Voice Disorder, Job Stress, and COVID-19 in Teachers: Impacts in Times of Pandemic

Introduction: The conditions of teachers' work during the COVID-19 pandemic affected teachers' lives regarding voice disorder and stress, even in emergency remote classroom situation. Objective: To analyze the relationship between the presence of voice disorder, job stress, and COVID-19 in teachers when in emergency remote classroom teaching situation at the time of the pandemic. Method: This is a primary, exploratory, observational cross-sectional study with the use of survey forwarded online during the period of emergency classes after the arrival of COVID-19 pandemic in Brazil. The teachers answered the sociodemographic questions about the presence of COVID-19 and the following instruments: Condition of Vocal Production-Teacher [Condição de Produção Vocal - Professor (CPV-P)], Screening Index for Voice Disorder (SIVD), and Job Stress Scale (JSS). Results: Of the 118 teachers analyzed, 94.1% were female; the average age was 44 years. The SIVD recorded the presence of voice disorder in 66.9% of the participants. Regarding the JSS, which are the findings related to stress at work in the demand domain, the teachers showed high levels, a fact which presupposes the existence of pressure of psychological nature to perform their work. Conclusion: The teachers self-reported the presence of voice disorder even in remote class situation, on the occasion of COVID-19, which were more common in older teachers. When comparing the presence of voice disorders, coronavirus symptoms, and stress domains in relation to demand, control, and social support, there was no significance. It is hoped that this study will help to reflect on the need to improve teachers' working conditions, strengthening work-related voice disorder actions and guiding actions for vocal care and well-being.

Introducción: Las condiciones de trabajo de los profesores durante la pandemia de COVID-19 afectaron sus vidas en lo que respecta al trastorno de la voz y el estrés, incluso en situaciones de emergencia en aulas remotas. Objetivo: Analizar la relación entre la presencia de trastorno de la voz, estrés laboral y COVID-19 en profesores cuando se encontraban en situación de emergencia de enseñanza en aulas remotas en la época de la pandemia. Método: Se trata de un estudio primario, exploratorio, observacional de tipo transversal, con el uso de encuesta remitida online durante el periodo de clases de emergencia tras la llegada de la pandemia de COVID-19 en Brasil. Los profesores respondieron a las preguntas sociodemográficas sobre la presencia de COVID-19 y a los siguientes instrumentos: Condición de Producción Vocal-Profesor (CPV-P), Índice de Detección de los Trastornos de la Voz (SIVD) y Escala de Estrés Laboral (JSS). Resultados: De los 118 profesores analizados, el 94,1% eran mujeres; la mediana de edad era de 44 años. El (SIVD) registró la presencia de trastorno de la voz en el 66,9% de los participantes. En cuanto a la JSS, que son los hallazgos relacionados con el estrés laboral en el dominio de la demanda, los profesores mostraron niveles elevados, hecho que presupone la existencia de presiones de naturaleza psicológica para realizar su trabajo. Conclusión: Los profesores autoinformaron de la presencia de trastornos de la voz incluso en situación de clase a distancia, con ocasión del COVID-19, que fueron más frecuentes en los profesores de más edad. Al comparar la presencia de trastornos de la voz, los síntomas del coronavirus y los dominios de estrés en relación con la demanda, el control y el apoyo social, no hubo resultados significativos. Se espera que este estudio ayude a reflexionar sobre la necesidad de mejorar las condiciones de trabajo de los docentes, fortaleciendo las acciones de Trastorno de la voz relacionado con el trabajo (WRVD) y orientando acciones para el cuidado y bienestar vocal.

Vocal Load of University Professors: Preliminary Results

Purpose: To describe the acoustic characteristics of a classroom, voice quality, fatigue, and vocal load of university professors. Methods: Exploratory, observational, longitudinal, and descriptive study with a single group of participants, including vocal monitoring data over two weeks. Acoustic characterization of the classroom, perceptual-auditory evaluation, and acoustic analysis of voice samples were conducted before and after classes. Vocal dosimetry was performed during classes, and the Vocal Fatigue Index (VFI) was assessed at the beginning of each week. Descriptive analysis of the findings was conducted, and randomization test was performed to verify the internal reliability of the judge. Results: All participants reported speaking loudly in the classroom, with the majority reporting vocal changes in the past six months, and only one participant reported a current vocal change. The classroom had acoustical measures and estimations that deviated from established standards. The professors used high vocal intensities during classes. After the classes, an increase in the absolute values of the aggregated data for CAPE-V, jitter, and fundamental frequency was found, varying within the range of normality. Furthermore, there was an observed increase in both post-lesson intensity and VFI when comparing the two-week period. Conclusions: Vocal intensities and VFI were possibly impacted by the acoustics of the classroom. The increase in average VFI between the weeks may be attributed to a cumulative fatigue sensation. Further research with a larger number of participants and in acoustically conditioned classrooms is suggested in order to evaluate collective intervention proposals aimed at reducing the vocal load on teachers.

