difficulty ear and earache. The comparative analysis of the data was performed using Chi-square, Fisher's Exact and Prevalence Ratio tests, considering a significance of 5%. The results were exactly the same in the bivariate analysis, more of a multivariate analysis by Poisson regression using the Wald test with the same robust one. A concordance analysis, Kappa (95% CI) was performed between the results of the evaluation, the auditory audit of the parents, the students and the meatoscopy result. Results: The prevalence of hearing loss among students aged 6 to 17 years (10.76 ± 2.81) was 16% (11.7% -21.4%); 16% reported not hearing well, 18.9% felt pain and 26.1% had altered carnoscopy. 71.26% of the participants belonged to economic classes A-B-C. The prevalence of hearing impairment is higher among schoolchildren who refer to audiometry and auditory sclerosis, among children aged 6 to 12 years and of airway type (p <0.05). Airway infection (RP = 3.37 CI 95% 1.48-7.68) was recognized as a risk factor associated with hearing loss, remaining significant in the multivariate model (PR = 6.79 95% CI 1.98-23 26 p-value = 0.002). The Kappa index indicates agreement in some situations evaluated. Conclusions: The prevalence of hearing loss in schoolchildren in the city of Natal is higher than that reported in other studies conducted in Brazil for this age group, which shows the need for phonoaudiological attention linked to the School Health Program, in order to systematize actions of hearing health promotion for this population in the city of Natal-RN (AU).

Desigualdade espacial na mortalidade por agressão no estado do Rio Grande do Norte, Brasil: 2010 a 2014 / Spatial inequalities of aggression mortality in Rio Grande do Norte state, Brazil: 2010-2014

Introdução: As mortes por agressão se destacam no Brasil, constituindo a primeira causa de morte entre as causas externas. Objetivo: analisar a distribuição espacial da mortalidade por agressão no Estado do Rio Grande do Norte no período de 2010 a 2014, buscando identificar o padrão dessa distribuição por meio de uma análise geoestatística. Métodos: estudo ecológico que analisou 6.035 óbitos ocorridos nos 167 municípios do estado registrados no Sistema de Informação sobre Mortalidade. Calculou-se a taxa média de mortalidade no período e analisou-se a distribuição espacial, a intensidade e a significância dos aglomerados por meio do índice de Moran Global, MoranMap e LisaMap. Para a produção dos mapas, foi utilizado o TerraView 4.2.2. Resultados: As mortes por agressão atingiram principalmente o sexo masculino (93,3%), a faixa etária de 20-29 anos (40,1%), os pardos (75%) e os solteiros (70%). A Região de Saúde de maior registro foi a Metropolitana com 3.038 óbitos. O índice de Moran Global (I) foi de 0.35505 (p=0,01), mostrando que os valores estão autocorrelacionados no espaço. Os resultados do MoranMap e do LisaMap mostraram que houve formação de clusters significativos nas regiões metropolitana e Oeste do estado. Conclusão: a mortalidade por agressões está desigualmente distribuída no estado do Rio Grande do Norte, apresentando clusters de alta mortalidade em duas regiões do estado. (AU)

Introduction: Deaths from aggression stand out in Brazil, being the first cause of death among external causes. Objective: To analyze the spatial distribution of aggression mortality in the state of Rio Grande do Norte from 2010 to 2014 in order to identify the pattern of this distribution through a geostatistical analysis. Methods: this is an ecological study that analyzed 6035 deaths in 167 municipalities in the state registered in the Mortality Information System. The average mortality rate in the period after the spatial distribution is calculated, as well as the intensity and the significance of agglomerates through the global Moran index, and MoranMap LisaMap. For the production of maps the terraView was used 4.2.2. Results: Deaths from assault affected mainly males (93.3%), the age group of 20-29 years old (40.1%), mulattos (75%) and single (70%). The highest record Health Region was the Metropolitan with 3,038 deaths. The Global Moran index (I) was 0.35505 (P = 0.01), showing that the values are autocorrelated in space. The results of MoranMap and the LisaMap showed that there was significant formation of clusters in the metropolitan and West regions. Conclusion: mortality by aggression is unevenly distributed in the Rio Grande do Norte state, with high mortality clusters in two regions of the state. (AU)

Spatial temporal analysis of mortality by suicide among the elderly in Brazil / Análise espaço-temporal da mortalidade por suicídio em idosos no Brasil

