Content validity of the Post-Stroke Guidance and Follow-up Booklet.

OBJECTIVES: to provide sources of content validity evidence for the Post-Stroke Guidance and Follow-up Booklet. METHODS: a quantitative-qualitative approach, using two Delphi method and content analysis rounds. The Educational Content Validation Instrument in Health was sent to 53 independent judges. A Content Validity Index above 0.90 was considered. RESULTS: of the 14 nurses who participated, 64.3% have experience with stroke care, 35.7% with primary care and 64.3% with educational material production. In content analysis, judges' suggestions were stratified into four categories: material conformation, objectivity, accuracy and perception. Spelling changes were made to the images, addition of functionality scale, adequacy of technical terms and language. The Content Validity Index in the second round showed a concordance of 0.97. CONCLUSIONS: the booklet presented satisfactory content validity sources of evidence.

Lian gong as a Therapeutic Treatment Option in Primary Care for Patients with Dizziness: A Randomized Controlled Trial.

Introduction Dizziness is one of the most common reasons for seeking primary health care. Vestibular rehabilitation (VR) is a conventional treatment method for peripheral balance disorders that effectively decreases symptoms. Lian gong [LG] is believed to benefit patients with dizziness and to reduce the impact of the condition on quality of life by stimulating visual fixation, attention, body balance, and neuroplasticity. Objective The present study aimed to evaluate the effects of LG on the impact of dizziness on quality of life and fear of falling in primary health care patients. Methods This was a two-arm, parallel randomized clinical trial that included 36 patients with dizziness not caused by central changes. After specific medical evaluations and indications for treatment, the participants were randomly assigned to 3 groups: the LG group ( n = 11), the VR group ( n = 11), and the control group ( n = 14). The interventions were conducted collectively over a period of 12 weeks. Results Lian gong reduced the influence of dizziness on quality of life in physical (1.8 points, 95% confidence interval [CI]: 0.2-3.4), functional (4.0 points, 95% CI: 2.1-5.9), and emotional domains of quality of life (4.4 points, 95% CI: 1.7-7.2), with no differences compared with VR. There were similar concerns among the groups about the risk of falling. Conclusion Lian gong was shown to be an effective balance rehabilitation strategy to reduce the impact of dizziness on quality of life, with similar results to those of VR.

Environmental resources, types of toys, and family practices that enhance child cognitive development. / Recursos ambientais, tipos de brinquedos e práticas familiares que potencializam o desenvolvimento cognitivo infantil.

PURPOSE: To identify the factors associated with the cognitive development of children from 24 to 42 months of age, as well as to characterize the availability of toys and resources present in the family environment, and the parental practices that signal family stability. METHODS: Cross-sectional analytical study conducted with children regularly enrolled in public and private educational institutions of a medium-sized city. Cognitive development was assessed by means of the Bayley test and the quality of the environment was evaluated using the Adapted Family Environment Resource Inventory (FERI). The children were allocated into two groups based on the cognitive test result and compared regarding activities performed at home; reports of outings and trips in the last year; presence of regular scheduled activities; activities developed with parents; toys the child has or has had; presence of newspapers, magazines, and books at home; the person responsible for monitoring the child during day-care; and routines of the child and family. RESULTS: Of the 104 children evaluated, 72% were enrolled in the public education network and 69% belonged to economic classes C and D. Regarding cognitive development, 55% had above-average development. In the bivariate analysis, it was observed that greater availability of toys and materials for the child and higher economic levels were related to better scores on the cognitive development test. These remained as predictors of cognitive development in binary logistic regression analysis. CONCLUSION: Greater availability of resources in the family environment and economic levels were positively associated with cognitive development in children.

OBJETIVO: Identificar fatores associados ao desenvolvimento cognitivo de crianças de 24 a 42 meses de idade, assim como caracterizar a disponibilidade de brinquedos e recursos presentes no ambiente familiar e as práticas parentais que sinalizam estabilidade familiar. MÉTODO: Estudo transversal analítico realizado com crianças regularmente matriculadas em instituições de ensino públicas e privadas de uma cidade de médio porte. O desenvolvimento cognitivo foi avaliado por meio do teste Bayley e a qualidade do ambiente que vive a criança foi avaliada utilizando-se o Inventário de Recursos do Ambiente Familiar- RAF adaptado. Para conhecimento do nível econômico das famílias utilizou-se o Critério de Classificação Econômica Brasil 2015 (CCEB). As crianças foram alocados em dois grupos com base no resultado do teste cognitivo e comparadas quanto às atividades e rotinas da família e recursos presentes no domicílio. RESULTADOS: Das 104 crianças avaliadas, 72% são matriculadas na rede de ensino público, 69% pertencentes as classes econômicas C e D. De acordo com o desenvolvimento cognitivo, 55% obtiveram desenvolvimento acima da média aritmética. Na análise bivariada observou-se que os passeios e viagens realizados pela criança, maior escolaridade materna e paterna, vínculo com creches particulares, assim como a maior disponibilidade de recursos e níveis econômicos maiores foram relacionados a melhores escores cognitivos. Os dois últimos fatores permaneceram como preditores do desenvolvimento cognitivo na análise de regressão logística binária. CONCLUSÃO: Maior disponibilidade de recursos no ambiente familiar e níveis econômicos foram positivamente associados ao desenvolvimento cognitivo.

