Sistema Único de Saúde: acessibilidade das pessoas surdas no interior da Bahia / Unified Health System: accessibility of deaf people in the countryside of Bahia state / Sistema Único de Salud: accesibilidad de las personas sordas en el interior de Bahia

A acessibilidade das pessoas surdasno Sistema Único de Saúde ainda é precária devido às barreiras de comunicação. O objetivo do estudo foi analisar o acesso e o atendimento ofertado à comunidade surda nos serviços de saúde públicos, no município de Vitória da Conquista, Bahia, por meio de uma pesquisa qualitativa. Participaram oito profissionais de saúde e treze usuários surdos, cujos dados foram coletados com aplicação de um questionário e um roteiro de entrevista semiestruturada. Os resultados, com base na análise do conteúdo, apontaram que não há capacitação, as Unidades Básicas de Saúde não apresentam estratégias de acessibilidade nos atendimentos, têm rara comunicação em Libras e um número reduzido de intérpretes ­ o que dificulta a comunicação entre o profissional de saúde e o usuário surdo. A formação em Libras e a presença de um intérprete são apontadas como estratégias para um atendimento de qualidade às pessoas surdas

The accessibility of deaf people in the Unified Health System is still precarious due to communication barriers. The objective of the study was to analyze the access and care offered to the deaf community in public health services, in the city of Vitória da Conquista, Bahia, through qualitative research. Eight health professionals and thirteen deaf users took part in the research, whose data were collected using a questionnaire and a semi-structured interview script. Based on the content analysis, the results showed that there is no training, the Basic Health Units do not have accessibility strategies in care, rarely communicate in Libras and a have a small number of interpreters in their ranks ­ hindering the communication between health professional and deaf user. Training in Libras and the presence of an interpreter are identified as strategies for quality care for deaf people

La accesibilidad para los sordos en el Sistema Único de Salud todavía es precaria debido a las barreras de comunicación. El objetivo del estudio fue analizar el acceso y la atención ofrecida a este público en los servicios de salud públicos, en el municipio de Vitória da Conquista, Bahia, con una investigación cualitativa. Participaron ocho profesionales de la salud y trece usuarios sordos, cuyos datos fueron recolectados a través de cuestionario y guión de entrevista semiestructurada. Los resultados, basados en el análisis de contenido, mostraron que no hay capacitación, las Unidades Básicas de Salud no tienen estrategias de accesibilidad, y tienen poca comunicación en Libras y reducido número de intérpretes ­ lo que dificulta la comunicación entre el profesional de la salud y el usuario sordo. La formación en Libras y la presencia de un intérprete se identifican como estrategias para la atención de calidad a los sordos

Discursos sobre o Papel do Tradutor-Intérprete Educacional de Libras/Português / Discourses about the Role of the Educational Translater-Interpreter of Libras/Portuguese

RESUMO: O tradutor-intérprete educacional de Língua Brasileira de Sinais (Libras)/Português é fundamental em um espaço educacional que busca ser inclusivo a surdos, porém sua função vem sendo debatida frente à pluralidade existente quanto às disciplinas e aos contextos nos quais esses profissionais atuam. Diante disso, este trabalho promove uma discussão a fim de somar a um constructo que, aos poucos, tece uma perspectiva mais clara acerca dos aspectos que caracterizam a prática de um intérprete educacional. Para isso, analisaram-se respostas de 53 intérpretes de diferentes regiões do Brasil, obtidas por meio de um questionário enviado via Google Forms, que indagava sobre qual seria a sua função no âmbito educacional. A partir disso, aplicando o método de análise de conteúdo, identificaram-se quatro categorias que apontavam o intérprete educacional como: colaborador no processo de inclusão, mediador cultural, coformador do discente surdo e mediador linguístico. Compreende-se que, em sua complexidade, a função do intérprete educacional possui alguns desdobramentos que não podem ser ignorados, atribuindo a esses profissionais um lugar de indiferença ou assistencialismo excessivo nos processos de ensino e de aprendizagem. Ao contrário, eles devem participar ativamente, compreendendo o que caracteriza sua função, também a partir do diálogo com a instituição, discente surdo e comunidade surda.

ABSTRACT: The educational translator-interpreter of Brazilian Sign Language (LIBRAS)/Portuguese is essential in an educational space that seeks to be inclusive for the deaf, however his/her role has been debated in view of the existing plurality regarding the disciplines and contexts in which these professionals work. Due to that, this work promotes a discussion in order to add to a construct that gradually makes a clearer perspective about the aspects that characterize the practice of an educational interpreter. For this, answers from 53 interpreters from different regions of Brazil, obtained through a questionnaire sent via Google Forms, which asked what their role in the educational field would be, were analyzed. From this, applying the method of content analysis, four categories were identified that pointed to the educational interpreter as: collaborator in the inclusion process, cultural mediator, co-trainer of the deaf student and linguistic mediator. It is understood that, in its complexity, the role of the educational interpreter has some ramifications that cannot be ignored, attributing to these professionals a place of indifference or excessive assistance in the teaching and learning processes. On the contrary, they must actively participate, understanding what characterizes their role, also based on dialogue with the institution, deaf students and the deaf community.

A Criança Surda como Sujeito do Olhar: Infância e Surdez nas Pesquisas em Educação / Deaf Child as a Subject of the Gaze: Childhood and Deafness in Education Research

RESUMO: O objetivo deste texto é debater como infância, criança, surdez e experiência visual têm se configurado como temas investigativos na Educação, detendo-se em uma análise sobre o olhar das crianças surdas e como sua experiência visual produz e é produzida pelo olhar. Realizou-se um levantamento bibliográfico no Banco de Theses e Dissertações da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes) e nos trabalhos aprovados nas reuniões nacionais da Associação Nacional de Pós-Graduação e Pesquisa em Educação (ANPEd) - GT Educação Especial, tendo como vetor decisivo pesquisas que tinham a infância e/ou a criança surda como temas centrais. Na análise das 23 pesquisas encontradas, verificaram-se três recorrências: a criança ou a infância surda como conceitos abrangentes, pouco abordados em suas singularidades; a experiência visual da criança surda assumida como secundária à aquisição, seja de outras linguagens (como, por exemplo, a escrita), seja da Língua Brasileira de Sinais (Libras), portanto, como experiência suplementar; o conceito de aprendizagem da criança surda vinculado à imagem como recurso didático. Com base nisso, percorreram-se pesquisas e trabalhos que rompem com essas recorrências e, assim, indicam caminhos para a construção de uma agenda de pesquisa sobre criança e infância surda.