Objetivo: Describir las características acústicas, calidad vocal, fatiga y carga vocal de profesores universitarios. Métodos: Estudio exploratorio, observacional, longitudinal, descriptivo con un solo grupo de participantes y datos de monitoreo vocal durante dos semanas. Se realizó caracterización acústica de la sala, evaluación auditiva-perceptiva y acústica de muestras de voz antes y después de las clases. Se realizó dosimetría vocal durante las clases y se verificó el Índice de Fatiga Vocal (IFV) en dos semanas. Se realizó un análisis descriptivo de los hallazgos y una prueba de aleatorización para verificar la confiabilidad interna del juez. Resultados: Todos los participantes informaron hablar en voz alta en clase, la mayoría informó cambios vocales en los últimos seis meses y solo uno informó cambios vocales actuales. La sala presentó mediciones y estimaciones acústicas fuera de las normas establecidas. Los profesores utilizaron intensidades vocales altas durante las clases. Hubo un aumento en los valores absolutos de los datos agrupados para CAPE-V, jitter y frecuencia fundamental, variando dentro de los límites normales, después de las clases. La intensidad después de las clases y el IFV, en la comparación entre las dos semanas, mostraron un aumento. Conclusiones: La dosis vocal y el IFV posiblemente se vieron afectados por la acústica del aula. El aumento del IFV medio entre semanas pudo deberse a la sensación de cansancio acumulada. Se sugieren nuevas investigaciones con un mayor número de participantes y que se realicen en la sala acondicionada acústicamente para evaluar propuestas de intervención colectiva, con el objetivo de reducir la carga vocal de los docentes.

Distúrbio de Voz Relacionado ao Trabalho: um olhar sobre o passado, o presente e o futuro / Work-Related Voice Disorder: a look at the past, present, and future

Resumo Introdução: o Distúrbio de Voz Relacionado ao Trabalho (DVRT) é um agravo de elevada prevalência, especialmente em professores. Em 2018, o Ministério da Saúde (MS) publicou o Protocolo DVRT, visando orientar sua identificação e notificação, de modo a subsidiar ações de vigilância sobre seus determinantes. Objetivo: sintetizar história, resultados de debates e reflexões acerca do DVRT no Brasil, desafios enfrentados e caminhos futuros para a formalização do seu reconhecimento. Método: ensaio teórico, realizado a partir de revisão de literatura, documentos e registros de participação dos atores sociais no processo de reconhecimento do DVRT. Resultados: a busca do reconhecimento do DVRT percorreu uma trajetória não linear, destacando-se três fases: elaboração de protocolos e formalização preliminar do DVRT; internacionalização das discussões; e inclusão do DVRT na nova lista de doenças relacionada ao trabalho do MS, seguida de revogação e repristinação. Conclusão: o processo de busca de reconhecimento do DVRT se transformou em um "imbróglio político-social", desdobrando-se em iniciativas do Poder Legislativo e do Conselho Nacional de Saúde e no reconhecimento nos estados da Bahia e do Espírito Santo. Desafios surgiram com as mudanças no mundo do trabalho, implementação de linhas de cuidado e capacitação profissional para o manejo do DVRT.

Abstract Introduction: Work-Related Voice Disorder (WRVD) is a highly prevalent condition, especially among teachers. In 2018, the Brazilian Ministry of Health (BMH) issued the WRVD Protocol to its identification and reporting as a means to subsidize health surveillance actions. Objective: to summarize the history, debate outcomes, challenges, and reflections about WRVD in Brazil. Methods: theoretical essay based on a literature review, documents, and records of social actors' involvement in the WRVD recognition process. Results: WRVD recognition followed a cumbersome trajectory comprising three phases: Protocol design and initial WRVD recognition; Improvement of exchanges with international communities; WRVD classification as a work-related disease (WRD), decision that was later repealed and then repristinated. Conclusion: WRVD recognition process unfolded into a "sociopolitical imbroglio," prompting initiatives by the Legislative Branch and the Brazilian National Health Council, and its recognition by the Bahia and Espirito Santo states. Challenges arose following changes in work, implementation of healthcare paths, and professional training for managing WRVD.