Determining factors in children's screen time in early childhood. / Fatores determinantes no tempo de tela de crianças na primeira infância.

The use of media by children in early childhood is increasingly common, and it is necessary to investigate the determinants of screen time, which is understood as the total child screen exposure time, including television and interactive media. This is a descriptive, exploratory, and cross-sectional study conducted with 180 children between 24 and 42 months of age, allocated in Group 1, less than two hours daily screen exposure time; Group 2, daily screen exposure time equal to or more than two hours. Bivariate and binary logistic regression analyses were performed. Screen time determining factors studied were family environment, evaluated with the Family Environment Resource Inventory; socioeconomic factors; nutritional status and child development status, evaluated with the Bayley III test. As a result, 63% of children had daily screen time exceeding two hours, and television still is the main culprit for children screen exposure. We observed that screen time exposure was positively associated with family resources, economic level, and language development. However, only the last two factors explained the longer screen time.

O uso de mídias por crianças na primeira infância está cada vez mais habitual, o que torna necessário investigar os fatores determinantes para o tempo de tela, entendido como o tempo total pelo qual a criança permanece exposta a todas as telas, incluindo televisão e mídias interativas. Trata-se de um estudo transversal, descritivo e exploratório, realizado com 180 crianças, entre 24 a 42 meses de idade, alocadas em: Grupo 1, exposição à tela inferior a duas horas/dia; Grupo 2, exposição à tela igual/superior a duas horas/dia. Realizou-se análise bivariada e de regressão logística binária. Os fatores determinantes no tempo de tela estudados foram os recursos do ambiente familiar, investigado por meio do Inventário de Recursos do Ambiente Familiar; fatores socioeconômicos; estado nutricional e status do desenvolvimento infantil, mensurado pelo teste Bayley III. Como resultado verificou-se que 63% das crianças apresentaram tempo de tela superior a 2 horas/dia e que a televisão ainda é a principal responsável pela exposição das crianças às telas. Observou-se que o tempo de exposição à tela esteve positivamente associado aos recursos familiares, nível econômico e desenvolvimento da linguagem. Entretanto, apenas os dois últimos fatores explicaram o maior tempo de tela.

CHILDREN'S USE OF INTERACTIVE MEDIA IN EARLY CHILDHOOD - AN EPIDEMIOLOGICAL STUDY.

OBJECTIVE: To describe the prevalence of interactive media (tablets and smartphones) use by children aged two to four years old, as well as to characterize this use, and investigate habits, practices, parents' participation and opinion about their child's interactive media use. METHODS: A cross-sectional study with 244 parents or legal guardians of children enrolled in daycare centers in a small Brazilian municipality was conducted. A questionnaire based on interactive media use and related habits were applied, and economic level was assessed. Children were divided into three different groups according to media use: Group 1 did not use (n=81); Group 2 uses up to 45 min/day (n=83) and Group 3 uses more than 45 min/day (n=80). Then, they were compared with regard to the sociodemographic variables and media use by the Chi-square test and Student's t-test. RESULTS: The prevalence of interactive media use was 67.2%, with a mean time of use of 69.2 minutes/day (confidence interval of 95% - 95%CI 57.1-81.2). The activities most performed were watching videos (55%), listening to music (33%) and playing games (28%). Most parents reported allowing media use in order to stimulate their child's development (58.4%), accompanying them during use (75.2%), and limiting media time (86.4%). CONCLUSIONS: We observed high interactive media use prevalence. The predominant way of using these devices was marked by parent-child participation. Most parents reported believing in the benefits of interactive media. Passive activities were more frequent, with restricted time of use.

Tablet Use in Young Children is Associated with Advanced Fine Motor Skills.

