Chronic oil spills revealed by the most important set of samples from the incident in northeastern Brazil, 2019.

In 2019, an oil spill of unprecedented dimensions and unknown source reached the Brazilian coast. Such incident, which occurred somewhere in the ocean and was detected only when the first oil patches reached the beaches in the northeastern region, is recognized as one of the most serious oil spills in the country. From the chromatographic analysis of the oily residues using n-alkanes, polycyclic aromatic hydrocarbons (PAH), and oil biomarkers, it was possible to characterize their coverage. The results confirmed that an oil of the same specification reached a length of coastline higher than 3,000 kilometers. However, were also found oily residues that did not match with the product involved in that incident, evidencing the occurrence of different discharges. This study documents the extension of the affected coastline during the incident and assesses the possible origin of such different oils from their geochemical characteristics by selecting 21 samples from more than 300 samples previously collected and analyzed during the response actions. The unexpected occurrence of these residues suggest chronic events. The results highlighted that unrelated oily residues were found even in a region far from the coast, indicating that discharges of oil in the open sea occur more regularly than initially expected.

Inhibition of hypoxia-associated response and kynurenine production in response to hyperbaric oxygen as mechanisms involved in protection against experimental cerebral malaria.

Cerebral malaria (CM) is a multifactorial syndrome involving an exacerbated proinflammatory status, endothelial cell activation, coagulopathy, hypoxia, and accumulation of leukocytes and parasites in the brain microvasculature. Despite significant improvements in malaria control, 15% of mortality is still observed in CM cases, and 25% of survivors develop neurologic sequelae for life-even after appropriate antimalarial therapy. A treatment that ameliorates CM clinical signs, resulting in complete healing, is urgently needed. Previously, we showed a hyperbaric oxygen (HBO)-protective effect against experimental CM. Here, we provide molecular evidence that HBO targets brain endothelial cells by decreasing their activation and inhibits parasite and leukocyte accumulation, thus improving cerebral microcirculatory blood flow. HBO treatment increased the expression of aryl hydrocarbon receptor over hypoxia-inducible factor 1-α (HIF-1α), an oxygen-sensitive cytosolic receptor, along with decreased indoleamine 2,3-dioxygenase 1 expression and kynurenine levels. Moreover, ablation of HIF-1α expression in endothelial cells in mice conferred protection against CM and improved survival. We propose that HBO should be pursued as an adjunctive therapy in CM patients to prolong survival and diminish deleterious proinflammatory reaction. Furthermore, our data support the use of HBO in therapeutic strategies to improve outcomes of non-CM disorders affecting the brain.-Bastos, M. F., Kayano, A. C. A. V., Silva-Filho, J. L., Dos-Santos, J. C. K., Judice, C., Blanco, Y. C., Shryock, N., Sercundes, M. K., Ortolan, L. S., Francelin, C., Leite, J. A., Oliveira, R., Elias, R. M., Câmara, N. O. S., Lopes, S. C. P., Albrecht, L., Farias, A. S., Vicente, C. P., Werneck, C. C., Giorgio, S., Verinaud, L., Epiphanio, S., Marinho, C. R. F., Lalwani, P., Amino, R., Aliberti, J., Costa, F. T. M. Inhibition of hypoxia-associated response and kynurenine production in response to hyperbaric oxygen as mechanisms involved in protection against experimental cerebral malaria.

Laparoscopic Sleeve Gastrectomy Lacks Intrasurgeon and Intersurgeon Agreement in Technical Key Points That May Affect Gastroesophageal Reflux Disease After the Procedure.

PURPOSE: Gastroesophageal reflux disease (GERD) after sleeve gastrectomy (SG) may be related to surgical technique. The fact that there is a lack of technical standardization may explain large differences in GERD incidence. The aim of this study is to evaluate auto- and hetero-agreement for SG technical key points based on recorded videos. METHODS: Ten experienced (minimum of 5 years performing bariatric surgery, minimum of 30 SG per year) bariatric surgeons (9 (90%) males) were selected. Participants were invited to send an unedited video with a typical laparoscopic SG (first round of the Delphi process). Videos were cropped into small clips comprising 11 key points of the technique. All anonymized clips (including their own) were returned to all surgeons. Individuals were asked to agree or not with the technique demonstrated (second round). The percentage of agreement was presented to the entire group that was asked for a second vote (third round). RESULTS: Agreement was poor/fair for all points except hiatal repair that had a very good agreement in the second round. For the third round, there was a slight increase in agreement for distance esophagogastric junction/proximal stapling and gastric mobilization for stapling and a slight decrease in agreement for gastric tube final shape. Only 1 (10%) surgeon recognized that he evaluated his own video. Five (50%) surgeons disagreed with themselves on 1 or more points. CONCLUSION: SG lacks intrasurgeon and intersurgeon agreement in technical key points that may justify significant differences in GERD incidence after the procedure.

Fundamental Voice Frequency: Acoustic, Electroglottographic, and Accelerometer Measurement in Individuals With and Without Vocal Alteration.

OBJECTIVE: To analyze the values of the fundamental frequency obtained through acoustic, electroglottographic, and accelerometer assessments on the skin of the neck in individuals with and without vocal alterations. METHODS: This was an observational cross-sectional study carried out at the Voice and Biomechanical Outpatient Clinic of the Federal University of Minas Gerais, approved by the Research Ethics Committee (study number 1,229,521). The nonprobabilistic sample consisted of 30 women (normal vocal quality, 15 and dysphonia, 15) aged 18-36 years (mean, 26.1 years) and 20 men (normal vocal quality, 15 and dysphonia, 5) aged 19-48 years (mean, 28.6 years). Subjects sustained a comfortable /ɑ/ with data captured by microphone, with electrodes on thyroid cartilage, and from accelerometer above the thyroid cartilage. Results of fundamental frequency extraction were compared between acoustic microphone vs electrodes vs accelerometer for each subject. RESULTS: Regarding the fundamental frequency, we observed a difference in the values estimated using the microphone and accelerometer, when compared to the values estimated by the electrodes, in the dysphonic and nondysphonic female groups and among nondysphonic men. The mean fundamental frequency found for normal voices was 195.8 Hz for female voices and 112.0 Hz for male voices obtained through the microphone and accelerometer. The values estimated using the electrodes were 209.6 Hz for female voices and 160.5 Hz for male voices. For dysphonic voices, the values were 187.7 Hz for female voices and 126.8 Hz for male voices obtained through the microphone and accelerometer. The values estimated using the electrodes were 226.8 Hz for female voices and 173.8 Hz for male voices. CONCLUSION: The fundamental frequency values estimated using the microphone and accelerometer showed perfect correlation; however, the values estimated by the electrodes differ from them.