ABSTRACT: The purpose of this text is to discuss how childhood, children, deafness and visual experience have been configured as research themes in Education, focusing on an analysis of the gaze of deaf children and how their visual experience produces and is produced by the gaze. A bibliographic review was carried out in the Theses and Dissertations Database of the Coordination for the Improvement of Higher Education Personnel (CAPES) and in the approved papers for the national meetings of the National Association of Research and Graduate Studies on Education (ANPEd) -Special Education Work Group), having as a decisive vector research that had childhood and/or deaf child as central themes. In the analysis of the 23 studies founded, three recurrences were verified: deaf child or childhood as general concepts, not assumed in their singularities; the visual experience of the deaf child assumed to be secondary to the acquisition, whether of other languages (such as writing), or the Brazilian Sign Language (LIBRAS), therefore, as a supplementary experience; the concept of learning for the deaf child linked to image as a didactic resource. Based on that, research and work that break with these recurrences have been investigated and thus indicate ways for the construction of a research agenda on children and deaf childhood.

Estágio Curricular na EPT: Proposta pa ra Potencializar a Inclusão de Estudantes Surdos do Instituto Federal de Roraima - Campus Novo Paraíso / Curricular Internship at EPT: Proposal to Enhance the Inclusion of Deaf Students from the Federal Institute of Roraima - Novo Paraíso Campus

RESUMO: Este estudo, como projeto da linha de pesquisa Práticas Educativas em Educação Profissional e Tecnológica, objetivou analisar o processo de acompanhamento e orientação durante o período de estágio curricular de estudantes surdos dos cursos técnicos no âmbito do Instituto Federal de Educação, Ciência e Tecnologia de Roraima - campus Novo Paraíso (IFRR/CNP), a fim de desenvolver e avaliar um Manual Orientador de Estágio. A pesquisa foi desenvolvida em quatro etapas processuais: processo de caracterização do cenário de inclusão dos estudantes surdos no âmbito do IFRR/CNP; processo de identificação dos aspectos positivos e dificuldades referentes ao período de estágio dos estudantes surdos do IFRR/CNP; processo de elaboração do produto educacional - Manual Orientador de Estágio para alunos surdos do IFRR/CNP; e processo de aplicação e avaliação do produto educacional. Os resultados apontaram a relevância do Núcleo de Atendimento às Pessoas com Necessidades Educacionais Específicas (NAPNE) em sua atuação no IFRR/CNP como um meio de promover a inclusão dos alunos surdos na instituição, destacando o papel primordial do intérprete de Língua Brasileira de Sinais (Libras) nesse processo. O produto educacional desenvolvido foi considerado, mediante avaliação, um instrumento inclusivo, proporcionando ao estudante surdo informações úteis ao período de estágio em Libras, sendo um apoio importante para outros estudantes surdos que ingressarem na instituição.

ABSTRACT: This study, as a project of the research line Educational Practices in Vocational and Technological Education, aimed to analyze the process of monitoring and guidance during the period of curricular internship of deaf students of technical courses within the scope of the Federal Institute of Education, Science and Technology of Roraima - Novo Paraíso campus (IFRR/ CNP), in order to develop and evaluate an Internship Guidance Manual. The research was developed in four procedural steps: process of characterization of the scenario of inclusion of deaf students in the scope of the IFRR/CNP; process of identifying the positive aspects and difficulties related to the internship period of deaf students at the IFRR/CNP; process of elaboration of the educational product - Internship Guidance Manual for deaf students of the IFRR/CNP and process of application and evaluation of the educational product. The results showed the relevance of the Center of Assistance for People with Specific Educational Needs (NAPNE) in its performance at the IFRR/CNP as a way of promoting the inclusion of deaf students in the institution, highlighting the primary role of the Brazilian Sign Language (LIBRAS) interpreter in this process. The educational product developed was considered, through evaluation, an inclusive instrument, providing the deaf student with useful information during the internship period in LIBRAS, being an important support for other deaf students who enter the institution.

Current status and influencing factors of chronic disease self-management behavior of middle-aged and elderly deaf people aged 50 years and over in Shanghai / 上海预防医学

ObjectiveTo investigate the current status and influencing factors of chronic disease self-management behavior of middle-aged and elderly deaf people aged 50 years and over in Shanghai， and to provide reference for improving their chronic disease self-management behavior. MethodsDuring September 2021 to February 2022， 271 middle-aged and elderly deaf people aged 50 years and over in Shanghai were investigated face-to-face by general questionnaire， chronic disease self-management study measures， self-efficacy scale， social capital questionnaire， hospital anxiety and depression scale， health disturbance scale. ResultsThe mean score of chronic disease self-management behavior was 32.107±7.527. Gender， frequency of searching health knowledge by mobile phone， whether to eat fruit， self-efficacy and social capital were influencing factors of chronic disease self-management behaviors， which could explain 37.04% of the variance. ConclusionThe chronic disease self-management behavior of the middle-aged and elderly deaf people aged 50 years and over is low and needs to be improved. We can promote the middle-aged and elderly deaf people to form the good self-management behavior by improving their self-efficacy， improving their level of social capital and forming good living habits.