To evaluate whether frequent interactive tablet-use at preschool age is associated with improved fine motor skills and to describe tablet-use in young children. Cross-sectional study with 78 children, aged 24-42 months: group 1 with previous frequent tablet-use exposure (n = 26), group 2 without previous tablet-use exposure (n = 52). Fine motor skills were evaluated with the Bayley-III. Socioeconomic data and home environment quality were similar in both groups. Fine motor skills of group 1 were better than those of group 2 (p = 0.013). Most participating children carried out passive and active tablet activities, usually accompanied by parents, not exceeding time recommendations for young age. We observed a difference in fine motor skills in young children slightly favoring those with tablet-use experience.

Impact of lian gong on the quality of life of individuals with dizziness in primary care.

OBJECTIVE: To assess the effects of the lian gong practice as a rehabilitation strategy in primary health care on the quality of life and functional capacity of people with dizziness. METHODS: Randomized controlled clinical trial. Thirty-six people, who were complaining of dizziness or vertigo without the presence of central signs and were referred by the physician of primary health care participated in the study. The individuals were randomly allocated to the three experimental conditions: lian gong group (n = 11), vestibular rehabilitation group (n = 11) and control group (n = 14). The interventions were weekly, in group, with duration of 12 sessions. The participants were evaluated before and after the intervention regarding quality of life by the 36-Item Short Form Health Survey and the functional capacity by the Short Physical Performance Battery. RESULTS: The scores of all domains of the Short Form Health Survey increased after intervention in the lian gong group. This variation was higher than that observed in the control group for the domains functional capacity, limitation by physical aspects and general health status, and also higher than that found after the intervention in the Vestibular Rehabilitation Group regarding pain. No differences were found in the Short Physical Performance Battery. CONCLUSIONS: Based on the results presented, lian gong improves the quality of life of individuals with dizziness, without altering the functional capacity.

The Effects of Amplification on Vocal Dose in Teachers with Dysphonia.

PURPOSE: The purpose of this study was to determine if voice amplification influenced vocal dose in female teachers with dysphonia. MATERIAL AND METHODS: This was an experimental study with comparative intrasubjects in which 15 individuals were compared in two different moments: condition 1 (C1) without voice amplification and condition 2 (C2) with voice amplification. All of them were female, kindergarten and elementary school teachers who presented organic or functional dysphonia. The search was carried out at the school where the teachers work. The professional voice use was considered the teachers' activity for a continuous period of two classes (average recording time of 96 minutes, with no difference in time between C1 and C2). To measure the dose we used the vocal dosimeter composed of a microphone, an accelerometer fixed to the neck, and a portable unit that stores the vocal data. The phonation data (intensity, fundamental frequency, phonation percentage, cycle dose, and distance dose) were analyzed by the equipment software (VoxLog). RESULTS: The use of vocal amplification in teachers promotes a reduction of the fundamental frequency (295.6-267.7 Hz), the voice intensity (96.2-93.3 dB sound pressure level), the cycle doses (489.4-345.2 thousand cycles per second), and distance doses (3,800-2,300 m). CONCLUSION: The vocal amplification allows the teacher to maintain the same phonation time (phonation percentage) but decreases the number of vocal fold oscillations (cycle dose) and the total distance traveled by the vocal fold tissue during phonation (distance dose), reducing the exposure of the vocal folds to voice trauma.

The Influence of Noise on the Vocal Dose in Women.

OBJECTIVE: The objective of this study was to evaluate if noise interferes with the vocal dose in women without vocal complaints. STUDY DESIGN: This is an experimental and comparative study. METHODS: Data were collected on 27 women between 22 and 50 years of age without vocal complaints in a university classroom. Speech-language pathology evaluation was performed employing auditory-perceptual analysis and a vocal symptom questionnaire. The acoustics of the classroom were evaluated via both observation of the characteristics of the room and the quantification of background noise and reverberation time. Two distinctive acoustic conditions were created for evaluations: condition 1, a room without acoustic treatment and without noise reproduction, and condition 2, a room without acoustic treatment with noise reproduction. Each participant was evaluated individually in both acoustic conditions. To obtain vocal dose data, a vocal dosimeter was used. Subjects were asked to perform two 10-minute readings, one in each acoustic condition. The order of conditions was randomized between subjects. Subjects were instructed to complete the reading tasks at the vocal intensity deemed appropriate to be heard by a listener in the back of the room. t Tests and the Wilcoxon test were employed to compare parameters across subjects and conditions. RESULTS: Fundamental frequency, vocal intensity, percentage of phonation, and cycle dose significantly increased in the background noise condition. CONCLUSION: A positive relation between vocal dose and the presence of excessive noise in the environment was observed.