ORTHOPEDIC RELATED COMORBIDITIES IN SPINAL CORD-INJURED INDIVIDUALS.

OBJECTIVE: This study aims to review, identify and study the determinations of the main orthopedic aspects in SCI patients. METHODS: A total of 80 articles from PUBMED and three theses (MSc. /DSc.) were examined. RESULTS: The results refer to the most essential joints. There is a chronic overload on the shoulder girdle due to the use of the upper limb as a supporting joint. The elbow presents osteoarthritis, subclinical, acute and chronic pain, mainly in quadriplegic patients. In the hand and wrist joints there are cases of paralysis, osteoporosis and osteoarthritis. Hips are the main weight-bearing joints while sitting which leads to a substantial degenerative process of this joint. Lastly, on the knee, feet and ankles, spasticity, contractures, osteoporosis and deformities can arise. CONCLUSION: Along with the increase in cases and research that analyze the alterations that spinal cord-injured individuals suffer, it is necessary to recognize the orthopedic changes to understand their limits and identify the relevance of the rehabilitation program to improve the muscle performance. Level of Evidence II, Prognostic Studies - Investigating the Effect of a Patient Characteristic on the Outcome of Disease.

OBJETIVO: O objetivo do estudo foi identificar, através de uma revisão sistemática, os aspectos ortopédicos e suas determinações nos pacientes lesados medulares. MÉTODOS: Foram examinados 80 artigos na base Pubmed e três teses de mestrado e doutorado. RESULTADOS: Os resultados obtidos referem-se às principais articulações. No ombro há uma sobrecarga crônica na cintura escapular devido ao uso como articulação de suporte. O cotovelo apresenta alterações osteocartilaginosas e dores subaguda, aguda e crônica principalmente no paciente tetraplégico. Nas articulações da mão e punho, a lesão leva à perda da capacidade de compressão por paralisia, osteoporose e osteoartrite. O quadril constitui a principal articulação de sustentação de peso quando sentado, ocorrendo um processo degenerativo importante nesses pacientes. Nos joelhos, pés e tornozelos surgem espasticidade, contraturas e osteoporose levando a deformidades. CONCLUSÃO: Devido ao aumento de casos e de pesquisas que analisam as alterações que os lesados medulares sofrem, se faz necessário o conhecimento das alterações ortopédicas do lesado medular para compreendermos a sua limitação e identificar a relevância do programa de reabilitação para melhora da performance muscular. Nível de Evidência II, Estudos Prognósticos - Investigação do efeito de característica de um paciente sobre o desfecho da doença.

Electroglotographic voice measurement analysis: normality standards for singers through Kay Pentax® CSL Program. / Análise das medidas eletroglotográficas da voz: padrões de normalidade para cantores por meio do programa CSL da Kay Pentax®.

PURPOSE: Analyze the measures of the fundamental frequency, electroglotographic jitter, contact quotient and periodicity of the electroglotographic waves of the singers in habitual voice. METHOD: A cross-sectional observational study, which selected individuals from singing schools in the central region of the municipality of Belo Horizonte. The sample was non-probabilistic, for convenience consisted of 60 singers aged between 18 and 55 years, 30 males and 30 females. For the electroglotographic record collection, the Kay Pentax ™ CSL program, model 6103, the Electroglotographic module was used. The participants were placed in a seated position, and after cleaning the skin of the neck with 70% alcohol, two electrodes were placed on the wings of the thyroid cartilage at the level of the vocal folds. Subsequently, the participants were instructed to emit the vowel/a/sustained in a habitual way. The measurements of the fundamental frequency (f0), contact quotient (QC), electroglotographic jitter and periodicity of the electroglotographic wave were analyzed. The data were statistically analyzed using Minitab 17. RESULTS: The parameters analyzed were statistically significant. The fundamental frequency (f0) was higher in females (226.91Hz) when compared to males (166.54Hz). The measure of contact quotient and periodicity was also higher in women (40.46% and 15.51% respectively) when compared to men (27.45% and 7.82, respectively). The jitter parameter was higher in men when compared to women. CONCLUSION: Women presented higher values in the fundamental frequency (f0), contact quotient (QC) and periodicity of the wave compared to men. The men presented the jitter value higher than that of the women.

OBJETIVO: Analisar as medidas de frequência fundamental, jitter eletroglotográfico, quociente de contato e periodicidade das ondas eletroglotográficas da voz de cantores em registro modal. MÉTODO: Estudo observacional de corte transversal que selecionou indivíduos de escolas de canto da região central do município de Belo Horizonte-MG. A amostra foi não probabilística, por conveniência, composta por 60 indivíduos cantores com faixa etária entre 18 e 55 anos, sendo 30 homens e 30 mulheres. Para a coleta do registro eletroglotográfico, foi utilizado o programa CSL da Kay Pentax™, model 6103, módulo Electroglottography. Os participantes foram posicionados sentados e, após a higienização da pele do pescoço com álcool 70 %, dois eletrodos foram colocados nas alas da cartilagem tireóidea no nível das pregas vocais. Posteriormente, os participantes foram orientados a emitir a vogal /a/ sustentada de forma habitual. Foram analisadas as medidas de frequência fundamental (f0), quociente de contato (QC), jitter eletroglotográfico e periodicidade da onda eletroglotográfica. Os dados foram analisados estatisticamente utilizando o Minitab 17. RESULTADOS: Os parâmetros analisados foram estatisticamente significantes. A frequência fundamental (f0) foi maior nas mulheres (226,91 Hz) quando comparada com a dos homens (166,54 Hz). As medidas de quociente de contato e de periodicidade também foram maiores nas mulheres (40,46 % e 15,51 %, respectivamente) se comparadas às dos homens (27,45 % e 7,82, respectivamente). O parâmetro de jitter foi maior nos homens, quando comparado ao das mulheres. CONCLUSÃO: Os valores de frequência fundamental (f0), quociente de contato (QC) e periodicidade da onda foram maiores nas mulheres. O valor de jitter foi maior nos homens.