Abstract Objective: to perform spatiotemporal analysis of suicide mortality in the elderly in Brazil. Methods: a mixed ecological study was carried out in which deaths from suicide among the elderly were analyzed using data from the Mortality Information System (MIS) and socio-demographic variables, from 2000 to 2014, with a trend analysis of this period. Univariate and bivariate spatial analysis was performed using the Moran Global and Moran Map index to evaluate the intensity and significance of spatial clusters. Results: there were 19,806 deaths due to suicide among the elderly in Brazil between 2000 and 2014. The ratio of male and female mortality rates was 4:1, with increasing trends for both genders (R2>0.8), but with greater intensity among men (p=0.0293). There was a moderate autocorrelation for men (I>0.40), with clusters forming for both genders in the south of Brazil. Bivariate analysis showed the formation of clusters in the southern region with the Human Development Index and aging variables and in the north and northeast regions based on dependence and illiteracy ratio. Conclusions: mortality due to suicide among the elderly has a tendency to increase and is unequally distributed in Brazil. AU

Resumo Objetivo: realizar análise espaço-temporal da mortalidade por suicídio em idosos no Brasil. Métodos: estudo ecológico misto onde se analisou os óbitos por suicídio em idosos, a partir dos dados do Sistema de Informações sobre Mortalidade (SIM) e variáveis sociodemográficas, no período de 2000 a 2014, sendo realizada uma análise de tendência temporal nesse período. A análise espacial uni e bivariada foi realizada por meio do índice de Moran Global e Moran Map para avaliar a intensidade e a significância dos aglomerados espaciais. Resultados: Foram registrados 19.806 óbitos por suicídio de idosos no Brasil entre 2000 a 2014. A razão das taxas de mortalidade entre os sexos masculino e feminino foi de 4:1, havendo tendência de aumento para ambos os sexos (R2>0,8), porém com maior intensidade no sexo masculino (β=0,0293). Houve autocorrelação moderada para o sexo masculino (I>0,40), com formação de clusters no Sul do Brasil para ambos sexos. A análise bivariada mostrou formação de clusters na região sul com as variáveis Índice de Desenvolvimento Humano e taxa de envelhecimento e nas regiões Norte e Nordeste com a razão de dependência e analfabetismo. Conclusões: A mortalidade por suicídio entre idosos apresenta tendência de aumento e está desigualmente distribuída no Brasil. AU

Araneísmo no município de natal, rio grande do norte no período de 2007 a 2014 / Spider bits in Natal, Rio Grande do Norte state in the period 2007- 2014

Objetivo: Apresentar o perfil do araneísmo no município de Natal-RN, no período de 2007 a 2014. Métodos: Trata-se de um estudo descritivo, utilizando dados secundários do SINAN. Analisou-se a distribuição dos acidentes de acordo com as principais variáveis epidemiológicas e clínicas e a distribuição geográfica dos acidentes por bairro do município de Natal. Resultados: Foram registrados 490 acidentes provocados por aranhas no município de Natal; 52% dos acidentados eram do sexo masculino; 25% acidentes ocorreram com indivíduos entre 15 e 35 anos; os pés e o tronco foram as áreas anatômicas mais afetadas; 96% dos acidentados apresentaram manifestações locais, sendo a dor a manifestação mais comum (76% dos casos). Em 96% dos casos o acidente foi classificado como leve; 37% dos acidentados foram atendidos até 6 horas após o acidente; em 21,5% dos casos, o atendimento foi em mais 24 horas após o acidente. Os bairros que registraram as maiores incidências foram Alecrim, Quintas, Bom Pastor, Felipe Camarão, Pitimbu e Potengi. Conclusões: O araneísmo vem aumentando em Natal, indicando a necessidade de estratégias de controle e prevenção dos acidentes nas áreas mais afetadas, além da organização do serviço de saúde para o atendimento aos acidentados em um menor tempo (AU)

Objective: To present the spider bites profile in the city of Natal, Brazil, from 2007 to 2014. Methods: This is a descriptive study using secondary data notifications Diseases Information System available on Datasus website. We analyzed the distribution of accidents according to the main epidemiological and clinical variables and the geographic distribution of accidents by Natal neighborhood. Results: Were recorded 490 accidents caused by spiders in Natal; 52% of the victims were male; 25% accidents occurred in individuals between 15 and 35 years; legs and trunk were the most affected anatomical areas; 96% of the victims had local manifestations, the most common manifestation of pain (76% of cases). In 96% of cases the accident was classified as mild and only 1.4% as moderate; 37% of the victims were seen within six hours after the accident; in 21.5% of cases, treatment was for 24 more hours after the accident. The neighborhoods that recorded the highest incidences were Alecrim, Quintas, Bom Pastor, Felipe Camarão, Pitimbu and Potengi. Conclusions: Spider bites is increasing in Natal, indicating the need for development of control strategies and prevention of accidents in the most affected areas, in addition to the health service organization to care for the victims in a shorter time (AU)