Construction and validation of the community health workers perception questionnaire on conditions amenable to physiotherapy in primary health care / Construção e validação do questionário de percepção dos Agentes Comunitários de Saúde sobre condições sensíveis à fisioterapia na Atenção Primária

Abstract Introduction Community health workers, like the physiotherapist, perform essential functions in primary health care, being an important element in the transformation of public policies. There are no reported studies investigating the knowledge of community health workers about health conditions amenable to physiotherapy intervention in primary health care. Objective To construct a questionnaire to investigate the perception of community health workers about health conditions that could be remedied by physiotherapy intervention in primary health care. Methods This was a methodological study in which it was initially an analysis matrix with the aim of encompassing the ideas contemplated in the questionnaire. To construct the instrument, a literature review was carried out, and health conditions treatable with physiotherapy in primary health care were chosen. To validate the content and appearance of the items, twelve physiotherapists specialized in primary health care judged the suitability of the items contained. The content validity index was used to determine the degree of agreement during the response analysis process. Subsequently, a semantic analysis was carried out through the understanding of the items by 15 community health workers. In the validation stage, two rounds of evaluation were carried out. Adjustments were made to 17 questions. Results The study investigated a questionnaire with 20 questions containing hypothetical situations of home visits, in which the resident's situation could or could not constitute a health risk amenable to physiotherapeutic intervention. Conclusion The community health workers perception instrument on health conditions amenable to physiotherapy intervention in primary health care proved to be valid for use in this context. The use of the instrument may contribute to the development of community health worker training programs, with the aim of facilitating team communication.

Resumo Introdução O Agente Comunitário de Saúde (ACS), assim como o fisioterapeuta, desencadeia funções fundamentais na Atenção Primária à Saúde (APS), sendo ele-mento importante na transformação de políticas públicas. Inexistem estudos que investiguem o conhecimento dos ACS sobre as condições de saúde sensíveis à inter-venção da fisioterapia na APS. Objetivo Construir um questionário de investigação da percepção dos ACS sobre as condições de saúde sensíveis à intervenção da fisioterapia na APS. Métodos Trata-se de um estudo metodológico no qual, inicialmente, construiu-se uma matriz de análise com o intuito de englobar as ideias contempladas no questionário. Para a construção do instrumento, realizou-se uma revisão da literatura, sendo eleitas condições de saúde sensíveis à intervenção da fisioterapia na APS. Para a validação de conteúdo e aparente dos itens, 12 fisioterapeutas especialistas em APS julgaram a adequação dos itens contidos. Utilizou-se o índice de validade de conteúdo para verificar o grau de concordância durante o processo de análise das respos-tas. Posteriormente, realizou-se análise semântica por meio da compreensão dos itens por 15 ACS. Na etapa de validação, foram realizadas duas rodadas de avaliação. Foram feitos ajustes em 17 questões. Resultados O estudo resultou em um questionário com 20 questões contendo situações hipotéticas de visitas domiciliares, cuja situação do morador poderia ou não configurar um risco à saúde sensível à intervenção fisioterapêutica. Conclusão O instrumento de percepção dos ACS sobre as condições de saúde sensíveis à intervenção da fisioterapia na APS mostrou-se válido para ser utilizado no contexto da APS. A utilização do instrumento poderá contribuir na elaboração de programas de capacitação dos ACS, com o intuito de facilitar a comunicação da equipe.

The influence of familial environment, parental perception and economic level on the receptive vocabulary of children / Influência do ambiente familiar, percepção parental e nível econômico no vocabulário receptivo de crianças

ABSTRACT Purpose: to examine the influence of familial environment, parental perception, and socioeconomic conditions on the receptive vocabulary of elementary school children. Methods: an analytical cross-sectional observational study. The students were selected by stratified proportional sampling, using the Receptive Vocabulary Test. Those responsible for the children answered the anamnesis and the inventory of family environmental resources. Initially, a bivariate analysis was performed using the chi-square test, considering p<0.20. In the multivariate analysis of binary logistic regression, p<0.05 was considered, and the quality of the model was evaluated through the Hosmer-Lemeshow method. Results: out of the 263 students, 131 were males, 142 were in the third grade and were on average 7.6 years old (±0.57), and 111 had a low receptive vocabulary. In the bivariate analysis, there was a relationship between parental perception about learning to read and write, school failure, and the outcome (p<0.05). The variables environment, resources, and stability of family life were also used for multivariate analysis (p<0.20). Conclusion: Parental perception of difficulty in reading and writing and a lack of family stability were factors associated with poor receptive vocabulary.