Influence of Long-Term Salt Diets on Cardiac Ca2+ Handling and Contractility Proteins in Hypertensive Rats.

BACKGROUND: High sodium intake contributes to the pathogenesis of hypertension and adversely affects cardiac function. Conversely, sodium reduction is associated with a blood pressure decrease and improved cardiovascular function. However, the mechanisms that underlie the cardiac effects induced by salt intake in hypertension have not been fully elucidated. Ca2+ handling is critical for efficient myocardial function; thus, we aimed to investigate the long-term effects of diets with different salt contents on cardiac function and Ca2+ handling proteins in spontaneously hypertensive rats (SHRs). METHODS: Cardiac function was evaluated by catheterization. Ca2+ handling and contractile proteins were evaluated by immunoblotting in hearts from SHRs fed for 6 months with diets containing high (HS, 3%), low (LS, 0.03%), or normal salt content (NS, 0.3%). Diets were introduced immediately after weaning. Tail cuff pletismography was assessed at the 3rd and 7th months of follow-up. RESULTS: Compared to the NS group, the HS group exhibited worsened hypertension, increased cardiac expression of ß-myosin heavy chain (MHC), a decreased α/ß-MHC ratio and reduced expression of both phospholamban (PLB) and Na+/Ca2+ exchanger (NCX). LS intake attenuated the blood pressure increase and left ventricle hypertrophy, slightly decreased the cardiac contractility and relaxation index, and increased the α/ß-MHC ratio. These effects were accompanied by increased cardiac PLB expression and decreased Ca2+ L-type channel and NCX expression. CONCLUSIONS: These findings indicate that the modulation of Ca2+ handling may be one of the molecular mechanisms underlying the effect of salt intake on myocardial function in hypertension.

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.

Orthopedic related comorbidities in spinal cord-injured individuals / Aspectos ortopédicos no paciente lesado medular

ABSTRACT Objective: This study aims to review, identify and study the determinations of the main orthopedic aspects in SCI patients. Methods: A total of 80 articles from PUBMED and three theses (MSc. /DSc.) were examined. Results: The results refer to the most essential joints. There is a chronic overload on the shoulder girdle due to the use of the upper limb as a supporting joint. The elbow presents osteoarthritis, subclinical, acute and chronic pain, mainly in quadriplegic patients. In the hand and wrist joints there are cases of paralysis, osteoporosis and osteoarthritis. Hips are the main weight-bearing joints while sitting which leads to a substantial degenerative process of this joint. Lastly, on the knee, feet and ankles, spasticity, contractures, osteoporosis and deformities can arise. Conclusion: Along with the increase in cases and research that analyze the alterations that spinal cord-injured individuals suffer, it is necessary to recognize the orthopedic changes to understand their limits and identify the relevance of the rehabilitation program to improve the muscle performance. Level of Evidence II, Prognostic Studies - Investigating the Effect of a Patient Characteristic on the Outcome of Disease.

RESUMO Objetivo: O objetivo do estudo foi identificar, através de uma revisão sistemática, os aspectos ortopédicos e suas determinações nos pacientes lesados medulares. Métodos: Foram examinados 80 artigos na base Pubmed e três teses de mestrado e doutorado. Resultados: Os resultados obtidos referem-se às principais articulações. No ombro há uma sobrecarga crônica na cintura escapular devido ao uso como articulação de suporte. O cotovelo apresenta alterações osteocartilaginosas e dores subaguda, aguda e crônica principalmente no paciente tetraplégico. Nas articulações da mão e punho, a lesão leva à perda da capacidade de compressão por paralisia, osteoporose e osteoartrite. O quadril constitui a principal articulação de sustentação de peso quando sentado, ocorrendo um processo degenerativo importante nesses pacientes. Nos joelhos, pés e tornozelos surgem espasticidade, contraturas e osteoporose levando a deformidades. Conclusão: Devido ao aumento de casos e de pesquisas que analisam as alterações que os lesados medulares sofrem, se faz necessário o conhecimento das alterações ortopédicas do lesado medular para compreendermos a sua limitação e identificar a relevância do programa de reabilitação para melhora da performance muscular. Nível de Evidência II, Estudos Prognósticos - Investigação do efeito de característica de um paciente sobre o desfecho da doença.

Análise das medidas eletroglotográficas da voz: padrões de normalidade para cantores por meio do programa CSL da Kay Pentax® / Electroglotographic voice measurement analysis: normality standards for singers through Kay Pentax® CSL Program

