Evidência de validade baseada nos processos de resposta de um protocolo de análise espectrográfica da voz / Evidence of response process validity of a spectrographic voice analysis protocol

RESUMO Objetivo desenvolver a etapa de validade baseada nos processos de resposta do Protocolo de Análise Espectrográfica da Voz (PAEV). Métodos foram recrutados dez fonoaudiólogos e dez alunos de graduação em Fonoaudiologia, que aplicaram o PAEV em dez espectrogramas, realizaram o julgamento dos itens do PAEV e participaram de uma entrevista cognitiva. A partir das respostas, o PAEV foi reanalisado para reformulação ou para exclusão de itens. Utilizou-se o teste Qui-Quadrado e os valores de acurácia para análise das respostas dos questionários, assim como análise qualitativa dos dados da entrevista cognitiva. Resultados os participantes obtiveram acurácia maior que 70% na maioria dos itens do PAE. Apenas sete itens alcançaram acurácia menor ou igual a 70%. Houve diferença entre as respostas de presença versus ausência de dificuldade na identificação dos itens no espectrograma. A maioria dos participantes não teve dificuldade na identificação dos itens do PAEV. Na entrevista cognitiva, apenas seis itens não obtiveram correta identificação da intenção, conforme verificado na análise qualitativa. Além disso, os participantes sugeriram exclusão de cinco itens. Conclusão após a etapa de validação baseada nos processos de resposta, o PAEV foi reformulado. Sete itens foram excluídos e dois itens foram reformulados. Dessa forma, a versão final do PAEV após essa etapa foi reduzida de 25 para 18 itens, distribuídos nos cinco domínios.

ABSTRACT Purpose To develop the validity step based on the response processes of the Spectrographic Analysis Protocol (SAP). Methods 10 speech therapists and 10 undergraduate students of the Speech Therapy course were recruited, who applied the SAP in 10 spectrograms, performed the evaluation of the PAE items, and participated in a cognitive interview (CI). The SAP was reanalyzed to reformulate or exclude items based on the responses. The chi-square test and the accuracy values were used to analyze the answers to the questionnaires and qualitative analysis of the CI data. Results the participants achieved accuracy > 70% in most items of the SAP. Only seven items achieved accuracy ≤ 70%. There was a difference between presence vs. absence of difficulty in identifying items in the spectrogram. Most participants had no problem identifying the SAP items. In the CI, only six items did not correctly identify the intention, verified in the qualitative analysis. In addition, participants suggested excluding five items. Conclusion After the validation step based on the response processes, the SAP is reformulated. Seven items were deleted, and two items were reformulated. Thus, the final version of the SAP after this stage was reduced from 25 to 18 items, distributed in the five domains.

Relationship between microcephaly and indicators of social inequality in the state of Paraíba, Brazil.

OBJECTIVE: • Seventy-four (33.18%) municipalities in the state of Paraíba registered live births with microcephaly. • The highest proportion of cases (23.03%) was concentrated in the capital, João Pessoa. • Number of inhabitants, number of cases of Zika virus, water supply, and average household income were associated with a higher proportion of new cases. To analyze the relationship between microcephaly and social inequality indicators in the state of Paraíba during the biennium January 2015 and December 2016. METHODS: Ecological study with data from newborn microcephaly records and municipal socioeconomic, environmental, and demographic indicators was conducted using two health information systems from the Brazilian Ministry of Health (SINASC and SINAN) and the Brazilian Institute of Geography and Statistics. A Poisson multiple regression model was applied with a significance level of 5%. RESULTS: Among 223 municipalities in Paraíba, 74 registered new cases of microcephaly. The number of Zika virus cases, number of inhabitants, number of households without adequate water supply, and household income were predictor variables of the number of new cases of microcephaly in Paraíba. CONCLUSION: Microcephaly is associated with indicators of social inequality in Paraíba. Zika virus cases, water supply, and family income are the indicators that best explain the increase in microcephaly cases. Therefore, these variables must be monitored by health professionals and authorities.