RESUMO Objetivo: verificar a influência do ambiente familiar, percepção parental e condições socioeconômicas no vocabulário receptivo de escolares do ensino fundamental. Métodos: trata-se de estudo observacional transversal analítico. Os escolares, selecionados por amostragem proporcional estratificada, realizaram o Teste de Vocabulário Receptivo. Os responsáveis responderam à anamnese e ao Inventário de Recursos do Ambiente Familiar. Inicialmente, realizou-se análise bivariada pelo teste Qui-quadrado, considerando p<0,20. Na análise multivariada de regressão logística binária, considerou-se o valor p<0,05 e a qualidade do modelo foi avaliada pelo método Hosmer-Lemeshow. Resultados: dos 263 escolares, 131 são do sexo masculino, 142 do terceiro ano, possuem idade média de 7,6 anos (±0,57) e 111 apresentam vocabulário receptivo rebaixado. Na análise bivariada, observou-se relação entre percepção parental acerca do aprendizado da leitura, da escrita, repetência escolar e o desfecho (p<0,05). Também foram para análise multivariada as variáveis recursos do ambiente e estabilidade da vida familiar (p<0,20). Conclusão: a percepção parental de dificuldade de leitura e de escrita e a falta de estabilidade familiar foram fatores associados ao pior vocabulário receptivo.

Content validity of the Post-Stroke Guidance and Follow-up Booklet / Validación de contenido del Cuaderno de Orientación y Seguimiento Post-Accidente Cerebrovascular / Validação de conteúdo da Caderneta de Orientação e Acompanhamento Pós-Acidente Vascular Cerebral

ABSTRACT Objectives: to provide sources of content validity evidence for the Post-Stroke Guidance and Follow-up Booklet. Methods: a quantitative-qualitative approach, using two Delphi method and content analysis rounds. The Educational Content Validation Instrument in Health was sent to 53 independent judges. A Content Validity Index above 0.90 was considered. Results: of the 14 nurses who participated, 64.3% have experience with stroke care, 35.7% with primary care and 64.3% with educational material production. In content analysis, judges' suggestions were stratified into four categories: material conformation, objectivity, accuracy and perception. Spelling changes were made to the images, addition of functionality scale, adequacy of technical terms and language. The Content Validity Index in the second round showed a concordance of 0.97. Conclusions: the booklet presented satisfactory content validity sources of evidence.

RESUMEN Objetivos: proporcionar fuentes de evidencia de validación de contenido para el Manual de Orientación y Seguimiento Post-Accidentes Cerebrovascular. Métodos: abordaje cuantitativo-cualitativo, utilizando dos rondas del método Delphi y análisis de contenido. El Instrumento de Validación de Contenido de Educación en Salud fue enviado a 53 jueces independientes. Se consideró un Índice de Validez de Contenido superior a 0,90. Resultados: de los 14 enfermeros que participaron, el 64,3% tiene experiencia en el cuidado del ictus, el 35,7% en la atención primaria y el 64,3% en la producción de material educativo. En el análisis de contenido, las sugerencias de los jueces fueron estratificadas en cuatro categorías: conformación, objetividad, precisión y percepción del material. Se realizaron cambios ortográficos a las imágenes, adición de escala de funcionalidad, adecuación de términos técnicos y lenguaje. El Índice de Validez de Contenido en la segunda ronda mostró una concordancia de 0,97. Conclusiones: la cartilla presentó fuentes de evidencia de validez de contenido satisfactorias.

RESUMO Objetivos: prover fontes de evidências de validação de conteúdo para a Caderneta de Orientação e Acompanhamento Pós-Acidente Vascular Cerebral. Métodos: abordagem quanti-qualitativa, utilizando duas rodadas do método Delphi e análise de conteúdo. O Instrumento de Validação de Conteúdo Educativo em Saúde foi enviado para 53 juízes independentes. Considerou-se um Índice de Validade de Conteúdo acima de 0,90. Resultados: dos 14 enfermeiros que participaram, 64,3% têm experiência com atendimento a Acidente Vascular Cerebral, 35,7% com atenção primária e 64,3% com produção de material educativo. Na análise de conteúdo, as sugestões dos juízes foram estratificadas em quatro categorias: conformação, objetividade, precisão e percepção do material. Foram realizadas alterações ortográficas nas imagens, adição de escala de funcionalidade, adequação de termos técnicos e linguagem. O Índice de Validade de Conteúdo na segunda rodada demonstrou concordância de 0,97. Conclusões: a caderneta apresentou fontes de evidências de validade de conteúdo satisfatórias.

