Effects on communication due to face mask use: an integrative review.

OBJECTIVES: to integrate evidence from studies on auditory perceptual and speech production effects in communication situations with face mask use. METHODS: an integrative literature review, in MEDLINE, Cochrane Library and Embase databases. The guiding question was: what effects on communication (perceptual-auditory and speech production) occur with face mask use? RESULTS: searches in electronic databases resulted in 1,478 studies and filtering resulted in 29 final studies. CONCLUSIONS: mask use has effects on communication, both in perception and speech production, factors that are also related to quality of life, stress and socio-emotional factors. These data can impact on indicators and alerts in favor of adopting strategies to manage mask use, involving speech production and perception when wearing a mask in health services.

Effects on communication due to face mask use: an integrative review / Efectos en la comunicación por el uso de cubrebocas: revisión integradora / Efeitos na comunicação em razão de uso de máscara facial: revisão integrativa

ABSTRACT Objectives: to integrate evidence from studies on auditory perceptual and speech production effects in communication situations with face mask use. Methods: an integrative literature review, in MEDLINE, Cochrane Library and Embase databases. The guiding question was: what effects on communication (perceptual-auditory and speech production) occur with face mask use? Results: searches in electronic databases resulted in 1,478 studies and filtering resulted in 29 final studies. Conclusions: mask use has effects on communication, both in perception and speech production, factors that are also related to quality of life, stress and socio-emotional factors. These data can impact on indicators and alerts in favor of adopting strategies to manage mask use, involving speech production and perception when wearing a mask in health services.

RESUMEN Objetivos: integrar evidencias de estudios sobre efectos perceptuales auditivos y de producción del habla en situaciones de comunicación con el uso de mascarilla facial. Métodos: revisión integrativa de la literatura, en las bases de datos MEDLINE, Cochrane Library y Embase. La pregunta orientadora fue: ¿qué efectos en la comunicación (perceptivo-auditiva y producción del habla) se producen con el uso de mascarillas? Resultados: las búsquedas en bases de datos electrónicas dieron como resultado 1.478 estudios y el filtrado dio como resultado 29 estudios finales. Conclusiones: el uso de mascarillas tiene efectos en la comunicación, tanto en la percepción como en la producción del habla, factores que también se relacionan con la calidad de vida, el estrés y factores socioemocionales. Estos datos pueden impactar en indicadores y alertas a favor de la adopción de estrategias para gestionar el uso de mascarillas, involucrando la producción y percepción del habla al usar mascarilla en los servicios de salud.

RESUMO Objetivos: integrar evidências de estudos sobre efeitos perceptivos auditivos e de produção de fala em situações de comunicação com o uso de máscara facial. Métodos: revisão integrativa da literatura, nas bases MEDLINE, Cochrane Library e Embase. O questionamento direcionador foi: quais efeitos na comunicação (perceptivo-auditivos e de produção de fala) ocorrem com o uso de máscaras faciais? Resultados: as buscas nas bases de dados eletrônicas resultaram em 1.478 estudos, e a filtragem culminou em 29 estudos finais. Conclusões: o uso de máscaras traz efeitos na comunicação, tanto na percepção quanto na produção da fala, fatores ademais relacionados à qualidade de vida, estresse e socioemocionais. Esses dados podem impactar em indicadores e alertas em prol da adoção de estratégias ao manejo de uso de máscaras, envolvendo a produção e percepção de fala em ocasião de uso de máscara nos serviços de saúde.

Desconforto do trato vocal e qualidade de vida em deglutição em idosos / Vocal tract discomfort and quality of life in swallowing in the elderly / Incomodidad del tracto vocal y calidad de vida en deglución de adultos mayores