RESUMO Objetivo: Analisar as medidas de frequência fundamental, jitter eletroglotográfico, quociente de contato e periodicidade das ondas eletroglotográficas da voz de cantores em registro modal. Método: Estudo observacional de corte transversal que selecionou indivíduos de escolas de canto da região central do município de Belo Horizonte-MG. A amostra foi não probabilística, por conveniência, composta por 60 indivíduos cantores com faixa etária entre 18 e 55 anos, sendo 30 homens e 30 mulheres. Para a coleta do registro eletroglotográfico, foi utilizado o programa CSL da Kay Pentax™, model 6103, módulo Electroglottography. Os participantes foram posicionados sentados e, após a higienização da pele do pescoço com álcool 70 %, dois eletrodos foram colocados nas alas da cartilagem tireóidea no nível das pregas vocais. Posteriormente, os participantes foram orientados a emitir a vogal /a/ sustentada de forma habitual. Foram analisadas as medidas de frequência fundamental (f0), quociente de contato (QC), jitter eletroglotográfico e periodicidade da onda eletroglotográfica. Os dados foram analisados estatisticamente utilizando o Minitab 17. Resultados: Os parâmetros analisados foram estatisticamente significantes. A frequência fundamental (f0) foi maior nas mulheres (226,91 Hz) quando comparada com a dos homens (166,54 Hz). As medidas de quociente de contato e de periodicidade também foram maiores nas mulheres (40,46 % e 15,51 %, respectivamente) se comparadas às dos homens (27,45 % e 7,82, respectivamente). O parâmetro de jitter foi maior nos homens, quando comparado ao das mulheres. Conclusão: Os valores de frequência fundamental (f0), quociente de contato (QC) e periodicidade da onda foram maiores nas mulheres. O valor de jitter foi maior nos homens.

ABSTRACT Purpose: Analyze the measures of the fundamental frequency, electroglotographic jitter, contact quotient and periodicity of the electroglotographic waves of the singers in habitual voice. Method: A cross-sectional observational study, which selected individuals from singing schools in the central region of the municipality of Belo Horizonte. The sample was non-probabilistic, for convenience consisted of 60 singers aged between 18 and 55 years, 30 males and 30 females. For the electroglotographic record collection, the Kay Pentax ™ CSL program, model 6103, the Electroglotographic module was used. The participants were placed in a seated position, and after cleaning the skin of the neck with 70% alcohol, two electrodes were placed on the wings of the thyroid cartilage at the level of the vocal folds. Subsequently, the participants were instructed to emit the vowel/a/sustained in a habitual way. The measurements of the fundamental frequency (f0), contact quotient (QC), electroglotographic jitter and periodicity of the electroglotographic wave were analyzed. The data were statistically analyzed using Minitab 17. Results: The parameters analyzed were statistically significant. The fundamental frequency (f0) was higher in females (226.91Hz) when compared to males (166.54Hz). The measure of contact quotient and periodicity was also higher in women (40.46% and 15.51% respectively) when compared to men (27.45% and 7.82, respectively). The jitter parameter was higher in men when compared to women. Conclusion: Women presented higher values in the fundamental frequency (f0), contact quotient (QC) and periodicity of the wave compared to men. The men presented the jitter value higher than that of the women.

Application of Mechanical Ventilation Weaning Predictors After Elective Cardiac Surgery.

OBJECTIVE: To test several weaning predictors as determinants of successful extubation after elective cardiac surgery. METHODS: The study was conducted at a tertiary hospital with 100 adult patients undergoing elective cardiac surgery from September to December 2014. We recorded demographic, clinical and surgical data, plus the following predictive indexes: static compliance (Cstat), tidal volume (Vt), respiratory rate (f), f/ Vt ratio, arterial partial oxygen pressure to fraction of inspired oxygen ratio (PaO2/FiO2), and the integrative weaning index (IWI). Extubation was considered successful when there was no need for reintubation within 48 hours. Sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) were used to evaluate each index. RESULTS: The majority of the patients were male (60%), with mean age of 55.4±14.9 years and low risk of death (62%), according to InsCor. All of the patients were successfully extubated. Tobin Index presented the highest SE (0.99) and LR+ (0.99), followed by IWI (SE=0.98; LR+ =0.98). Other scores, such as SP, NPV and LR-were nullified due to lack of extubation failure. CONCLUSION: All of the weaning predictors tested in this sample of patients submitted to elective cardiac surgery showed high sensitivity, highlighting f/Vt and IWI.

Effect of classroom acoustics on the speech intelligibility of students.

PURPOSE: To analyze the acoustic parameters of classrooms and the relationship among equivalent sound pressure level (Leq), reverberation time (T30), the Speech Transmission Index (STI), and the performance of students in speech intelligibility testing. METHODS: A cross-sectional descriptive study, which analyzed the acoustic performance of 18 classrooms in 9 public schools in Belo Horizonte, Minas Gerais, Brazil, was conducted. The following acoustic parameters were measured: Leq, T30, and the STI. In the schools evaluated, a speech intelligibility test was performed on 273 students, 45.4% of whom were boys, with an average age of 9.4 years. The results of the speech intelligibility test were compared to the values of the acoustic parameters with the help of Student's t-test. RESULTS: The Leq, T30, and STI tests were conducted in empty and furnished classrooms. Children showed better results in speech intelligibility tests conducted in classrooms with less noise, a lower T30, and greater STI values. The majority of classrooms did not meet the recommended regulatory standards for good acoustic performance. CONCLUSION: Acoustic parameters have a direct effect on the speech intelligibility of students. Noise contributes to a decrease in their understanding of information presented orally, which can lead to negative consequences in their education and their social integration as future professionals.

O cotidiano dos enfermeiros que atuam no serviço de atendimento móvel de urgência / El día a día de las enfermeras que trabajan en servicio de urgencia de servicio móvil / The daily life of nurses acting in service mobile service urgency

Objetivo: compreender o cotidiano de trabalho dos enfermeiros que atuam no Serviço de Atendimento Móvel de Urgência.Métodos: pesquisa com abordagem qualitativa e exploratória, tendo como método para coleta de dados o Grupo Focal,realizada com quatro enfermeiros atuantes no SAMU. Resultados: emergiram quatro categorias: Cotidiano laboral do enfermeiro no serviço móvel de urgência: vivências no gerenciamento e na assistência; Implicações do Atendimento Pré-Hospitalar Móvel na vida pessoal e profissional;Formas de reconhecimento do enfermeiro atuante no Pré-Hospitalar Móvel: cenário de relações interpessoais; e Enfrentamento das dificuldades encontradas pelo enfermeiro no Atendimento Pré-Hospitalar Móvel. Conclusão:cenas traumáticas causam impacto nos enfermeiros ocasionando um desequilíbrio emocional, sendo necessário trabalhar o desenvolvimento das questões psicológicas para melhorar a qualidade de vida, e o reconhecimento é capaz de gerar motivação,sendo estes propulsores para a superação dos desafios em prol de salvar vidas.