Drying, Physical, Nutritional and Bioactive Characteristics of Apple Peel Flour Subjected to Blanching and Ultrasound Pretreatments.

The aim of this work was to study the effect of blanching and ultrasound pretreatments on drying and quality characteristics of apple peel. Blanching was conducted in boiling water, ultrasound in a water bath, and drying in a batch tray dryer. The product obtained was ground into a flour, and assessed for color, water activity, proximate composition, sugars, and bioactive compounds. Results showed that effective moisture diffusivity increases with a decrease in product moisture content, being such dependence well described by a second order polynomial model. Average drying rate was higher and product moisture content was lower for blanched and sonicated flour, especially for the former. Such result suggests that blanching and ultrasound enhance water removal during drying of apple peel. Physical properties were significantly affected by pretreatments, being more intense red color and lower water activity obtained for sonicated flour. Nutritional and bioactive properties were also significantly affected by pretreatments, being lower sugar, higher protein, fiber, catechin and epicatechin content observed for blanched flour. Summarizing, blanching and ultrasound pretreatments improve drying of apple peel, both regarding process efficiency and product quality.

Linking geographical origin with nutritional, mineral, and visual proprieties of pinhão (Araucaria angustifolia seed) from the south of Brazil.

The effect of harvest location on cooked pinhão seeds (Araucaria angustifolia) was investigated with regard to its centesimal composition, minerals, and color, and later correlated with environmental and soil variables. Significant differences between cooked pinhão from various harvesting locations were seen; also, principal component analysis was performed for the minerals, protein, moisture, total starch, and color parameters. The geographic location was one of the most important factors. Caçador presented greater differences: lower values for moisture, minerals, geographic parameter, and color characteristics. However, nearby localities, such as Cruz Machado with Bituruna and Lapa with São João do Triunfo, presented similar overall values for minerals and geographic parameters. Each regional geographic location was able to present unique characteristics so that the principal component analysis categorized it in specific quadrants, which is also in agreement with the CIELAB color space. However, hierarchical tree exhibited that CAÇ was the most distinct, due to the most distant municipality, presenting a unique microbiome. The pinhão is a source of various nutrients, which contributes to healthy dietetic daily values. It provides from 20% to 30% of dietary fiber, Cu (42.2%), P (31.1%), K (23.5%), and Zn (22.1%), while also providing quantities of Mg (12.9%), Mn (12.4%), Fe (11.5%), and Ca (6.4%). Therefore, it is possible to obtain food products based on cooked pinhão that contain many nutritional components associated with human health benefits. PRACTICAL APPLICATION: The pinheiro-do-paraná is a conifer that is currently endangered. However, the commercial use of its seeds may be key to guaranteeing its preservation, in addition to strengthening the economies of households and small producers. The pinhão collected from a large area of Araucária forests, after subsequent boiling, removal of the almond, grinding, and freezing provides large amounts of carbohydrates, higher dietary fiber content, resistant starch, and large quantities of Cu, P, K, and Z, in addition to significant amounts of Mg, Mn, Fe, and Ca. All of these are desirable characteristics that increase the value of pinhão.

O uso da voz nos rituais indígenas Pankararu / The use of voice in Pankararu indigenous rituals / El uso de la voz en los rituales indígenas Pankararu

Introdução: a voz é essencial para preservação e manutenção da cultura de grupos sociais. O povo Pankararu, vincula sua língua-mãe aos rituais religiosos. A principal forma de transmitir a tradição oral é através dos cantos nos rituais dos Praiás. Objetivo: resgatar o uso de voz pelos cantadores Pankararu no ritual dos Praiás, à luz do saber tradicional e científico. Método: estudo qualitativo, do tipo história de vida, autobiográfica, no qual foram acessadas memórias individuais e coletivas da comunidade Pankararu, considerando a caracterização do povo, do ambiente e o uso de voz nos rituais. Resultados: os cantadores utilizam a voz de maneira intensa e contínua, sem hidratação, e fumam cachimbo durante o ritual. O local onde cantam é um terreiro, espaço aberto, exposto às intempéries da natureza, com presença de poeira. Para cuidar da voz, baseiam-se no saber tradicional, apresentando uma visão distinta do conhecimento científico, no qual a voz representa sua cultura e identidade. Nesta perspectiva, hábitos descritos pela literatura como deletérios, são considerados saudáveis, demonstrando uma concepção singular de saúde. Conclusão: o conhecimento científico, paralelamente ao tradicional, poderá contribuir para estabelecimento de cuidados que visem à saúde vocal dos Pankararus.  Poderei oferecer ao meu povo, o qual apresenta demandas de saúde, conhecimentos científicos proporcionando uma melhor qualidade de voz e vida.