Introdução: O processo do envelhecimento no ser humano se dá por alterações funcionais de forma progressiva e degenerativa, pelo enfraquecimento dos mecanismos de defesa e perda das reservas funcionais que atingem todo o organismo. Objetivo: Caracterizar o desconforto do trato vocal e a qualidade de vida relacionada à deglutição em indivíduos idosos. Métodos: Estudo transversal, realizado no setor de clínica médica e nos arredores do hospital Universitário. Aprovado pelo Comitê de Ética em Pesquisa sob o nº 1.943.445. Foram aplicados os questionários Escala de Desconforto do Trato Vocal e Qualidade de Vida relacionada à deglutição em dois grupos: idosos internados (n=200), acima de 60 anos, e idosos considerados saudáveis (n=200), acima de 60 anos, de ambos os sexos. Resultados: Nos idosos saudáveis houve prevalência do sexo feminino (50,50% n=101) e nos internados houve prevalência do sexo masculino (61,50% n=123). Os idosos internados apresentaram maior frequência e intensidade de sintomas sensoriais de desconforto do trato vocal. Em relação à qualidade de vida em deglutição, os menores escores foram para os domínios sono e fadiga. Houve correlação negativa e fraca entre os sintomas sensoriais de desconforto do trato vocal e qualidade de vida relacionada à deglutição. Conclusão: Os idosos internados apresentaram mais sintomas/sensações de desconforto do trato vocal com pior impacto na qualidade de vida em deglutição, quando comparados a idosos saudáveis.

Introduction: The process of aging in the human being is due to functional changes in a progressive and degenerative way, by the weakening of defense mechanisms and loss of functional reserves that affect the whole organism. Objective: To characterize the vocal tract discomfort and the quality of life related to swallowing in elderly individuals. Methods: Cross-sectional study, carried out in the medical clinic sector and in the vicinity of an University hospital. Approved by the Research Ethics Committee under No. 1,943,445. The questionnaires related to swallowing were analyzed in two groups: hospitalized elderly (n = 200), older than 60 years, and elderly considered healthy (n = 200), older than 60 years, of both genders. Results: In the healthy elderly, there was a prevalence of females (50,50% n=101) and in the hospitalized there was a prevalence of males (61,50% n=123).The hospitalized elderly presented higher frequency and intensity of sensory symptoms of vocal tract discomfort. Regarding the quality of life in swallowing, the lowest scores were for the domains sleep and fatigue. There was a negative and weak correlation between the sensorial symptoms of vocal tract discomfort and swallowing related to quality of life. Conclusion: The hospitalized elderly presented more symptoms / sensations of vocal tract discomfort with worse impact on swallowing quality of life when compared to healthy elderly.

Introdução: El proceso del envejecimiento en el ser humano se da por cambios funcionales de forma progresiva y degenerativa, por el debilitamiento de los mecanismos de defensa y pérdida de las reservas funcionales que alcanzan todo el organismo. Objetivo: Caracterizar la incomodidad del tracto vocal y la calidad de vida relacionada a la deglución en individuos adultos mayores. Métodos: Estudio transversal, realizado en el sector de clínica médica y en los alrededores, de un hospital universitario. Aprobado por el Comité de Ética en Investigación bajo el nº 1.943.445. Se utilizaron los cuestionarios Escala de Incomodidad del Trato Vocal y Calidad de Vida relacionada a la deglución en dos grupos: adultos mayores internados (n=200), con mas de 60 años, y adultos mayores considerados sanos (n=200), con mas de 60 años, de ambos los sexos. Resultados: En los ancianos sanos hubo prevalencia del sexo femenino (50,50% n=101) y en los internados hubo prevalencia del sexo masculino (61,50% n=123). Los adultos mayores internados presentaron mayor frecuencia e intensidad de síntomas sensoriales de incomodidad del tracto vocal. En cuanto a la calidad de vida en deglución, los menores escores fueron para los dominios sueño y fatiga. Se observó una correlación negativa y débil entre los síntomas sensoriales de incomodidad del tracto vocal y la calidad de vida relacionada con la deglución. Conclusión: Los adultos mayores internados presentaron más síntomas / sensaciones de incomodidad del tracto vocal con peor impacto en la calidad de vida en deglución cuando comparados a adultos mayores sanos.

Identification of familial clustering for cancer through the family health strategy program in the municipality of Angra dos Reis, Rio de Janeiro, Brazil.