Objective: to understand the daily work of nurses working in the Mobile Emergency Care Service. Methods: A qualitative andexploratory approach taking as a method of data collection the focus group held with four nurses working in the SAMU. Results:Emerged up four categories: labor Everyday Nurses in the emergency mobile service: experiences in management and assistance;Implications of Prehospital Care Mobile in personal and professional life; Nurse recognition of forms active in Prehospital Mobile:setting of interpersonal relationships and coping difficulties encountered by the nurse in Prehospital Care Mobile. Conclusion:Traumatic Scenes impact the Nurses causing an emotional imbalance, it is necessary to work the development of psychologicalissues to improve the quality of life and recognition is capable of generating motivation, and these thrusters to overcome thechallenges for the sake of saving lives.

Objetivo: comprender el trabajo diario de las enfermeras que trabajan en el Servicio de Atención Móvil de Urgencia. Métodos: Unenfoque cualitativo y exploratorio tomando como método de recolección de datos del grupo focal realizado con cuatro enfermerasque trabajan en el SAMU. Resultados: Surgieron cuatro categorías: Todos los días de Enfermeras de trabajo en el servicio deemergencia móvil: experiencias en la gestión y asistencia; Implicaciones de la atención prehospitalaria móvil en la vida personal yprofesional; Enfermera reconocimiento de formas activas en prehospitalaria móvil: establecimiento de relaciones interpersonales ydificultades para hacer frente encontradas por la enfermera en Atención Prehospitalaria móvil. Conclusión: escenas traumáticasafectan a las enfermeras que causa un desequilibrio emocional, es necesario trabajar el desarrollo de problemas psicológicos paramejorar la calidad de vida y el reconocimiento es capaz de generar motivación y estos propulsores para superar los retos para elbien de salvar vidas.

[Auditory-perceptive, acoustic and vocal self-perception analyses in children]. / Análise perceptivo-auditiva, acústica e autopercepção vocal em crianças.

PURPOSE: To establish the occurrence of dysphonic children and to relate data from auditory-perceptive, acoustic and vocal self-perception analyses of dysphonic and non-dysphonic children. METHODS: Participants were 70 children, 37 female and 33 male, with ages ranging from 6 to 10 years. The sustained emission of the vowel /a/ was recorded, and children replied to the question "What do you think of your voice?".After that, the auditory-perceptive analysis of their voices was carried out, based on the parameters of the GRBASI scale. The acoustic analysis was also conducted, considering the following measures: fundamental frequency, frequency and amplitude perturbation quotient, and harmonic-to-noise ratio. The self-perception analysis of the subjects' voices was based on content analysis. Data were statistically analyzed. RESULTS: The occurrence of dysphonic children was 37.14%. Breathiness was the most common vocal quality among dysphonic children, followed by roughness, which was also common. The acoustic measures frequency and amplitude perturbation quotient and harmonic-to-noise ration were higher among dysphonic children. However, these measures were similar between children that had positive self-perception and those with negative self-perception. Negative self-perception was more frequent among dysphonic children. CONCLUSION: The occurrence of dysphonia in the studied group was 37.14%. Dysphonic children present negative self-perception of their voices, voice quality predominantly rough and/or breathy, and altered acoustic measures, when compared to non-dysphonic children.

Avaliação e percepção docente sobre os efeitos do nível de pressão sonora na sala de aula / Evaluation and perception of teachers on the effects of sound pressure level in the classroom / Evaluación y percepción de los docentes sobre los efectos del nivel de presión de sonora en el aula

Objetivo: Avaliar o nível de pressão sonora em salas de aula de escolas públicas e a percepção de professores sobre sua interferência nas atividades escolares e em sua saúde. Métodos: Estudo transversaldescritivo com avaliação do ruído de 14 salas de aula de oito escolas. Avaliou-se o parâmetro acústico nível de pressão sonora equivalente. Aplicou-se um questionário a 23 professores com perguntas sobre:a) influência do ruído em atividades escolares, b) influência do ruído na voz e comunicação, c) influência do ruído no organismo, d) influência do ruído interno à escola, e) influência do ruído externo à escola. As questões obedeceram à escala Likert com as seguintes respostas: nenhuma, pouca, média e elevada. Resultados: O nível de pressão sonora encontrado nas salas de aula variou de 54,5 dB(A) a 70,3 dB(A), com mediana de 60 dB(A). As queixas de maior ocorrência (média a elevada) relacionadas ao ruído foram: interferência no rendimento escolar do aluno (95,7%) e na compreensão do conteúdo em sala de aula (95,7%), elevação do tom de voz durante o trabalho (87,0%), fadiga vocal (82,6%), irritabilidade (82,6%) e cansaço (82,6%). Esses dois últimos foram mais citados por professores das salas com maior ruído (p?0,05). As conversas no corredor também foram um fator relacionado ao maior ruído em sala deaula (p=0,03). Conclusão: Os níveis de pressão sonora mensurados estão acima do preconizado pelas normas. De acordo com os professores, o ruído interfere negativamente no ambiente escolar, além de estar relacionado aos sintomas de cansaço e irritabilidade.(AU)