Relationship between microcephaly and indicators of social inequality in the state of Paraíba, Brazil

ABSTRACT Objective To analyze the relationship between microcephaly and social inequality indicators in the state of Paraíba during the biennium January 2015 and December 2016. Methods Ecological study with data from newborn microcephaly records and municipal socioeconomic, environmental, and demographic indicators was conducted using two health information systems from the Brazilian Ministry of Health (SINASC and SINAN) and the Brazilian Institute of Geography and Statistics. A Poisson multiple regression model was applied with a significance level of 5%. Results Among 223 municipalities in Paraíba, 74 registered new cases of microcephaly. The number of Zika virus cases, number of inhabitants, number of households without adequate water supply, and household income were predictor variables of the number of new cases of microcephaly in Paraíba. Conclusion Microcephaly is associated with indicators of social inequality in Paraíba. Zika virus cases, water supply, and family income are the indicators that best explain the increase in microcephaly cases. Therefore, these variables must be monitored by health professionals and authorities.

Oral Health: Work Process and Interdisciplinarity

ABSTRACT Objective: To contribute to the debate about tools that favor the organization of the health work process and its interface with interdisciplinary practices. Material and Methods: We opted for a textual construction based on more specific publications on the field of oral health care. Results: The matrix support is configured as a method of inter-professional activity in co-management that aims to favor the qualification of the health care network. From this perspective, it is an interdisciplinary practice capable of integrating two or more areas of knowledge for a better performance of the actors involved in a given organizational and decision-making process, whether in the clinical or health management scope. Conclusion: Matrix support is an essential tool for the practice of managing health services and amplifying interdisciplinary actions.

Caracterização do câncer infantojuvenil no Brasil a partir dos Registros Hospitalares de Câncer (RHC), 2000-2016 / Characterization of childhood cancer in Brazil from the hospital-based cancer registries, 2000-2016 / Caracterización del cáncer infantil en Brasil a partir de los Registros de Cáncer del Hospital (RCH), 2000-2016

Objetivo: caracterizar o câncer infantojuvenil no Brasil, a partir da investigação nacional e regional dos registros hospitalares de câncer, no período de 2000 a 2016. Método: estudo observacional, retrospectivo e de base secundária, com amostra de 71.925 registros contendo informações de crianças e adolescentes (0 a 19 anos). Resultados: o câncer infantojuvenil foi mais frequente no sexo masculino com 39.049 (54,3%) casos, existindo 22.391 (31,1%) registros de crianças de 0 e 4 anos de idade e 19.892 (40,4%) com cor de pele parda. As leucemias, doenças mieloproliferativas e doenças mielodisplásicas acometeram 20.744 (28,8%) indivíduos. Os tumores sólidos foram diagnosticados em 42.087 (58,5%) crianças e adolescentes, sendo 23.941 (48,7%) submetidas a quimioterapia no início do tratamento e 56.518 (78,6%) que iniciaram o tratamento até 60 dias após comprovação diagnóstica. Conclusão: foi possível conhecer o perfil demográfico, clínico e assistencial das crianças e adolescentes com câncer no Brasil, e por regiões

Objective: to characterize childhood cancer in Brazil, based on the national and regional investigation of hospital-based cancer registries, from 2000 to 2016. Method: observational, retrospective and secondary-based study, with a sample of 71,925 records containing information of children and adolescents (0 to 19 years old). Results: infant-juvenile cancer was more frequent in males with 39,049 (54.3%) cases, with 22,391 (31.1%) records of children aged 0 and 4 years and 19,892 (40.4%) with color of brown skin. Leukemias, myeloproliferative diseases and myelodysplastic diseases affected 20,744 (28.8%) individuals. Solid tumors were diagnosed in 42,087 (58.5%) children and adolescents,23,941 (48.7%) of which underwent chemotherapy at the beginning of treatment and 56,518 (78.6%) who started treatment within 60 days of the diagnosis. Conclusion: it was possible to know the demographic, clinical and care profile of children and adolescents with cancer in Brazil, and by region