Introduction: The voice is essential for the preservation and maintenance of the culture of social groups. The Pankararu people link their mother language to religious rituals. The main way of transmitting the oral tradition is through singing in the rituals of Praiás. Objective: To rescue the use of voice by Pankararu singers in the Praiás ritual, considering the traditional and scientific knowledges. Method: Qualitative study, history life, autobiography design, which individual and collective memories of the Pankararu community were accessed, considering the characterization of the people, environment, and voice use in the rituals. Results: The singers use their voices intensely and continuously, without hydration, and smoking pipes during the ritual. The "terreiro" is the place where they sing, an open space, exposed to wuthering and dust. They are based on traditional knowledge for taking care of their voices, in a different view of scientific knowledge, in which voice represents their culture and identity. In this perspective, habits described in the literature as harmful are considered healthy, demonstrating a unique conception of health. Conclusion: Scientific knowledge, in parallel with the traditional one, can contribute to establish care aimed at the vocal health of the Pankararus. I will be able to offer to my people, who have health demands, scientific knowledge providing a better quality of voice and life.

Introducción: la voz es fundamental para la preservación y mantenimiento de la cultura de los grupos sociales. La gente de Pankararu, vincula su lengua materna a los rituales religiosos. La principal forma de transmitir la tradición oral es a través del canto en los rituales de Praiás. Objetivo: rescatar el uso de la voz de los cantantes de Pankararu en el ritual Praiás, a la luz de los conocimientos tradicionales y científicos. Método: estudio cualitativo, del tipo de historia de vida; Se accedió a las memorias individuales y colectivas de la comunidad Pankararu, considerando la caracterización de las personas, el entorno y el uso de la voz en los rituales. Resultados: los cantantes utilizan sus voces de forma intensa y continua, sin hidratarse, pipas de humo durante el ritual. El lugar donde canta el terreiro, un espacio abierto, expuesto a la intemperie de la naturaleza, con presencia de polvo. Para cuidar la voz, se basan en los conocimientos tradicionales, presentan una visión diferente del conocimiento científico, donde la voz representa la cultura y la identidad. En esta perspectiva, los hábitos descritos en la literatura como nocivos, se consideran saludables, demostrando una concepción única de la salud. Conclusión: El conocimiento científico, además del conocimiento tradicional, puede contribuir al establecimiento de cuidados dirigidos a la salud vocal de los Pankararus. Podré ofrecer a mi gente, que tiene demandas de salud, conocimientos científicos que brinden una mejor calidad de vida.

Distúrbio de Voz Relacionado ao Trabalho: atividades desenvolvidas por fonoaudiólogos em Centros de Referência em Saúde do Trabalhador (CEREST) / Voice Disorders Related to Work: activities developed by speech therapists in Workers' Health Reference Centers (CEREST)

Resumo Introdução: a publicação do Protocolo de Distúrbio de Voz Relacionado ao Trabalho (DVRT) reforçou o papel dos Centros de Referência em Saúde do Trabalhador (CEREST) na atenção a esse agravo. Objetivo: descrever as atividades desenvolvidas por fonoaudiólogos nos CEREST, de acordo com assistência prestada e fatores associados aos distúrbios vocais. Métodos: estudo descritivo com dados fornecidos por coordenadores dos CEREST em todo o Brasil, que foram contatados via e-mail para responder questionário semiestruturado, desenvolvido com ferramenta de formulários online. Os dados foram coletados de abril de 2017 a fevereiro de 2018. Resultados: dos 195 coordenadores contatados, 93 (44,2%) responderam ao questionário. Desses, 39 informaram contar com fonoaudiólogos nos CEREST. Em 26 CEREST, havia atuação da fonoaudiologia em distúrbios de voz, com ações que incluíam palestras, orientações e visitas aos locais de trabalho. Os profissionais da voz mais frequentemente atendidos foram docentes (n=24), teleoperadores (n=16) e radialistas (n=15). Entre os fatores identificados na ocorrência de distúrbios de voz, predominaram os relacionados ao ambiente de trabalho (n=24). Conclusão: em menos da metade dos CEREST foi relatada a presença de fonoaudiólogos. Comparado com levantamento anterior, percebe-se uma maior participação do fonoaudiólogo nos CEREST, especialmente no que se refere à atuação junto ao DVRT.