Objective: To evaluate the sound pressure level in classrooms of public schools and perceptions of teachers about its interference with school activities and their health. Methods: A descriptive crosssectional study evaluating the noise of 14 classrooms in eight schools. An assessment of noise was made using the acoustic equivalent sound pressure level parameter. To verify the perceptions of teachers regarding noise in the classroom and its interference in school activities and their health, it applied a questionnaire to 23 teachers with questions about: a) influence of noise in school activities, b) the influence of noise in speech and communication, c) influence of noise in the body, d) influence of internal noise of school, e) influence of external noise of school. The questions obeyed Likert scale with the following answers: none, small, medium, and high. Results: The sound pressure level in the classroom ranged from 54,5 dB(A) 70,3 dB(A), with a median of 60 dB(A). Complaints related to noise greater occurrence(medium and high) were student academic performance (95.7%) and understanding of the content in the classroom (95.7%), raising the voice at work (87.0%), vocal fatigue (82.6%), irritability (82.6%) and fatigue (82.6%). The later two were most cited by teachers in the noisiest rooms (p?0.05). The conversations in the hall were also a factor related to increased noise in class (p=0.03). Conclusion: The measured sound pressure levels are above the recommended by the standards. According to teachers, noise negatively affects the school environment and it is related to the symptoms of tiredness and irritability.(AU)

Objetivo: Evaluar el nivel de presión sonora en las aulas de escuelas públicas y la percepción de maestros sobre su interferencia en las actividades escolares y su salud. Métodos: Estudio descriptivo de corte transversal con la evaluación del ruido en 14 aulas en ocho escuelas. Se evaluó el parámetro acústico nivelde presión sonora equivalente. Se aplicó un cuestionario a 23 maestros con preguntas sobre: a) influencia del ruido en actividades escolares, b) influencia del ruido en voz y comunicación, c)influencia del ruido en el cuerpo, d) influencia del ruido interno a la escuela, e) influencia del ruido externo a la escuela. Las preguntas obedecieron a la escala Likert con las siguientes respuestas: ninguna, poca, media y alta. Resultados: El nivel de presión sonora en las aulas osciló entre 54,5 dB(A) a 70,3 dB(A), con mediana de 60 dB(A). Las quejas de mayor incidencia (media y alta) relacionadas al ruido fueron interferencia en el rendimiento académico del alumno (95,7%) y en la comprensión de los contenidos enel aula (95,7%), elevar la voz durante el trabajo (87,0%), fatiga vocal (82,6%), irritabilidad (82,6%) y cansancio (82,6%). Estos dos últimos fueron los más citados por los docentes en las aulas más ruidosas(p?0,05). Las conversaciones en el pasillo fueron también un factor relacionado con el aumento de ruido en el aula (p=0,03). Conclusión: Los niveles de presión de sonido medidos fueron superiores a losrecomendados por las normas. De acuerdo con los maestros, el ruido afecta negativamente el ambiente escolar y se relaciona con los síntomas de cansancio y irritabilidad(AU)

Avaliação e percepção docente sobre os efeitos do nível de pressão sonora na sala de aula / Evaluation and perception of teachers on the effects of sound pressure level in the classroom / Evaluación y percepción de los docentes sobre los efectos del nivel de presión de sonora en el aula

Objetivo: Avaliar o nível de pressão sonora em salas de aula de escolas públicas e a percepção de professores sobre sua interferência nas atividades escolares e em sua saúde. Métodos: Estudo transversal descritivo com avaliação do ruído de 14 salas de aula de oito escolas. Avaliou-se o parâmetro acústico nível de pressão sonora equivalente. Aplicou-se um questionário a 23 professores com perguntas sobre: a) influência do ruído em atividades escolares, b) influência do ruído na voz e comunicação, c) influência do ruído no organismo, d) influência do ruído interno à escola, e) influência do ruído externo à escola. As questões obedeceram à escala Likert com as seguintes respostas: nenhuma, pouca, média e elevada. Resultados: O nível de pressão sonora encontrado nas salas de aula variou de 54,5 dB(A) a 70,3 dB(A), com mediana de 60 dB(A). As queixas de maior ocorrência (média a elevada) relacionadas ao ruído foram: interferência no rendimento escolar do aluno (95,7%) e na compreensão do conteúdo em sala de aula (95,7%), elevação do tom de voz durante o trabalho (87,0%), fadiga vocal (82,6%), irritabilidade (82,6%) e cansaço (82,6%). Esses dois últimos foram mais citados por professores das salas com maior ruído (p?0,05). As conversas no corredor também foram um fator relacionado ao maior ruído em sala de aula (p=0,03). Conclusão: Os níveis de pressão sonora mensurados estão acima do preconizado pelas normas. De acordo com os professores, o ruído interfere negativamente no ambiente escolar, além de estar relacionado aos sintomas de cansaço e irritabilidade.

Objective: To evaluate the sound pressure level in classrooms of public schools and perceptions of teachers about its interference with school activities and their health. Methods: A descriptive crosssectional study evaluating the noise of 14 classrooms in eight schools. An assessment of noise was made using the acoustic equivalent sound pressure level parameter. To verify the perceptions of teachers regarding noise in the classroom and its interference in school activities and their health, it applied a questionnaire to 23 teachers with questions about: a) influence of noise in school activities, b) the influence of noise in speech and communication, c) influence of noise in the body, d) influence of internal noise of school, e) influence of external noise of school. The questions obeyed Likert scale with the following answers: none, small, medium, and high. Results: The sound pressure level in the classroom ranged from 54,5 dB(A) 70,3 dB(A), with a median of 60 dB(A). Complaints related to noise greater occurrence(medium and high) were student academic performance (95.7%) and understanding of the content in the classroom (95.7%), raising the voice at work (87.0%), vocal fatigue (82.6%), irritability (82.6%) and fatigue (82.6%). The later two were most cited by teachers in the noisiest rooms (p?0.05). The conversations in the hall were also a factor related to increased noise in class (p=0.03). Conclusion: The measured sound pressure levels are above the recommended by the standards. According to teachers, noise negatively affects the school environment and it is related to the symptoms of tiredness and irritability.