Objetivo: caracterizar el cáncer infantil en Brasil, con base en la investigación nacional y regional de registros hospitalarios de cáncer, de 2000 a 2016. Método: estudio observacional, retrospectivo y secundario, con una muestra de 71,925 registros que contienen información de niños. y adolescentes (0 a 19 años). Resultados: el cáncer infantil-juvenil fue más frecuente en el sexo masculino con 39.049 (54,3%) casos, con 22.391 (31,1%) registros de niños de 0 y 4 años y 19.892 (40,4%) con color de piel morena. Las leucemias, enfermedades mieloproliferativas y enfermedades mielodisplásicas afectaron a 20.744 (28,8%) individuos. Se diagnosticaron tumores sólidos en 42.087 (58,5%) niños y adolescentes, 23.941 (48,7%) de los cuales se sometieron a quimioterapia al inicio del tratamiento y 56.518 (78,6%) que iniciaron el tratamiento dentro de los 60 días del diagnóstico. Conclusión: fue posible conocer el perfil demográfico, clínico y de atención de niños y adolescentes con cáncer en Brasil y por región

Qualidade de serviços de fisioterapia neuropediátrica: validação de instrumento baseado na percepção de cuidadores / Quality of neuropediatric physiotherapy services: validation of instrument based on caregivers' perception

A elaboração de instrumentos requer a seleção de métodos adequados que garantam consistência e validade. Assim, o objetivo deste trabalho foidesenvolver um instrumento para avaliar a qualidade de serviços de Fisioterapia neuropediátrica, com base na percepção de cuidadores. Foram realizadas as etapas de definição conceitual e seleção de dimensões e itens; determinação do processo de amostragem; e avaliação das propriedades psicométricas, mediante análise da fidedignidade e da validade, pela Análise Fatorial Exploratória (AFE) e Confirmatória (AFC). O teste de Kaiser-Meyer-Olkin obteve um índice de 0,917 e o de esfericidade de Bartlett de ꭓ2 = 4540,178 (p < 0,001). Obteve-se uma consistência interna superior a 0,70 para cada um dos quatro fatores definidos pela AFE. A estrutura obtida foi confirmada pela AFC, indicando um bom ajuste de modelo (ꭓ2/gl = 1,534; RMSEA = 0,046; TLI = 0,927; CFI = 0,936). Construiu-se, desse modo, um instrumento para avaliar a qualidade de serviços de Fisioterapia neuropediátrica, cujas propriedades psicométricas demonstraram evidências de validade e fidedignidade.

The elaboration of instruments requires the selection of suitable methods that guarantee consistency and validity. Thus, the ob-jective of this study was to develop an instrument to assess the quality of neuropediatric physiotherapy services, based on the perception of caregivers.The following steps were performed: theoretical definition and selection of dimensions and items; determination of the sampling process; and evaluation of psychometric properties, analysis of reliabil-ity and validity, by Exploratory (EFA) and Confirmatory (CFA) Factor Analysis. The Kaiser-Meyer-Olkin test had an index of 0.917 and Bart-lett's sphericity was ꭓ² = 4540.178 (p < 0.001). It obtained an internal consistency greater than 0.70 for each of the four factors used by EFA. A selected structure was confirmed by the CFA, indicating a good model fitting (ꭓ²/gl = 1.534; RMSEA = 0.046; TLI = 0.927; CFI = 0.936). An instrument was constructed to assess the quality of neuropediatric physiotherapy services, whose psychometric properties demonstrated evidence of validity and reliability.

Severe Oral Mucositis in Pediatric Cancer Patients: Survival Analysis and Predictive Factors.

This paper investigates the occurrence of severe oral mucositis and associated factors in blood and solid cancer pediatric patients subjected to cancer treatment, using a survival analysis. A longitudinal, descriptive, observational and inductive study of 142 pediatric patients aged from 0 to 19 years was conducted from 2013 to 2017. Data were collected using a form to record the sociodemographic characteristics and health-related aspects of patients and the modified Oral Assessment Guide (OAG). Survival analysis was performed using the Kaplan-Meier method and Cox semiparametric model. The median times to occurrence of severe oral mucositis were 35.3 and 77.1 days for patients with hematologic malignancies and solid tumors, respectively. The Cox model showed that white cell changes and platelet counts as well as the use of natural chemotherapeutic agents are risk factors for the occurrence of oral mucositis among patients with hematologic malignancies. Nonetheless, among patients with solid tumors, the occurrence of oral mucositis was associated with female sex, mixed ethnicity, the presence of metastasis, abnormal creatinine levels, a combination of chemotherapy, radiotherapy, and surgery, and the administration of chemotherapeutic agents included in the miscellaneous group. The time to occurrence of severe oral mucositis and its associated factors varied according to cancer type.