Prevalence of dizziness in the population of Minas Gerais, Brazil, and its association with demographic and socioeconomic characteristics and health status.

INTRODUCTION: The state of Minas Gerais, Brazil has no data on the prevalence of dizziness in the population and this information can be fundamental as the basis of public health policies, promotion, prevention and rehabilitation campaigns. OBJECTIVE: Investigate the prevalence of the symptom of dizziness in the population of Minas Gerais according to Sample Survey of Households, as well as describe the profile of interviewed individuals and the association between dizziness and socioeconomic, demographic features and health status. METHODS: This was a cross-sectional observational study that analyzed individuals with dizziness symptom reported in the previous month. The data entered in the Sample Survey of Households of 2011 were analyzed. An independent statistical association was determined between the selected variables and dizziness through multivariate analysis. RESULTS: Dizziness was the third major complaint among individuals who mentioned any health problems in the previous month, with an estimated population of 209,025 individuals and reported by 6.7% of symptomatic ones, with higher prevalence values only reported for the symptoms of fever and headache. Among individuals who reported dizziness, 94% were adults or elderly (p≤0.001) and 63% were females (p=0.003). A statistically significant association (p<0.001) was observed between the response variable and the variables: self-perceived health, hypertension, heart disease, diabetes, depression, seeking or requiring medical or health care in the previous month and private health care plan or insurance. Among individuals with dizziness, 84.2% sought or required medical or health care and 80.1% did not have a private health plan or insurance in the assessed period. CONCLUSION: The dizziness symptom was highly prevalent in the population of Minas Gerais during the assessed month of the investigation. Dizziness was prevalent in adults and the elderly and showed a statistical association with socioeconomic and demographic characteristics, as well as the assessed health status.

[Auditory training in workshops: group therapy option]. / Treinamento auditivo em oficinas: opção terapêutica grupal.

BACKGROUND: auditory training in groups. AIM: to verify in a group of individuals with mental retardation the efficacy of auditory training in a workshop environment. METHOD a longitudinal prospective study with 13 mentally retarded individuals from the Associação de Pais e Amigos do Excepcional (APAE) of Congonhas divided in two groups: case (n=5) and control (n=8) and who were submitted to ten auditory training sessions after verifying the integrity of the peripheral auditory system through evoked otoacoustic emissions. Participants were evaluated using a specific protocol concerning the auditory abilities (sound localization, auditory identification, memory, sequencing, auditory discrimination and auditory comprehension) at the beginning and at the end of the project. Data (entering, processing and analyses) were analyzed by the Epi Info 6.04 software. RESULTS: the groups did not differ regarding aspects of age (mean = 23.6 years) and gender (40% male). In the first evaluation both groups presented similar performances. In the final evaluation an improvement in the auditory abilities was observed for the individuals in the case group. When comparing the mean number of correct answers obtained by both groups in the first and final evaluations, a statistically significant result was obtained for sound localization (p=0.02), auditory sequencing (p=0.006) and auditory discrimination (p=0.03). CONCLUSION: group auditory training demonstrated to be effective in individuals with mental retardation, observing an improvement in the auditory abilities. More studies, with a larger number of participants, are necessary in order to confirm the findings of the present research. These results will help public health professionals to reanalyze the theory models used for therapy, so that they can use specific methods according to individual needs, such as auditory training workshops.

The Impact of Dizziness on the Quality of Life of 235 Individuals who Completed Vestibular Testing in Brazil.

Introduction In Vestibular Testing (VT), caloric tests allow evaluation of unilateral weakness (UW) and directional preponderance (DP), where different criteria of normality are adopted in Brazil and worldwide. The Brazilian version of the Dizziness Handicap Inventory (Brazilian DHI) evaluates the impact of dizziness on the quality of life of an individual. Objectives The objective of this research is to evaluate the impact of dizziness on the quality of life of patients undergoing VT, and to relate these findings to the results obtained according to national and international criteria. Methods Cross-sectional analytic study of 235 patients referred for VT in two hospitals. The authors performed the Brazilian DHI, history, static, and dynamic balance tests, positional nystagmus, and the Dix-Hallpike maneuver, as well as vectoelectronystagmography. Subjects were divided into three groups according to UW and DP values. Descriptive statistics and comparisons between groups were performed, considering a significance level of 5% in all analyses. Results Patients groups had 20.9% men, and 79.1% women. There was no significant difference between groups for the scores obtained in the Brazilian DHI. There was, however, a statistically significant difference in the redistribution of individuals according to the UW and DP values. Conclusion There was no relationship between VT results and the impact of dizziness in the quality of life. A review of normal values for UW and DP adopted in Brazil is suggested, as well as the application of the Brazilian DHI as an additional tool to evaluate the impact of dizziness on quality of life in all patients undergoing VT.