Libras no contexto escolar: instrumento ilustrado de avaliação de narrativas sinalizadas1 / Libras in the school context: illustrated instrument for evaluation of signed narratives

RESUMO O contato inicial com uma língua acessível ocorre, para os estudantes surdos brasileiros, frequentemente no ambiente escolar, ao entrar em contato com outras crianças surdas e com interlocutores adultos fluentes em Língua Brasileira de Sinais (Libras). Esse acesso tardio pode ocasionar um certo atraso na aquisição e no desenvolvimento da linguagem. Assim, a educação bilíngue de surdos coloca os professores frente ao desafio de como avaliar a Libras no contexto escolar. Diante das propostas educacionais, ainda há poucos instrumentos que contribuam para avaliar os conhecimentos em Libras dos estudantes surdos. Portanto, o objetivo deste estudo é, por meio de um instrumento ilustrado de investigação de narrativas sinalizadas, contribuir com a avaliação da Libras e com o trabalho pedagógico de professores que atuam na educação bilíngue de surdos. O instrumento de avaliação de textos narrativos mostra-se bastante sensível para detectar o desenvolvimento linguístico dos discursos narrativos sinalizados, contribuindo intrinsicamente para a observação de funções/necessidades comunicativas.

ABSTRACT The initial contact with an accessible language occurs, for Brazilian deaf students, often in the school environment, when they encounter other deaf children and with adult interlocutors who are fluent in Brazilian Sign Language (LIBRAS). This late access can cause a certain delay in language acquisition and development. Thus, bilingual education for the deaf place's teachers in the face of the challenge of how to evaluate LIBRAS in the school context. In view of the educational proposals, there are still few instruments that contribute to assessing deaf students' knowledge in LIBRAS. Therefore, the objective of this study is, through an illustrated instrument for investigating signaled narratives, to contribute to the evaluation of LIBRAS and to the pedagogical work of teachers who work in bilingual education for the deaf. The instrument for evaluating narrative texts proves to be quite sensitive to detect the linguistic development of signaled narrative discourses, intrinsically contributing to the observation of communicative functions/needs.

Early numerical cognition in deaf and hearing children: Closer than expected? / Cognición numérica temprana en niños sordos y oyentes: ¿más cercana de lo esperado?

Abstract Deaf students show a significant delay in their understanding of numeracy and measurement concepts as well as verbal problem solving. There is still no consensus about the origin of this delay but several studies have shown that deaf people show differences in basic numerical skills and executive function (EF), which could underlie the differences in the way they learn and develop their cognitive abilities. Children have the innate ability to estimate and compare numerosities without using language or numerical symbols. The ability to discriminate large numerosities depends on the approximate number system (ANS), a cognitive system believed to be governed by a neural circuit within the intraparietal sulcus. Researchers hypothesize that the ANS underlies the development of arithmetic and there is data supporting the contribution of the ANS for math achievements. Little is known about the approximate number system of deaf children at early ages. Deaf and hearing preschool children were compared in terms of specific cognitive functions shown to be important for success in mathematics. Executive functions and symbolic and nonsymbolic magnitude comparison abilities of 7 deaf children and 14 hearing children aged 4-7 years (M = 69.90 months, SD = 11.42), were compared. To do so, neuropsychological assessments for school-aged children were adapted into Portuguese Sign Language. Significant group differences were found in abstract counting as well as in symbolic and nonsymbolic magnitude comparisons. These findings suggest that deaf children are less competent in these early numeracy skills than are their hearing peers.

Resumen La cognición de los sordos ha sido objeto de numerosos estudios que buscan comprender cómo los niños y adultos sordos procesan la información. Dichos estudios han demostrado que las personas sordas muestran diferencias en las habilidades numéricas y la función ejecutiva (FE), lo que podría ser la base de las diferencias conocidas en la forma en que las personas sordas aprenden y desarrollan sus habilidades cognitivas. Se han encontrado diferencias entre estudiantes sordos y oyentes en varias áreas de razonamiento numérico, en matemática y en la eficiencia en el procesamiento de representaciones numéricas como la comparación de magnitud. En las tareas de comparación de magnitud, los resultados dependían de si se estaban haciendo comparaciones simbólicas (números arábigos) o no simbólicas (puntos). En un estudio, los niños sordos fueron más lentos que sus compañeros oyentes en las tareas de comparación de magnitud simbólica, pero no en las tareas no simbólicas. Sin embargo, en un estudio más reciente, también se encontraron diferencias en las tareas no simbólicas. Se considera que la capacidad para comparar y discriminar grandes numerosidades depende del sistema numérico aproximado (ANS, Approximate Number System), un sistema cognitivo que se cree está gobernado por un circuito neuronal dentro del surco intraparietal. Los investigadores plantean la hipótesis de que el ANS subyace en cierta medida al desarrollo de la aritmética. Hay algunos datos que apoyan esta hipótesis: por ejemplo, las diferencias individuales en la agudeza del ANS se correlacionan positivamente con las habilidades numéricas y los logros futuros en matemática. Por otro lado, se ha encontrado un deterioro en la agudeza del ANS en niños con discapacidades de aprendizaje matemático. En consecuencia, los investigadores han propuesto que el ANS contribuye a la aparición de conceptos numéricos que los niños requieren para la competencia básica en el conteo y las comparaciones de magnitud simbólica. Otros han sugerido que la asociación entre la agudeza en la comparación de magnitud no simbólica y el rendimiento en matemática está moderada por factores de dominio general como las funciones ejecutivas (FE), en particular el control inhibitorio. En general, no está claro si existen diferencias en la agudeza de comparación de magnitud simbólica y no simbólica en niños sordos más pequeños y en qué medida se relacionan con las FE. El estudio actual examina la agudeza de las representaciones numéricas simbólicas y no simbólicas en niños sordos en edad preescolar e investiga la posible influencia del funcionamiento ejecutivo en estas habilidades matemáticas básicas. Se recolectaron datos de 21 niños portugueses del área de Lisboa, siete de los cuales eran sordos congénitamente y 14 tenían audición normal; los niños tenían entre 4 y 7 años de edad (M = 69.9 meses, DT = 11.42). Se seleccionaron tareas para medir lo siguiente: (a) FE, (b) memoria de trabajo, (c) lenguaje y (d) habilidades numéricas tempranas. Se empleó la tarea Shape School Task para evaluar FE. Se administró la versión portuguesa de la tarea de tapping de bloques de Corsi para evaluar la amplitud visuoespacial. Se desarrolló una tarea de comparación de puntos para examinar la capacidad de los niños de decidir instantáneamente cuál de las dos matrices de puntos es más grande utilizando el software Panamath. Se utilizaron dos tareas para evaluar la capacidad de los niños para producir palabras numéricas en un contexto cardinal y el Numeracy Screener para medir su capacidad para comprender la magnitud numérica simbólica. Los resultados indicaron que los niños sordos mostraron retrasos en las capacidades de comparación de magnitud simbólica y no simbólica. En las FE solo se encontraron diferencias en una tarea que implicaba una combinación de conmutación e inhibición; por lo demás, su función ejecutiva era comparable a la de los niños no sordos.