Abstract Introduction: the work-related voice disorder (WRVD) protocol publication reinforced the Reference Centers for Occupational Health (CEREST) role in this disorder care. Objective: to describe speech therapist activities developed at CEREST according to the assistance it provides and factors associated with voice disorders. Methods: descriptive study with data obtained from CEREST coordinators in Brazil, contacted via e-mail to answer a semi-structured questionnaire, developed using an online form tool. Data were collected from 2017 April until 2018 February. Results: of the 195 coordinators contacted, 93 (44.2%) answered the questionnaire. Of these, 39 reported receiving speech therapists. Among these, 26 CEREST worked with voice disorders, giving lectures, guidance, and visits to the workplace. The professionals who often received greater attention were teachers (n=24), telemarketers (n=16), and radio announcers (n=15). Of the factors we found to cause voice disorders, those related to work environment stood out (n=24). Conclusion: speech therapists were present in less than half of all CEREST. Compared with a previous survey, we found that the speech therapists' participation has become more present in CEREST, especially caring with WRVD.

Impact of Foam-Mat Drying on Plant-Based Foods Bioactive Compounds: a Review.

Plant-based foods are recognized by their remarkable content of bioactive compounds. In an attempt to increase plant-based foods shelf-life, technologies like drying can be used. Foam-mat drying is a mild drying technology that removes water, usually by using hot air, from a foam obtained by the whipping of a liquid or semi-liquid food added with a foaming agent. There are several reports on the use of foam-mat drying for extending plant-based foods shelf-life, including reports on the effect of drying on their bioactive compounds. Therefore, this study aimed at reviewing the literature on the impact of foam-mat drying on plant-based foods bioactive compounds published in the last 10 years. Results show that short foam-mat drying time is beneficial to bioactive compounds retention. In addition, hot air temperature between 40-65 °C, foam thickness between 0.2 and 1 cm and the use of egg white as one of the foaming agents leads to high bioactive retention. Egg white is also the most used foaming agent. Regarding the mathematical models used for fitting the foam-mat drying kinetics, the Page model was shown as the most proper model. Foaming agent concentration is a delicate parameter, as its increase in foam formulation may beneficially enhance drying rates but, at the same time, it dilutes bioactive compounds and may cause their loss by oxidation. In conclusion, foam-mat drying stands out as a suitable technology for producing food powders with high bioactive retention.

Direct acidification of requeijão cremoso model by lactobionic acid: physical, chemical and antimicrobial effects.

ABSTRACT: Lactobionic acid (LBA) shows singular properties (antioxidant and antimicrobial). However, few studies aim to test them in foods and confirm the actual occurrence of properties. The present study aims to apply LBA/lactic acid in the production of requeijão cremoso model in order to recognize some of the effects caused by the component as a food additive. The effects on the requeijão cremoso model were evaluated by the final properties of the product: water activity, rheological properties, antioxidant and antimicrobial capacity. Model of requeijão completely acidified with LBA showed the maximum antioxidant activity (88%). The results revealed a potential of application of LBA for microbial inhibition. All model produced presented pseudo plastic behaviour.

Effects of Fundamental Frequency, Vocal Intensity, Sample Duration, and Vowel Context in Cepstral and Spectral Measures of Dysphonic Voices.

