Effectiveness of a Blended-Learning Intervention in Teachers' Vocal Health.

OBJECTIVE: To verify the effectiveness of a blended-learning voice assistance program for elementary school teachers. STUDY DESIGN: Nonrandomized and comparative interventional clinical trial. METHODS: A total of 59 teachers participated; 33 of the 59 teachers participated in face-to-face learning (control group-CG), and 26 of the 59 teachers participated in blended learning (experimental group-EG). The Voice Assistance Program included the following for both groups: preintervention assessment, four voice workshops and postintervention assessment. The instruments used were the Vocal Production Condition - Teacher (VPC-T) questionnaire, the Screening Index for Voice Disorder (SIVD), the Vocal Health and Hygiene Questionnaire (VHHQ) and the Voice-Related Quality of Life (V-RQOL) measure. Additionally, voice samples were collected for auditory-perceptual analysis of voice quality. The workshops included theoretical and practical content for both groups. All the workshops for the CG were conducted face-to-face, while the workshops for the EG consisted of two online workshops and two face-to-face workshops. A descriptive analysis of the data was performed, and paired Wilcoxon and Mann-Whitney tests were performed using R software, with a significance level of 0.05. RESULTS: Both groups showed improved acquisition of knowledge regarding vocal health and improved voice quality, but the improvement was greater for the EG. There was a significant decrease in the risk of voice disorder in the EG. Only the CG showed significant improvement in voice-related quality of life. CONCLUSION: The voice assistance program with blended learning is effective for increasing knowledge about vocal health, reducing the risk of voice disorder and improving the voice quality of teachers.

Feeding development of children with microcephaly: a descriptive study / Desenvolvimento alimentar de crianças com microcefalia: estudo descritivo

ABSTRACT Purpose: to describe feeding characteristics of children with microcephaly, encompassing the feeding route, food consistencies, and utensils used to feed them. Methods: a descriptive study approved by the Research Ethics Committee, including 34 caregivers of children diagnosed with microcephaly. They answered a structured interview on the children's feeding route, breastfeeding, utensils used to feed them, and the food consistencies, besides sociodemographic and overall development data. Descriptive statistical analyses were performed, presenting absolute and percentage frequencies and measures of central tendency and dispersion. Results: the 34 caregivers in the sample were responsible for 34 children born between 2015 and 2018, diagnosed with microcephaly, due to various causes. Of these, 33 (97.02%) were on oral feeding in their first year of life - 26 (76.44%) on breastfeeding, nine of which (26.46%) exclusively so until 6 months old. The children were served food in baby bottles, cups, spoons, and syringes. Pureed food was the consistency most accepted by the children. Conclusions: there was a low prevalence of exclusive breastfeeding until they were 6 months old, delayed progress of consistencies, use of utensils inadequate to their age, and necessary adaptations to feed children, orally.

RESUMO Objetivo: descrever características relacionadas à alimentação de crianças com microcefalia, considerando via de alimentação, consistência e utensílios utilizados. Métodos: estudo descritivo, aprovado pelo Comitê de Ética em Pesquisa. Participaram 34 cuidadores de crianças com diagnóstico de microcefalia. Foi realizada entrevista estruturada com os cuidadores quanto à via de alimentação, amamentação, utensílios para oferta e consistência do alimento, além de aspectos sociodemográficos e de desenvolvimento global. Foi realizada análise estatística descritiva, apresentada por meio de frequências absoluta e percentual, e medidas de posição e dispersão. Resultados: os 34 cuidadores que compuseram a amostra eram responsáveis por 34 crianças nascidas entre os anos de 2015 e 2018 com diagnóstico de microcefalia de causas diversas. Dessas, 33 (97,02%) alimentaram-se por via oral durante o primeiro ano de vida, sendo que 26 (76,44%) foram amamentadas, nove delas (26,46%) de forma exclusiva até o sexto mês. Para oferta do alimento foram utilizados mamadeira, copo, colher e seringa. A consistência alimentar mais aceita pelas crianças foi a pastosa. Conclusões: observa-se baixa prevalência de aleitamento materno exclusivo até o sexto mês, atraso na progressão de consistências, uso de utensílios inadequados para a idade e necessidade de adaptações para as crianças que se mantiveram em alimentação por via oral.

Geographic Distribution of Childhood Cancer in Brazil and the Time between the Diagnosis and the Start of Treatment: An Analysis of Hospital-Based Cancer Registries, 2010-2016

Abstract Objective: To analyze the distribution of childhood cancer in Brazil and the time between the diagnosis and the start of treatment, according to hospital-based cancer registries (2010-2016). Material and Methods: This was an observational descriptive study using secondary data (36,187 records) from hospital databases of the National Cancer Institute (INCA) and the Onco-center Foundation of São Paulo (FOSP). Epidemiological data were obtained, and compliance with Federal Law 12,732/12 was verified, which establishes a maximum period of 60 days to start cancer therapy after the diagnosis. Absolute and percent frequencies, central tendency and dispersion measures, and the coefficient of prevalence of childhood cancer were calculated. Results: The mean age of the pediatric patients was 9.3 years (± 6.2); 54.1% (n=19,586) of them were males; 32.0% (n=11,440) were aged 0 to 4 years; and 43.4% (n=11,338) had a self-reported mixed-race skin color. The Southeast region of Brazil accounted for 40.2% (n=14,564) of the cases, of which 63.0% (n=9,178) corresponded to solid neoplasms, as opposed to the North region, where hematological neoplasms prevailed (53.9%, n=1,535). Most registered patients aged 0 to 19 years were treated in 60 days or less (77%, n=27,929). However, for 24.0% (n = 2,207) of adolescents (15 to 19 years) this time was more than 60 days after the diagnosis. Conclusion: The characteristics related to childhood cancer varied across the Brazilian geographic regions, and most patients were properly treated within the time enforced by law.

Motor Alterations Favor the Occurrence of Oral Mucositis in Pediatric Oncology Patients

Objective: To identify the predictive factors for the appearance of oral mucositis (OM) in pediatric oncology patients based on their motor alterations. Material and Methods: This study was an observational, cross-sectional study with 2-19-year-old patients undergoing treatment at the pediatric oncology outpatient service of the Napoleão Laureano Hospital in João Pessoa, Brazil. The convenience sample consisted of 42 patients aged 2 to 19 years with a first diagnosis of cancer and under treatment. The instruments used were a questionnaire with sociodemographic questions - the modified Oral Assessment Guide (OAG) - and some categories of the International Classification of Functioning Disability and Health (CIF), applied by a calibrated examiner (Kappa>0.65). The data were organized in Excel spreadsheet and analyzed descriptively and inferentially using logistic regression (α=5%). Results: Most patients were female (52.4%, n=22), mean age of 11.6 years, median 12.0 years, self-declared as non-white (61.9%, n=26), non-white (66.7%, n=28), family monthly income of up to 2 Brazilian minimum wages (88.1%, n = 37). Most patients presented hematologic neoplasia (54.8%, n=23) with acute lymphoid leukemia (36.6%; n=15) and most of them were subjected to chemotherapy (45.2%; n = 19). OAG identified oral mucositis in a few cases (23.8%, n=10). Logistic regression and odds ratio showed that individuals with moderate and mild difficulty in changing basic body position had, respectively, 19.7 and 30.8 times more chances of developing oral mucositis. In patients with severe motor impairment, this risk is 17.3 times greater and those with mild difficulty in taking care of the bodily parts had an increase of 33.4 times the risk for oral mucositis. Conclusion: The deficit in motor activities increased the chances of developing oral mucositis.