Identification of families with history of cancer in the municipality of Angra dos Reis, Rio de Janeiro (Brazil), through the Brazilian Unified Primary Health Care System was explored based in the Community Health Agents (CHA) program. This study was divided into two phases: a descriptive one with a cross-sectional epidemiological data of families with history of cancer based on CHA-collected data from home visits in four primary health care units. The second phase consisted in identifying familial clustering of three or more individuals with cancer through construction of a three-generation pedigree and revisited by an itinerant group of medical geneticists. Genetic counseling was carried out with the intent of selecting potential families at risk for hereditary familial cancers. In the first phase of the study, 1,581 families were interviewed by the CHA at their homes. A positive history for cancer was present in 42.3 % of families, comprising 22.3 % with only one case per family, 11.2 % with two cases, and 8.6 % with three or more cases in the family. The informant reported that 15 % of the cases were from the father lineage, 12 % from the mother lineage, and 12.1 % within siblings. In the remaining 60.9 % families, cancer was present in both sides of the family. The types of cancer reported were uterus 8.7 % (n = 137), stomach 7.7 % (n = 122), breast 6.9 % (n = 109), throat 6.8 % (n = 99), prostate 5.4 % (n = 85), lung 5.6 % (n = 88), bowel 3.7 % (n = 59), and unspecified sites in 6.8 % (n = 108) of families. No statistical differences were noted between the data collected on each primary care unit. In the second phase of the study, 136 families (2.9 %) from the total of families interviewed in phase 1 were selected due to the presence of three or more individuals with cancer in the family. Among those, only 73 families attended genetic counseling. Comparison between the data obtained by the CHA and the medical geneticists shows complete agreement in 36 cases (49.3 %), partial agreement in 25 cases (34.2 %) with more detailed information in the CHA sheets, discordance in 4 cases (5.5 %), and not possible to correlate in 8 cases due to identification inconsistency. Risk assessment for cancer was calculated based on the criteria adopted by Scheuner et al. (Genet Med 12(11):726-735, 2010) and revealed that 50.0 % of the families were classified as having a weak risk, 36.1 % a moderate risk, and 13.8 % were considered of high risk. Concerning known hereditary cancer syndromes, we found one family that met the criteria for breast and ovary hereditary cancer (1.4 %) and one family with non-polyposis hereditary colon cancer as revised by Bethesda protocol. Such preliminary results indicated that the Brazilian Primary Health Care system based on the CHA framework can be an effective entrance into the Unified Brazilian Health Care System (SUS-Brazil) for individuals with genetically determined diseases, such as familial cancer. Families with a history of three or more cases of cancer and considered of high risk for familial cancer could be referred to a tertiary health center for proper oncogenetic counseling.

Atenção em genética médica no sus: a experiência de um município de médio porte / Attention in medical genetics in the brazilian health system: the experience of a medium-sized municipality

Realizou-se estudo descritivo e exploratório da experiência em município de médio porte da implantação de ações na área da Genética, conjugando a análise dos documentos oficiais e de um questionário aplicado a 43 profissionais de nível superior da Estratégia Saúde da Família. Os dados obtidos foram analisados buscando obter respostas sobre como e por que foram realizadas determinadas estratégias de atenção à saúde na área da Genética Clínica e Comunitária. Tais ações foram classificadas em "educação permanente", "vigilância em saúde" e "ampliação do acesso à assistência". Os resultados revelaram que ainda é necessário estender as ações de educação permanente na área para profissionais da atenção primária, possibilitando assim promover a efetivação dessa porta de entrada do Sistema Único de Saúde para a área da Genética e o acesso a um cuidado integral em saúde.

We conducted a descriptive study on the experience of implementation of actions in the area of genetics in a medium-sized municipality, combining the analysis of official documents and a questionnaire administered to 43 university level professionals of the Family Health Strategy. The data were analyzed looking for answers about how and why certain health care strategies in the area of clinical and community genetics were performed. Such actions were classified as "continuing education", "health surveillance" and "enhanced access to care". The results showed that it is still necessary to extend the actions of continuing education in genetics for primary care professionals, promoting this gateway to the SUS also to the area of genetics, in order to allow full access to comprehensive health care.