Purpose Smoothed cepstral peak prominence (CPPS) and harmonics-to-noise ratio (HNR) are acoustic measures related to the periodicity, harmonicity, and noise components of an acoustic signal. To date, there is little evidence about the advantages of CPPS over HNR in voice diagnostics. Recent studies indicate that voice fundamental frequency (F0) and intensity (sound pressure level [SPL]), sample duration (DUR), vowel context (speech vs. sustained phonation), and syllable stress (SS) may influence CPPS and HNR results. The scope of this work was to investigate the effects of voice F0 and SPL, DUR, SS, and token on CPPS and HNR in dysphonic voices. Method In this retrospective study, 27 Brazilian Portuguese speakers with voice disorders were investigated. Recordings of sustained vowels (SVs) /a:/ and manually extracted vowels (EVs) /a/ from Consensus Auditory-Perceptual Evaluation of Voice sentences were acoustically analyzed with the Praat program. Results There was a highly significant effect of F0, SPL, and DUR on both CPPS and HNR (p < .001), whereas SS and vowel context significantly affected CPPS only (p < .05). Higher SPL, F0, and lower DUR were related to higher CPPS and HNR. SVs moderately-to-highly correlated with EVs for CPPS, whereas HNR had few and moderate correlations. In addition, CPPS and HNR highly correlated in SVs and seven EVs (p < .05). Conclusion Speaking prosodic variations of F0, SPL, and DUR influenced both CPPS and HNR measures and led to acoustic differences between sustained and excised vowels, especially in CPPS. Vowel context, prosodic factors, and token type should be controlled for in clinical acoustic voice assessment.

Vocal warm-up and cool-down in teachers: a quasi-experimental controlled study. / Aquecimento e desaquecimento vocal em professores: estudo quase-experimental controlado.

PURPOSE: To verify the effects of vocal warm-up (VWU) and vocal cool-down (VCD) strategies on teachers. METHODS: A quasi-experimental exploratory blind-evaluator study with control group that included teachers from a public secondary school. Teachers assigned to the experimental group (EG) performed VW prior to classes and VCD after classes. Teachers in the control group (CG) did not perform VWU and simply got voice rest after classes. Intergroup (EG vs. CG) and intragroup (pre-test versus post-test) comparisons were drawn from an auditory-perceptual evaluation, acoustic analysis, and self-reported discomfort. The mean acoustic and discomfort indicators and the percentage of improvement or worsening of vocal quality were calculated with a statistically significance level of p<0.05. RESULTS: EG and CG did not differ from each other in the intergroup analysis. The intragroup analysis showed that VWU improved voice quality and decreased the degree of body-related discomfort. VCD decreased both the fundamental frequency (f0) and the degree of discomfort, particularly in relation to the voice aspects. Vocal rest did not show any statistical difference. CONCLUSION: VWU showed positive effects on the auditory-perceptual evaluation and self-reported discomfort (body). VCD impacted f0 and self-reported discomfort (voice). Due to the exploratory nature of the research, the statistical power was not enough to demonstrate a difference in the comparison between EG and CG. However, the results indicate a potential for protecting teachers' voice and may be incorporated into daily work settings. Further controlled studies with random samples and greater numbers of participants should be conducted to confirm these results.

OBJETIVO: Verificar os efeitos de uma estratégia de aquecimento (AV) e desaquecimento vocal (DV) em professores. MÉTODO: Estudo exploratório quase-experimental, cego ao avaliador, com grupo controle composto por professores de uma escola pública de ensino médio. Os professores, alocados no grupo experimental (GE), realizaram AV prévio e DV posterior à aula. Os professores do grupo controle (GC) não realizaram AV prévio e ficaram em repouso vocal após a aula. Compararam-se os dados intergrupos (GE vs. GC) e intragrupos (pré vs. pós-teste), segundo avaliação perceptivo-auditiva, análise acústica e desconforto autorreferido. Calcularam-se as médias dos indicadores acústicos e de desconforto; o percentual de melhora ou piora na avaliação perceptivo-auditiva, considerando-se p<0,05 como nível de significância. RESULTADOS: GE e GC não diferiram entre si na análise intergrupos em nenhum dos indicadores avaliados. Na análise intragrupos, AV melhorou a qualidade vocal e reduziu o grau de desconforto no corpo; DV diminuiu tanto a frequência fundamental (f0) quanto o grau de desconforto, particularmente nos aspectos relacionados à voz. O repouso vocal não revelou diferença estatística. CONCLUSÃO: AV demonstrou efeitos positivos na avaliação perceptivo-auditiva e no desconforto autorreferido (corpo). DV impactou f0 e desconforto autorreferido (voz). Devido ao caráter exploratório do estudo, não houve poder suficiente para demonstrar diferença na comparação entre GE e GC. Porém, os resultados obtidos indicam potencial proteção para a voz de professores, podendo ser incorporados no cotidiano de trabalho docente. Novos estudos controlados, com amostra aleatória e maior número de participantes, devem ser realizados para se comprovar tais resultados.