Representação social sobre a surdez: uma revisão integrativa / Social representation on deafness: an integrative review / Representación social sobre la sordera: una revisíon integradora

O presente estudo teve como objetivo realizar uma revisão integrativa da lite-ratura referente aos estudos científicos que envolvessem a representação social e a surdez. Para isso, realizou-se uma busca nas bases de dados SciELO.org, PePSIC, LILACS, PsycINFO (APA) e Scopus (Elsevier), por meio da plataforma Periódicos CAPES no mês de setembro do ano 2020. Os descritores foram: representação social, surdez, surdo e deficiente auditivo, na língua portuguesa, inglesa e espanhola. Foram analisados 11 artigos e com resultados acerca das populações surda e ouvinte. Nos artigos com pessoas surdas observam--se temáticas sobre identidade, cultura e direitos enquanto cidadãos para dirimirem e modificarem os estereótipos acerca da surdez. As pesquisas com os ouvintes foram realizadas com os familiares e a sociedade de modo geral, tendo como destaque representações baseadas em estereótipos negativos e aspectos limitantes. Ademais, sugerem-se novas produções cientificas que deem continuidade à teoria das representações sociais associadas com outros aspectos que envolvam a surdez e tenham como amostra, a comunidade surda.

The present study aimed to carry out an integrative review of the literature regarding scientific studies involving social representation and deafness. For this, a search was carried out in the databases SciELO.org, PePSIC, LILACS, PsycINFO (APA) and Scopus (Elsevier), through the platform Periodicals CAPES, in September 2020. The descriptors were: representation social, deaf, deaf and hearing impaired, in Portuguese, English and Spanish. Eleven articles were analyzed with abouth the deaf, and hearing populations. In the articles with deaf people, themes about identity, culture and rights as citizens are observed to resolve and modify stereotypes about deafness. Surveys with listeners were carried out with family members and society in general, highli-ghting representations based on negative stereotypes and limiting aspects. Furthermore, new scientific productions are suggested that give continuity to the theory of social representations associated with other aspects that involve deafness and have the deaf community as a sample.

El presente estudio tuvo como objetivo realizar una revisión integradora de la literatura sobre estudios científicos que involucran la representación social y la sordera. Para ello, se realizó una búsqueda en las bases de datos SciELO.org, PePSIC, LILACS, PsycINFO (APA) y Scopus (Elsevier), a través de la plataforma de Publicaciones CAPES, en septiembre de 2020. Los descriptores fueron: representación social, sordo, sordo y con discapacidad auditiva, en portugués, inglés y español. Se analizaron once artículos con resultados sobre la población sorda y auditiva. En los artículos con personas sordas se observan temas sobre identidad, cultura y derechos como ciudadanos para resolver y modificar estereotipos sobre la sordera. Se realizaron encuestas con los oyentes a familiares y sociedad en general, destacando representaciones basadas en estereotipos negativos y aspectos limitantes. Además, se sugieren nuevas producciones científicas que dan continuidad a la teoría de las representaciones sociales asociadas a otros aspectos que involucran la sordera y tienen como muestra a la comunidad sorda.

Exploiting Genetic Counseling as a Tool for the Analysis of Dissociative Behavior and Sub-normality from Conception to Birth among Maladjusted Blind, Deaf and Dumb Infants

This paper analyzes the dissociation behavior of children from pregnancy to birth and resultant sub-normality using genetic counseling in an attempt to mainstream children with birth disabilities and the challenges of the genetic counselor. Genetic counseling is a process of communication to provide information about a genetic condition, or inheritance, and support decision making and adjustment in families with the inheritance gene. It uses children that need special needs, the blind, deaf and dumb. Genetic counseling approach, re-affirmation, care and integration, and confidence-building institutionalized in school and family life remains some of the vital tools needed to support these children using genetic guidance and counseling as the best approach to adjusting the different maladaptive behavior of children. The genetic counseling approach includes information about the implications of testing positive for the genetic disorder, including the psychological impact and other consequences, whether to inform relatives of your intention to test, or not to test and the usual pattern of progression of the sub-normality identified tested for and its potential treatments. Thus, the paper seems to analyze sub-normality as classified within the adequacy of social adaptation. Analysis of dissociation behavior associated with sub mentality shows discouragement, contempt, and neglect from an early age, emotionally and maladjusted social growth. Therefore, the counselor must experience sub-normality by getting involved and clarifying their feeling toward the children with these disabilities.

Caracterización fenotípica de la retinitis pigmentaria asociada a sordera / Phenotypic characterization of retinitis pigmentosa associated with deafness

Introducción. El síndrome de Usher es una alteración genética caracterizada por la asociación de retinitis pigmentaria y sordera. Sin embargo, hay casos con familias en las cuales, a pesar de presentarse dicha asociación, no se puede diagnosticar un síndrome de Usher ni ninguno otro. Objetivo. Reevaluar fenotípicamente a 103 familias con diagnóstico previo de posible síndrome de Usher o retinitis pigmentaria asociada con sordera. Materiales y métodos. Se revisaron las historias clínicas de 103 familias con un posible diagnóstico clínico de síndrome de Usher o retinitis pigmentaria asociada con sordera. Se seleccionaron las familias cuyo diagnóstico clínico no correspondía a un síndrome de Usher típico. Los afectados fueron valorados oftalmológica y audiológicamente. Se analizaron variables demográficas y clínicas. Resultados. Se reevaluaron 14 familias cuyo diagnóstico clínico no correspondía al de síndrome de Usher. De las familias con diagnóstico inicial de síndrome de Usher típico, el 13,6 % recibieron uno posterior de "retinitis pigmentaria asociada con sordera" de "otro síntoma ocular asociado con hipoacusia',' o en forma aislada en una misma familia, de "retinitis pigmentaria" o "hipoacusia'.' Conclusiones. Es fundamental el estudio familiar en los casos en que la clínica no concuerda con el diagnóstico de síndrome de Usher típico. En los pacientes con retinitis pigmentaria asociada con sordera, el diagnóstico clínico acertado permite enfocar los análisis moleculares y, así, establecer un diagnóstico diferencial. Es necesario elaborar guías de nomenclatura en los casos con estos hallazgos atípicos para orientar a médicos e investigadores en cuanto a su correcto manejo.