Vocal dose in teachers: correlation with dysphonia. / Dose vocal em professores: correlação com a presença de disfonia.

Teachers are professionals with high prevalence of dysphonia, whose main risk factors are the large work hours in classrooms with the presence of background noise. The purpose of the study was to calculate the phonation time and the cycle dose of teachers with dysphonia and teachers without voice disorders during the class. There were two groups analyzed: five teachers with functional dysphonia were the first group and five teachers without voice disorders were the second group. For the data was used the VoxLog® dosimeter and the parameters were: intensity; fundamental frequency; phonation time and cycle dose. The statistical analysis used ANOVA, Student's T-test, and Kruskal-Wallis test. Dysphonic teachers showed major values of phonation time and cycle dose compared with teachers without voice disorders. The dysphonia is related to extended period of speech time and greater exposure of the tissue of the vocal fold to phonotrauma.

Recursos ambientais, tipos de brinquedos e práticas familiares que potencializam o desenvolvimento cognitivo infantil / Environmental resources, types of toys, and family practices that enhance child cognitive development

RESUMO Objetivo Identificar fatores associados ao desenvolvimento cognitivo de crianças de 24 a 42 meses de idade, assim como caracterizar a disponibilidade de brinquedos e recursos presentes no ambiente familiar e as práticas parentais que sinalizam estabilidade familiar. Método Estudo transversal analítico realizado com crianças regularmente matriculadas em instituições de ensino públicas e privadas de uma cidade de médio porte. O desenvolvimento cognitivo foi avaliado por meio do teste Bayley e a qualidade do ambiente que vive a criança foi avaliada utilizando-se o Inventário de Recursos do Ambiente Familiar- RAF adaptado. Para conhecimento do nível econômico das famílias utilizou-se o Critério de Classificação Econômica Brasil 2015 (CCEB). As crianças foram alocados em dois grupos com base no resultado do teste cognitivo e comparadas quanto às atividades e rotinas da família e recursos presentes no domicílio. Resultados Das 104 crianças avaliadas, 72% são matriculadas na rede de ensino público, 69% pertencentes as classes econômicas C e D. De acordo com o desenvolvimento cognitivo, 55% obtiveram desenvolvimento acima da média aritmética. Na análise bivariada observou-se que os passeios e viagens realizados pela criança, maior escolaridade materna e paterna, vínculo com creches particulares, assim como a maior disponibilidade de recursos e níveis econômicos maiores foram relacionados a melhores escores cognitivos. Os dois últimos fatores permaneceram como preditores do desenvolvimento cognitivo na análise de regressão logística binária. Conclusão Maior disponibilidade de recursos no ambiente familiar e níveis econômicos foram positivamente associados ao desenvolvimento cognitivo.

ABSTRACT Purpose To identify the factors associated with the cognitive development of children from 24 to 42 months of age, as well as to characterize the availability of toys and resources present in the family environment, and the parental practices that signal family stability. Methods Cross-sectional analytical study conducted with children regularly enrolled in public and private educational institutions of a medium-sized city. Cognitive development was assessed by means of the Bayley test and the quality of the environment was evaluated using the Adapted Family Environment Resource Inventory (FERI). The children were allocated into two groups based on the cognitive test result and compared regarding activities performed at home; reports of outings and trips in the last year; presence of regular scheduled activities; activities developed with parents; toys the child has or has had; presence of newspapers, magazines, and books at home; the person responsible for monitoring the child during day-care; and routines of the child and family. Results Of the 104 children evaluated, 72% were enrolled in the public education network and 69% belonged to economic classes C and D. Regarding cognitive development, 55% had above-average development. In the bivariate analysis, it was observed that greater availability of toys and materials for the child and higher economic levels were related to better scores on the cognitive development test. These remained as predictors of cognitive development in binary logistic regression analysis. Conclusion Greater availability of resources in the family environment and economic levels were positively associated with cognitive development in children.