Objetivo: Evaluar el nivel de presión sonora en las aulas de escuelas públicas y la percepción de maestros sobre su interferencia en las actividades escolares y su salud. Métodos: Estudio descriptivo de corte transversal con la evaluación del ruido en 14 aulas en ocho escuelas. Se evaluó el parámetro acústico nivelde presión sonora equivalente. Se aplicó un cuestionario a 23 maestros con preguntas sobre: a) influencia del ruido en actividades escolares, b) influencia del ruido en voz y comunicación, c)influencia del ruido en el cuerpo, d) influencia del ruido interno a la escuela, e) influencia del ruido externo a la escuela. Las preguntas obedecieron a la escala Likert con las siguientes respuestas: ninguna, poca, media y alta. Resultados: El nivel de presión sonora en las aulas osciló entre 54,5 dB(A) a 70,3 dB(A), con mediana de 60 dB(A). Las quejas de mayor incidencia (media y alta) relacionadas al ruido fueron interferencia en el rendimiento académico del alumno (95,7%) y en la comprensión de los contenidos enel aula (95,7%), elevar la voz durante el trabajo (87,0%), fatiga vocal (82,6%), irritabilidad (82,6%) y cansancio (82,6%). Estos dos últimos fueron los más citados por los docentes en las aulas más ruidosas(p?0,05). Las conversaciones en el pasillo fueron también un factor relacionado con el aumento de ruido en el aula (p=0,03). Conclusión: Los niveles de presión de sonido medidos fueron superiores a losrecomendados por las normas. De acuerdo con los maestros, el ruido afecta negativamente el ambiente escolar y se relaciona con los síntomas de cansancio y irritabilidad

The impact of noise exposure on workers in Mobile Support Units / O impacto do ruído em trabalhadores de Unidades de Suporte Móveis

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. .

OBJETIVO: Investigar a presença de sintomas auditivos e não auditivos em profissionais que atuam em ambulâncias. MÉTODOS: Estudo transversal descritivo com amostra de conveniência. Participaram 36 profissionais que atuam em unidades de suporte móveis, incluindo motoristas e técnicos de enfermagem de dois serviços particulares de urgência e emergência na cidade de Belo Horizonte, Minas Gerais. Foi aplicado um questionário contendo 17 questões de múltipla escolha sobre a história de vida e ocupação, antecedente familiar de perda auditiva, uso de medicamentos, presença de sintomas auditivos e não auditivos, entre outras investigações. Os profissionais responderam o questionário individualmente, no seu ambiente de trabalho, e, na existência de dificuldade de compreensão das questões, a pesquisadora explicou o conteúdo da questão. Os dados foram analisados estatisticamente utilizando-se o software Statistical Package for the Social Sciences (SPSS) 16.0. RESULTADOS: Os sintomas auditivos mais relatados pelos profissionais foram zumbido, intolerância a sons intensos e plenitude auricular. Os sintomas não auditivos mais frequentes foram irritabilidade, dor de cabeça, dificuldade de conversar em ambiente ruidoso e alteração do sono. Foi observada diferença (p≤0,05) ao se analisar a relação entre autopercepção de motoristas e técnicos de enfermagem sobre acuidade auditiva, presença de zumbido, irritabilidade e dificuldade de comunicação. CONCLUSÃO: Sintomas auditivos e não auditivos são frequentes em trabalhadores de unidades de suporte móveis. Pôde-se observar associação entre sintomas e função desempenhada pelo trabalhador. Dessa forma, verifica-se a necessidade do desenvolvimento de ações preventivas voltadas à saúde geral, visando à preservação da saúde auditiva e qualidade de vida desses profissionais. .

Exposição ao ruído ocupacional pelos tripulantes de ambulâncias / Occupational exposure to noise by ambulance crew

OBJETIVO: descrever os níveis de pressão sonora a que os trabalhadores estão expostos durante a jornada de trabalho em ambulâncias e verificar possível associação do uso da sirene, das condições do trânsito e do período do dia em que foi realizada a medição. MÉTODOS: trata-se de estudo transversal descritivo dividido em duas etapas. Na primeira etapa foram realizadas medições do nível de pressão sonora na cabine da ambulância durante as viagens de emergência, e investigação da percepção do motorista sobre as condições do trânsito e uso da sirene. Na segunda etapa foi realizada análise da exposição de um trabalhador ao ruído durante a jornada de trabalho. Os dados foram analisados estatisticamente. RESULTADOS: a média do nível sonoro contínuo equivalente durante 12 viagens de emergência foi superior a 85 dB(A), valor acima do permitido pela Norma Regulamentadora 15, sendo que o ruído elevado esteve associado às condições do trânsito e uso da sirene (p<0,05). A dose de ruído em porcentagem durante os plantões de um motorista variou de 17.51% a 155.68%, ultrapassando o limite preconizado e também teve influência das condições do trânsito e uso da sirene. CONCLUSÃO: os níveis de pressão sonora a que os trabalhadores estão expostos durante a jornada de trabalho em ambulâncias são elevados e ultrapassam o que é estabelecido pela norma Brasileira. Dessa forma, verifica-se a necessidade do desenvolvimento de ações preventivas voltadas à saúde desses profissionais já que elevados níveis de ruído podem interferir negativamente na saúde auditiva e qualidade de vida dos trabalhadores. .

PURPOSE: to describe the sound pressure levels that workers are exposed during working hours in ambulances and verify possible association between the use of sirens, traffic conditions and time of the day that the measurement was taken. METHODS: in the first stage, it was measured the sound pressure level in the cabin of the ambulance during emergency trips, and performed the investigation of the driver's perception about traffic conditions and use of the siren. In the second stage, it was analyzed the noise exposure of a worker during the working hours. The data were analyzed statistically. RESULTS: the average of the equivalent continuous sound level for 12 emergency trips exceeded 85 dB (A) above the value allowed by the Regulatory Standard 15, and the loud noise was associated with traffic conditions and use of the siren (p <0.05). The noise dose in percentage during a driver shifts varied from 17,51% to 155,68%, exceeding the recommended limit and also had an influence on traffic conditions and siren's use. CONCLUSION: the sound pressure levels to which workers are exposed during working hours in ambulances are high and beyond what is established by the Brazilian standard. Thus, it is necessary to develop preventive health actions to this professionals since the high noise levels can adversely affect their hearing health and quality of life. .