Introduction: There are several syndromes that associate retinitis pigmentosa with deafness or hearing loss. The most frequent is Usher syndrome, a genetic disorder of autosomal recessive inheritance, which, in some cases, is accompanied by vestibular dysfunction. However, there are cases of families that despite having retinitis pigmentosa associated with deafness, cannot be classified as Usher or other syndromes due to additional findings. Objective: To reassess the phenotypes of 103 families previously diagnosed as possible Usher syndrome and/or retinitis pigmentosa associated with deafness. Materials and methods: We conducted a descriptive and retrospective study by reviewing the medical records of 103 families with a probable clinical diagnosis of Usher syndrome and/or retinitis pigmentosa associated with deafness. Families whose clinical diagnosis did not correspond to the typical Usher syndrome were selected and evaluated ophthalmologically and audiologically. Demographic and clinical variables were analyzed. Results: We selected and then reevaluated 14 families and 55 individuals as they did not correspond to a clinical diagnosis of Usher syndrome; 13.6% of the families initially considered to have typical Usher syndrome were later diagnosed with retinitis pigmentosa associated with deafness, another ocular symptom associated with hearing loss, retinitis pigmentosa, or isolated hearing loss in the same family. Conclusions: Family studies are essential in cases where the symptoms do not match the typical Usher' syndrome. In the cases of retinitis pigmentosa associated with deafness, a correct clinical diagnosis allows for focusing on the molecular analyses to establish a differential diagnosis. The need for nomenclature guidelines on these atypical findings is relevant to aid physicians and researchers in the best approach to these cases.

Current criteria for selecting cochlear implant in deaf patients: areview

Cochlear implantation is indicated in patients with severe to profound hearing loss that cannot be adequately treated by other auditory rehabilitation measures.The definitive indication of cochlear implantation is made on the basis of an extensive interdisciplinary clinical,audiological,radiological, and psychological diagnostic work-up.There are numerous changes are happening in cochlear implant candidacy.These have been associated with concomitant changes in surgical techniques,which enhanced the utility and safety of cochlear implantation.Currently, cochlear implants are approved for individuals with severe to profound unilateral hearing loss rather than previously needed for bilateral profound hearing loss.Studies have begun using the short electrode arrays for shallow insertion in patients with low-frequency residual hearing loss.The advancement in designs of thecochlear implant along with improvements in surgical techniques reduce the complications and result in the safety and efficacy of the cochlear implant which further encourages the use of these devices.This review article aims to discuss the new concepts in the candidacy of the cochlear implant,cochlear implant in younger children and hearing preservation,a cochlear implant for unilateral deafness,bilateral cochlear implant, and cochlear implant with neural plasticity and selection of patients for the cochlear implant.

Improvement of the visual acuity assessment system in deaf-mute children / 中华实验眼科杂志

Objective:To improve the visual acuity assessment system in deaf-mute children based on an original and fundamentally new chart for visometry.Methods:The study included 31 deaf-mute children (62 eyes) without previously diagnosed ocular pathology at the age of 2-11 years.Visometry was performed using standard Golovin-Sivtsev table (Russian: Таблица Головина-Сивцева) and a fundamentally new original technique Just Evident Images/Jonnazarov Eldor Ikhtiyorovich (abbreviated as JEI/JEI), including cards duplicating optotypes.The set of optotypes in the JEI/JEI chart consists of 13 color and black optotypes of various sizes, equal in width and height, which reflect well-known and easily recognized objects by children even at an early age.Results:When the results of visometry according to the Golovin chart and using the original technique coincided, which occurred in 16(51.6%) and 13(41.9%) cases, respectively, when determining the visual acuity of the right and left eyes, respectively, the effectiveness of both methods was evaluated as identical.In 15(48.4%) and 18(58.1%) cases, when examining the right eye and the left eye, respectively, the visometry data differed with a homogeneous trend: the indicator obtained using the JEI/JEI charts exceeded the same indicator when using the Golovin charts in the range of 0.1-0.4; and in the group of children aged 2-5 years -0.2-0.4.Conclusions:The results obtained indicate the prospects of using the JEI/JEI chart for visometry in deaf-mute children in clinical practice.The developed technique of duplicating optotypes with the help of special cards simplifies and enhances the effectiveness of visometry.

Developing and pre-testing of nutrition cartoon video to promote healthy eating among hearing and deaf and mute children

@#Introduction: A six-minute nutrition cartoon video “The Magical Pinggang Pinoy in Nutrilandia” was developed and pre-tested to encourage hearing and deaf and mute children to eat a variety of foods by following the Pinggang Pinoy® (Healthy Plate). This study described the development process of the nutrition cartoon video and explored the participants’ acceptance towards it. Methods: The video underwent two levels of pre-testing to ensure comprehensibility, attractiveness, acceptability, and self-involvement. The first level was conducted among three DOST-FNRI experts, while the second level was among six deaf-mute school teachers and 30 mothers/ caregivers of 6-9 years old hearing children. Data were collected through an online self-administered questionnaire. Open-ended questions allowed participants to express themselves freely on the given subjects. Data analysis used thematic analysis. Results: The video conveyed clear information on the Pinggang Pinoy®, and the inclusion of animation, subtitles, visuals, and voice-over made the video easier to understand. Participants stated that the message of the video was directed to children, teens, adults, malnourished people, and everyone in general. Pre-testing the nutrition cartoon video before final production identified terminologies and concepts that participants found unfamiliar, confusing and unacceptable; offered suggestions for improvement and made pre-tested video appropriate for hearing and deaf-mute children. Conclusion: Overall, the participants had positive perceptions on the nutrition cartoon video. The video can be used in nutrition education classes among hearing and deaf and mute children, and serves as a tool to measure children’s nutrition knowledge on healthy eating.