Fatores determinantes no tempo de tela de crianças na primeira infância / Determining factors in children's screen time in early childhood

Resumo O uso de mídias por crianças na primeira infância está cada vez mais habitual, o que torna necessário investigar os fatores determinantes para o tempo de tela, entendido como o tempo total pelo qual a criança permanece exposta a todas as telas, incluindo televisão e mídias interativas. Trata-se de um estudo transversal, descritivo e exploratório, realizado com 180 crianças, entre 24 a 42 meses de idade, alocadas em: Grupo 1, exposição à tela inferior a duas horas/dia; Grupo 2, exposição à tela igual/superior a duas horas/dia. Realizou-se análise bivariada e de regressão logística binária. Os fatores determinantes no tempo de tela estudados foram os recursos do ambiente familiar, investigado por meio do Inventário de Recursos do Ambiente Familiar; fatores socioeconômicos; estado nutricional e status do desenvolvimento infantil, mensurado pelo teste Bayley III. Como resultado verificou-se que 63% das crianças apresentaram tempo de tela superior a 2 horas/dia e que a televisão ainda é a principal responsável pela exposição das crianças às telas. Observou-se que o tempo de exposição à tela esteve positivamente associado aos recursos familiares, nível econômico e desenvolvimento da linguagem. Entretanto, apenas os dois últimos fatores explicaram o maior tempo de tela.

Abstract The use of media by children in early childhood is increasingly common, and it is necessary to investigate the determinants of screen time, which is understood as the total child screen exposure time, including television and interactive media. This is a descriptive, exploratory, and cross-sectional study conducted with 180 children between 24 and 42 months of age, allocated in Group 1, less than two hours daily screen exposure time; Group 2, daily screen exposure time equal to or more than two hours. Bivariate and binary logistic regression analyses were performed. Screen time determining factors studied were family environment, evaluated with the Family Environment Resource Inventory; socioeconomic factors; nutritional status and child development status, evaluated with the Bayley III test. As a result, 63% of children had daily screen time exceeding two hours, and television still is the main culprit for children screen exposure. We observed that screen time exposure was positively associated with family resources, economic level, and language development. However, only the last two factors explained the longer screen time.

[Hearing loss in urban transportation workers in Greater Metropolitan Belo Horizonte, Minas Gerais State, Brazil]. / Perda auditiva em trabalhadores do transporte urbano na Região Metropolitana de Belo Horizonte, Minas Gerais, Brasil.

This study analyzed the association between self-reported diagnosis of hearing loss and individual and occupational factors among urban transportation workers in Greater Metropolitan Belo Horizonte, Minas Gerais State, Brazil. The sample size was calculated by quotas and stratified by occupation (drivers and fare collectors) in the urban transportation companies in Belo Horizonte, Betim, and Contagem. Data were collected with face-to-face interviews and recorded by the interviewers on netbooks. The dependent variable was defined as an affirmative response to the question on prevailing medical diagnosis of hearing loss. The independent variables were organized in three blocks: social and demographic characteristics, lifestyle, and work aspects. Diagnosis of hearing loss was reported by 213 of the 1,527 workers and was associated with age and diagnosis of tinnitus. At the occupational level, hearing loss was associated with history of sick leave, time-on-the-job, and two environmental risks, unbearable noise and whole-body vibration. Measures to prevent hearing loss are needed for urban transportation workers.

The impact of noise exposure on workers in Mobile Support Units.

PURPOSE: To investigate the presence of auditory and nonauditory symptoms in professionals working in ambulances. METHODS: This was a descriptive cross-sectional study with a convenience sample. Thirty-six professionals working in mobile support units, including drivers and nursing technicians from two private urgency and emergency services in the city of Belo Horizonte, Minas Gerais, Brazil, participated in the study. A questionnaire containing 17 multiple-choice questions was applied to the participants with questions regarding life history and occupation, family history of hearing loss, use of medications, and presence of auditory and nonauditory symptoms, among others. The professionals answered the questionnaire individually, in their workplaces, and received help from the researcher to understand the content of questions, if needed. Data were statistically analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 16.0. RESULTS: The most reported auditory symptoms were tinnitus, intolerance to intense sounds, and ear plenitude. The most reported nonauditory symptoms were irritability, headache, talking difficulties in noisy environments, and sleep alterations. A difference (p≤0.05) was observed when the relation between self-perception of drivers and nursing technicians on hearing acuity, presence of tinnitus, irritability, and communication difficulty was analyzed. CONCLUSION: Auditory and nonauditory symptoms are frequent in workers from mobile support units. An association between the worker's symptoms and the performed function was also observed. The results indicate a need of developing preventive actions regarding general health, which are aimed at the preservation of hearing health and quality of life of these professionals.