Consumo de sal em universitários de um curso de nutrição / Salt consumption of students from the nutrition course

Objetivo ­ Avaliar o consumo de sal dos alunos do curso de nutrição de uma universidade particular do interior do Estado de São Paulo a partir do exame de urina de 24 horas e identificar a frequência de consumo dos alimentos ricos em sódio, bem como correlacionar estas duas variáveis. Métodos ­ Para avaliar o consumo de sal foi utilizado o exame da excreção urinária de sódio das 24 horas. Para identificar a frequência de consumo dos alimentos ricos em sódio foi utilizado um questionário de frequência alimentar autoaplicável elaborado pelas pesquisadoras. Resultados ­ Fizeram parte deste estudo 30 alunos. O exame de excreção urinária de sódio das 24 horas indicou um consumo de sal médio de 7,65 ± 3,5g/dia, sem diferença significativa entre os seguimentos do curso (p=0,1048). A aplicação do questionário de frequência alimentar apontou um escore individual médio de 29 ± 10,6, sendo o valor mínimo de 8 e o máximo de 50, numa amplitude de variação entre 0 a 126. Os alunos que com menor escore de consumo de alimentos ricos em sódio apresentaram consumo de sal significativamente menor (p<0,0001) em relação ao que tiveram escores superiores. A correlação entre o escore individual do consumo de alimentos ricos em sódio e a ingestão de sal mostrou-se positiva e sem significância (r=0,1622, p=0,3918). Conclusões ­ Acumulam-se evidências que apontam para a necessidade de programas educacionais que atuem na motivação para agir, visto que conhecimento por si só não gera melhor consumo alimentar.

Objective ­ Evaluate the course of students' salt intake nutrition from a private university in the state of Sao Paulo from the urine test 24 hours and identify the frequency of consumption of foods high in sodium as well as correlate these two variables. Methods ­ To evaluate the consumption of salt was used an examination of urinary sodium excretion of 24 hours. To identify the frequency of high sodium consumption was used a food frequency survey developed by the researchers. Results ­ This study included 30 students. The examination of urinary sodium excretion of 24 hours indicated an average consumption of salt 7.65 ± 3.5g/day, with no significant difference between the segments of the course (p=0.1048). The application of the survey showed an average score of 29 ± 10.6, with a minimum value of 8 and a maximum of 50, in a range of variation between 0 and 126. Students with low scores of high sodium consumption showed a salt consumption significantly lower (p<0.0001) compared to those higher scores. The correlation between the individual score of consumption of high sodium foods was positive and not statistically significant (r=0.1622, p=0.3918). Conclusions ­ There are evidences pointing to the need for educational programs that operate on the motivation to act, because knowledge alone does not generate better food consumption.

Medidas de biossegurança adotadas por profissionais atuantes em audiologia / Biosecurity preacautions adopted by professionals working in audiology

OBJETIVO: explicitar as práticas de biossegurança adotadas por fonoaudiólogos atuantes na área de Audiologia e relacioná-las com a educação continuada e o tempo de formação dos profissionais. MÉTODOS: participaram deste estudo 70 fonoaudiólogos atuantes na área de Audiologia, nos municípios de Belo Horizonte e Contagem. Foi aplicado um questionário sobre biossegurança em Audiologia, com base na Norma Regulamentadora 32, composto por 27 perguntas fechadas, abordando os aspectos de higienização das mãos, equipamentos de proteção individual e organização e higienização dos artigos e do ambiente. RESULTADOS: a maioria dos fonoaudiólogos relatou que adota as seguintes medidas de biossegurança: higienização das mãos antes dos atendimentos (71%), uso de jaleco com mangas longas (74%) e abotoado (91%), cabelos presos (79%), unhas limpas e cortadas (91%), separação e desinfecção dos artigos usados (83%) e organização do ambiente (97%). No entanto somente 40% dos profissionais referiram higienizar as mãos entre os atendimentos e 9% referiram o uso de luvas na realização da meatoscopia. Observou-se que a destinação dos artigos para desinfecção é uma prática mais rotineira para profissionais com especialização (p< 0,05). Os profissionais com maior tempo de formação aderiram melhor à prática de higienização das mãos. CONCLUSÃO: higienizar as mãos antes dos atendimentos, vestir-se corretamente, destinar os artigos para desinfecção e organizar o ambiente de trabalho são práticas de biossegurança adotadas pela maioria dos fonoaudiólogos. Fatores como tempo de formação e educação continuada influenciam de maneira positiva na adoção de corretas medidas de biossegurança. .

PURPOSE: to know the practices of biosecurity practices adopted by Speech Therapists working in Audiology and relate these practices with continuing education and professionals' time of graduation. METHODS: 70 speech therapists working in Audiology in the cities of Belo Horizonte and Contagem participated in this study. It was administered a questionnaire on Biosafety in Audiology, based on Regulatory Norm 32, comprising 27 closed questions, covering aspects of hand hygiene, personal protective equipment, organization and cleanliness of working items and the environment. RESULTS: most of the speech therapists interviewed reported adopting the following biosafety precautions: hand hygiene before attendance (71%), use of lab coats with long sleeves (74%) and buttoned (91%), hair tied (79%), cleaned and cut nails (91%), separation and disinfection of used items (83%), organization of the environment (97%). However, only 40% of them reported washing their hands between patients' appointments and 9% reported to wear gloves when carrying out meatoscopy. It was observed that the allocation of items for disinfection is a routine practice for most professionals with expertise (p <0.05). Professionals with longer time of graduation adhered better to the hand hygiene practice. CONCLUSION: washing hands before the attendance, dressing properly, allocating the items intended for disinfection and organizing the workplace are biosecurity practices adopted by most of speech therapists. Some factors such as time of graduation and continuous education positively influence the adoption of correct precautions on Biosafety. .