Barriers to utilization of sexual and reproductive health services among young deaf persons in Ghana

Despite significant progress made to improve access to sexual and reproductive health (SRH) services to the general populace in Ghana, information on the accessibility of such services to deaf persons is limited. This study investigated access to and utilization of SRH services among young female deaf persons in Ghana. Sixty deaf persons were interviewed from six metropolis/municipalities/districts in three regions of Ghana. The data were collected using focus group discussion and one-on-one interviews. The data were subjected to content analysis, leading to the identification of two broad themes. The study identified barriers at two levels: point of service delivery and barriers at the individual level. For instance, at the point of service delivery, they were claims that deaf women were victims of negative attitudes from health workers. The study concludes on the need for health policymakers to consider collaborating with the Ghana National Association of the Deaf in an effort towards designing inclusive SRH programmes.

Atendimento psicológico à pessoa surda por meio da Libras no Brasil: Uma revisão de literatura / Psychological assistance to the Deaf subject through Libras in Brazil: A literature review / Asistencia psicológica al sujeto sordo a través de Libras en Brasil: Una revisión de la literatura

A partir do modelo social, considera-se a deficiência um fenômeno interacional, emergente na relação entre o indivíduo e o seu meio. Assume-se a saúde mental como um direito humano, sendo dever do Estado e da comunidade os esforços para inclusão de todos os cidadãos. A pesquisa almejou verificar se a Psicologia tem se debruçado sobre a inclusão da pessoa surda, se há registros acadêmicos de atendimento em língua brasileira de sinais (Libras) e se a fluência dos psicólogos é suficiente para realizá-lo. A metodologia baseou-se numa revisão sistemática da literatura científica e numa análise bibliométrica e qualitativa dos dados. A partir dos resultados, é possível enxergar um crescente movimento de atendimento psicológico a pessoas surdas com uso da Libras desde 2015. Entretanto, considera-se necessária uma maior proximidade dos profissionais da psicologia clínica com a Libras e a cultura surda.

From the social model, disability is considered an interactional phenomenon, emerging in the relationship between the individual and his environment. Mental health is assumed to be a human right, and it is the duty of the state and the community to endeavor to include all citizens. The research aimed to verify if Psychology has been focusing on the inclusion of the Deaf, if there are academic records of attendance in Brazilian sign language (Libras) and if the fluency of the psychologists is sufficient to carry it out. The methodology was based on a systematic review of the scientific literature, and on a bibliometric and qualitative analysis of the data. Based on the results, it is possible to see a growing movement for psychological assistance to deaf people using Libras since 2015. However, it is considered necessary to bring professionals from clinical psychology closer to Libras and deaf culture.

Desde el modelo social, la discapacidad se considera un fenómeno de interacción, emergiendo en la relación entre el individuo y su entorno. Se asume que la salud mental es un derecho humano y es deber del Estado y de la comunidad esforzarse por incluir a todos los ciudadanos. La investigación tuvo como objetivo verificar si la Psicología se ha centrado en la inclusión de la persona sorda, si existen registros académicos de asistencia en lengua de signos brasileña (Libras) y si la fluidez de los psicólogos es suficiente para llevarla a cabo. La metodología se basó en una revisión sistemática de la literatura científica y en un análisis bibliométrico y cualitativo de los datos. Con base en los resultados, es posible ver un movimiento creciente de asistencia psicológica a las personas sordas que usan Libras desde 2015. Sin embargo, se considera necesario acercar a los profesionales de la psicología clínica a Libras y la cultura sorda.

Implantes cocleares: prioridad para niños con pérdida sensorial dual en Cuba / Cochlear implants: priority for children with dual sensory loss in Cuba

RESUMEN Fundamento: desde el año 2005 se crea el Programa Cubano de Implantes Cocleares para niños sordos y sordociegos, con prioridad para niños con pérdida sensorial dual. Objetivo: describir el comportamiento de la pérdida sensorial dual en niños del Programa Cubano de Implantes Cocleares. Métodos: se realizó un estudio observacional, descriptivo, retrospectivo de niños con pérdida sensorial dual que recibieron implante coclear entre febrero de 2005 y marzo de 2013 en Cuba. De las historias clínicas y la base de datos del programa fue obtenida la información que permitió elaborar el informe. Con antelación, se ilustran los primeros resultados sobre neuroplasticidad obtenidos con potencial evocado somatosensorial de nervio mediano realizado con parte del protocolo de estudio de investigación preimplante coclear en el Programa Cubano de Implantes Cocleares. Resultados: con el programa se han beneficiado 27 niños con pérdida sensorial dual con implantes cocleares, con cobertura a todas las provincias del país. Seis niños presentaron una enfermedad asociada, predominaron los factores pre/peri-natales y el síndrome de Usher como principales agentes causales de la sordoceguera. La pérdida auditiva fue prelocutiva en 24 niños, confirmada y caracterizada mediante electroaudiometría. Los estudios de imágenes de oídos no mostraron malformaciones. La implantación fue unilateral, sobre todo el oído derecho, sin complicaciones quirúrgicas en ninguno de los niños. Mientras que el estudio de neuroplasticidad evidencia reorganización cortical somestésica en niños con pérdida sensorial dual. Conclusiones: el Programa Cubano de Implantes Cocleares ha logrado un trabajo sostenido en la evaluación e implantación de niños con pérdida sensorial dual, distinguiéndose la investigación sobre neuroplasticidad, la cual ha dado evidencias de representación cortical somestésico preimplante coclear en estos niños. Ello será útil para evaluar la reorganización cortical post-implante coclear y correlacionarlo con el aprovechamiento del uso del implante coclear.

ABSTRACT Background : since 2005 the Cuban Cochlear Implant Program for deaf and deaf-blind children has been created, with priority for children with dual sensory loss. Objective: is to describe the work of the Cuban Cochlear Implant Program with children with dual sensory loss. Methods : a descriptive, retrospective study of children with dual sensory loss who received a cochlear implant between February 2005 and March 2013 in Cuba. The information to conform this descriptive report was obtained from the clinical histories and the database of the program; it also illustrates the first results on neuroplasticity obtained with the somatosensory evoked potential of the median nerve carried out with part of the pre-cochlear implant research study protocol in the Cuban Cochlear Implant Program. Results : the program has benefited 27 children with dual sensory loss with cochlear implants, covering all provinces of the country. Six children presented an associated pathology, with pre/peri-natal factors and Usher Syndrome as the main causal agents of deaf-blindness. Hearing loss was pre-lingual in 24 children, confirmed and characterized by electro-audiometry. No malformations were found in the ear images. The implantation was unilateral, mostly the right ear, without surgical complications in all the children. While the neuroplasticity study shows somesthetic cortical reorganization in children with dual sensory loss. Conclusions : the Cuban Cochlear Implant Program has achieved sustained work in the evaluation and implantation of children with dual sensory loss, a distinctive aspect being the research on neuroplasticity, which has provided evidence of somesthetic cortical representation pre-cochlear implantation in these children. This will be useful to assess cortical reorganization post- cochlear implant and correlate it with the use of the cochlear implant.

Un relato de la educación de estudiantes sordos en el municipio de Chapecó (SC) / Um relato da educação de estudantes surdos no município de chapecó (sc) / A report about the education of deaf students in the city of chapecó (sc)

Este artigo objetiva evidenciar a educação de surdos no município de Chapecó (SC), explicitando os fundamentos teóricos estruturantes e os processos de formação docente para esta especificidade no período de 1996 a 2016. A pergunta que orientou a investigação assim se constitui: Como a educação de surdos foi desenvolvida de 1996 a 2016 na rede municipal de educação de Chapecó e quais os fundamentos teóricos estruturantes nos processos de formação docente? A pesquisa se caracteriza como qualitativa numa perspectiva pós-estruturalista. Participaram do estudo três secretários municipais de educação que exerceram a função por maior tempo em cada gestão municipal do período pesquisado. Além de pesquisa documental, foram realizadas entrevistas semiestruturadas, gravadas, transcritas e organizadas em agrupamentos temáticos. As materialidades empíricas foram examinadas por meio da análise do discurso com referenciais foucaultianos. O estudo evidencia que em cada tempo são instituídas verdades acerca da educação de surdos e que abordagens teórico-metodológicas, adotadas em contextos históricos e geográficos mais amplos, se manifestam também na região investigada.

En este artículo se tiene como objetivo evidenciar la educación de sordos en el municipio de Chapecó (SC), explicitando los fundamentos teóricos estructurantes y los procesos de formación docente para esta especificidad en el período de 1996 a 2016. La pregunta que orientó la investigación fue: ¿Cómo la educación de sordos fue desarrollada de 1996 a 2016 en la red municipal de educación de Chapecó y cuáles son los fundamentos teóricos estructurantes en los procesos de formación docente? La investigación se caracteriza como cualitativa en una perspectiva posestructuralista. Participaron del estudio tres secretarios municipales de educación que ejercieron la función por más tiempo en cada gestión municipal del período investigado. Además de investigación documental, se realizaron entrevistas semiestructuradas, gravadas, transcriptas y organizadas en grupos temáticos. Las materialidades empíricas se examinaron por intermedio del análisis del discurso con referenciales foucaultianos. El estudio evidencia que en cada tiempo son instituidas verdades acerca de la educación de sordos y que abordajes teórico-metodológicas, adoptadas en contextos históricos y geográficos más amplios, se manifiestan también en la región investigada.

This article aims to highlight the education of the deaf in the city of Chapecó (SC), explaining the structural theoretical foundations and the processes of teacher education for this specificity in the period 1996 to 2016. The question that guided the investigation is: How was the education for the deaf developed from 1996 to 2016 in the municipal education network of Chapecó and what are the structuring theoretical foundations in teacher training processes? The research is characterized as qualitative in a post-structuralist perspective. Three municipal education secretaries participated in the study, who exercised the function for the longest time in each municipal administration during the researched period. In addition to documentary research, semi-structured interviews were conducted, recorded, transcribed and organized into thematic groups. The empirical materialities were examined through discourse analysis with Foucaultian references. The study shows that truths about deaf education are established at each time and that theoretical-methodological approaches, adopted in broader historical and geographical contexts, are also manifested in the investigated region.

Formación de Profesores de Lengua Portuguesa en la Perspectiva de la Educación de Sordos / Portuguese Language Teachers' Education on the Perspective of Education of the Deaf

RESUMEN: Las dificultades de las personas sordas en la lengua portuguesa escrita y del docente en su enseñanza, sumadas a la escasez de investigaciones en el área, hacen relevante la revisión de estrategias en el proceso de formación docente. Se trata de una investigación cualitativa y cuantitativa con 16 profesores de los últimos años de Educación Primaria y Secundaria de la lengua portuguesa de la red de escuelas públicas que trabajaron con estudiantes Sordos en algún momento de su experiencia docente. Fueron seleccionados 8 profesores de la Educación Inclusiva y 8 de una escuela Bilingüe para Sordos. Se utilizó el software NVivo10 para el análisis de datos. En la formación inicial, los docentes no tuvieron contacto con la Lengua de Señas ni estrategias metodológicas específicas para la enseñanza de Sordos. En la educación continua, la enseñanza más eficaz fue la de otros profesores con más experiencia. Destaca una dicotomía entre los profesores de las escuelas inclusivas y los de la escuela bilingüe para Sordos, donde los primeros utilizam la Lengua Brasileña de Señales - Libras como una lengua accesoria para la enseñanza del portugués escrito, ya, los docentes de la escuela bilíngue la utilizan como lengua de instrucción con el uso del metalenguaje. En cuanto a las concepciones, los docentes sugirieron algunas prácticas en formación para trabajar con el público Sordo. Por tanto, es fundamental invertir en escuelas inclusivas y bilingües que trabajen con estudiantes Sordos, así como en la formación continua de los docentes, proponiendo grupos de estudio con todo el equipo pedagógico como parte del proceso de formación.

ABSTRACT: The difficulties of the deaf in written Portuguese and of the teacher in teaching, added to the scarcity of research in the area, make the revision of strategies in the process of teacher training relevant. This is a qualitative and quantitative research with 16 teachers from the last years of Elementary and High School of Portuguese language in the public-school network who worked with deaf students at some point in their teaching experience. Eight teachers from Inclusive Education and eight from a Bilingual School for the Deaf were selected. NVivo10 software was used for data analysis. In the initial training, the teachers did not have contact with Sign Language or specific methodological strategies for teaching the Deaf. In continuing education, the most effective teaching was that of other, more experienced teachers. There is a dichotomy between teachers from inclusive schools and those from the bilingual school for the deaf, where the former use the Brazilian Sign Language as an accessory language for the teaching of written Portuguese, whereas teachers in the bilingual school use it as the language of instruction with the use of metalanguage. Regarding the conceptions, the teachers suggested some training practices to work with the Deaf audience. Therefore, it is essential to invest in inclusive and bilingual schools that serve deaf students, as well as in the continued training of teachers, proposing study groups with the entire pedagogical team as part of the training process.

Effect of oral health education on oral health of deaf-mute students / 上海预防医学

Objective:This study was to explore the effect of HBM-based education and to help establish the measures on improving oral health status in deaf-dumb students. Methods:A total of 152 students aged 9-18 from two deaf-mute schools in Jing'an District， Shanghai were selected. The study subjects were randomly assigned to either experimental or control group. Students in the control group received oral health education with sign language every 6 months， and students in the experimental group received oral health education based on HBM. Before and two years after the intervention， data were collected by oral examinations and questionnaires. SPSS 22.0 software package was used for statistical processing of the data. Results:Before the intervention， there was no significant difference between the control group and the experimental group in caries rate， soft scale detection rate， calculus detection rate， caries average， debris index and calculus index. After the intervention， the caries rate （47.3% vs 68.5%）， soft scale detection rate （77.0% vs 91.8%）， and calculus detection rate （37.8% vs 58.9%） in the experimental group were all significantly （P<0.05） lower than those in the control group. After the intervention， caries average， debris index and calculus index in the experimental group were 1.93±2.25， 0.55±0.45， and 0.37±0.50， respectively， while the corresponding values in the control group were 2.82±3.24， 1.17±0.47， and 0.41±0.44. The difference in debris index between two groups was statistically significant （P<0.05）. Conclusion:Oral health education for deaf-mute students based on Health Belief Model（HBM）shows a good effect on improving the oral health. Further oral health education as well as the implementation of intervention measures such as using local fluoride， pit and fissure sealing， and early dental caries filling， are needed to effectively control the occurrence and development of dental caries in deaf-mute students.

Acessibilidade Linguística de Surdos no Ensino Superior: Reflexões Sobre o Curso de Letras Libras/Língua Portuguesa da Universidade Federal do Rio Grande do Norte / Linguistic Accessibility for Deaf People in Higher Education: Reflections about the Brazilian Sign Language/Portuguese Language Undergraduate Course of the Federal University of Rio Grande do Norte

RESUMO: Este trabalho teve como objetivo conhecer quais ações concernentes à acessibilidade linguística da Pessoa Surda foram implementadas pelo Curso de Letras Libras/Língua Portuguesa (CLLLP) da Universidade Federal do Rio Grande do Norte (UFRN). A construção deste estudo ocorreu com base nos dados elaborados durante a pesquisa de Mestrado intitulada Estudantes Surdos no Ensino Superior: reflexões sobre a inclusão no curso de Letras-Libras/Língua Portuguesa da UFRN. Mais especificamente, empenhamos esforços em lançar um olhar para a categoria "acessibilidade linguística" que foi construída a partir de uma entrevista em Libras com sete estudantes surdos do curso. Para tanto, entremeamos as ações voltadas à acessibilidade linguística dos surdos envolvendo o curso de LLLP com os discursos desses sujeitos. Desse modo, orientamos nossas discussões teóricas considerando as raízes históricas da Educação de Surdos, dos Estudos Surdos, da Políticas Linguísticas e dos Estudos Culturais. Finalmente, observamos a importância de considerar as devolutivas dos surdos acerca das ações promovidas pelo CLLLP para oportunizar a efetivação do direito linguístico da Pessoa Surda em todos os espaços da universidade. E, ainda, da necessidade de um movimento de reflexão constante para o engendramento de estratégias institucionais que contribuam para o enfrentamento dos desafios de implementação da acessibilidade linguística e, por conseguinte, assegurem o acesso e a permanência com qualidade do Surdo no Ensino Superior.

ABSTRACT: This work aimed to know which actions concerning the linguistic accessibility for deaf people have been implemented by the Brazilian Sign Language/Portuguese Language Undergraduate Course (Curso de Letras Libras/ Língua Portuguesa - CLLLP) of the Federal University of Rio Grande do Norte (Universidade Federal do Rio Grande do Norte - UFRN). The construction of this study was based on data elaborated during the Master's research entitled 'Deaf Students in Higher Education: reflections on the inclusion in the Brazilian Sign Language/Portuguese Language Undergraduate Course at UFRN'. More specifically, we endeavor to glance at the "linguistic accessibility" category that was built from an interview in Brazilian Sign Language with seven deaf students from the course. To this end, we interweave actions aimed at the linguistic accessibility of the deaf involving the CLLLP course with the speeches of these subjects. In this way, we guide our theoretical discussions considering the historical roots of the Deaf Education, Deaf Studies, Linguistic Policies and Cultural Studies. Finally, we observed the importance of considering the feedback of the deaf about the actions promoted by CLLLP to provide opportunities for the deaf person's linguistic rights to be implemented in all spaces of the university. And, still, the need for a constant reflection movement to generate institutional strategies that contribute to face the challenges of implementing linguistic accessibility and, therefore, ensure the access and permanence with quality of the Deaf in Higher Education.