Lactobionic Acid as a Potential Food Ingredient: Recent Studies and Applications.

Lactobionic acid (LBA) is a bionic acid naturally found in the "Caspian Sea yogurt" and chemically constituted of a gluconic acid bonded to a galactose. The compound is known for its numerous proven attributes as an antioxidant, chelator, and moisturizer agent. There is a growing interest of the academic community and industry research sectors in the application of LBA as a food ingredient. Thus, this review describes the current methods of LBA production, patents related, general applications and regulations, research statistics, future prospects, and an overview of the challenges faced by the food industry to incorporate the acid in their products. Studies associated to food application and human intake are scarce in the literature. To date, they account for only a small amount of all available research papers and patents on the subject, which is due to LBA prohibitions despite the approval of its salt (calcium lactobionate) and the lack of regulation in most countries. Further studies on the safety of consumption should be carried out in coming years in order to elucidate its toxicological aspects and to extend the technological possibilities of the food processing industry.

Teachers' work and health in Brazil: thoughts on the history of research, strides, and challenges. / Trabalho e saúde de professoras e professores no Brasil: reflexões sobre trajetórias das investigações, avanços e desafios.

This Essay discusses the theme of teachers' work and health in Brazil. The objectives are to describe the initial history of research on teachers' health, discuss elements leading to a consensus on the characterization of the group's work and principal health problems, and systematize the main strides and challenges. The Essay draws on more than two decades of research and practice in this field. Based on this experience, the authors identify the movements, the accumulated evidence, and prospects for future development. The elements brought to the discussion point to substantial growth in the field: the number of studies, the diversity and scope of topics, the groups of men and women teachers studied, and the experiences with application of the knowledge (programs and interventions). Despite these strides, the studies and practices still emphasize the individual and the disease, with little or no attention to work factors (work process and management) in the health/disease process. Issues pertaining to gender differences (in work and in health status) also remain invisible. There is little linkage between researchers and teachers' movements (a relevant characteristic of the first initiatives in the field). There are no public policies to regulate the workplace and work management. The contributions to the discussion provide insight for thought to assist the identification of critical nodes and analytical scenarios with the potential for progress in this field of research and intervention.

Este Ensaio discute a temática de trabalho e saúde docente no Brasil. Tem como objetivos: descrever trajetórias iniciais das investigações de saúde do/a professor/a no contexto brasileiro; discutir elementos que consolidaram consenso com relação à caracterização do trabalho e os principais problemas de saúde neste grupo; e sistematizar seus principais avanços e desafios. O Ensaio é organizado com base na experiência de mais de duas décadas em investigações e práticas nessa temática. Valendo-se dessa experiência identificam-se seus movimentos, as evidências acumuladas e perspectivas potenciais de desenvolvimento futuro. Com base nos elementos trazidos à discussão observa-se o crescimento substantivo do campo: do número de investigações, da diversidade e abrangência dos temas abordados, dos grupos de professores/as estudados/as e das experiências de aplicação do conhecimento (programas e intervenções). Apesar desses avanços, as investigações e práticas ainda mantêm a ênfase no indivíduo e na doença, com ausência ou abordagem limitada dos fatores do trabalho (processo e gestão do trabalho) no processo saúde/doença. Questões relativas aos diferenciais de gênero (no trabalho e na situação de saúde) também permanecem invisíveis. Observa-se pouca articulação de pesquisadores/as e movimentos docentes (uma característica relevante das primeiras iniciativas no campo). Registra-se ausência de políticas públicas de regulação dos ambientes e gestão do trabalho. Os aspectos trazidos à discussão fornecem uma base de reflexão, de modo a auxiliar na identificação de nós críticos e de cenários analíticos com potencial para avançar nesse campo de investigação e de intervenção.

Este Ensayo discute la temática de trabajo y salud docente en Brasil. Tiene como objetivos: describir trayectorias iniciales de investigaciones de salud del/a profesor/a en el contexto brasileño; discutir elementos que consolidaron el consenso referente a la caracterización del trabajo y los principales problemas de salud en este grupo; además de sistematizar sus principales avances y desafíos. El estudio está organizado en base a la experiencia de más de dos décadas en investigaciones y prácticas en esta temática. Valiéndose de esta experiencia se identifican sus movimientos, las evidencias acumuladas y perspectivas potenciales de su desarrollo futuro. En base a los elementos en liza se observa un crecimiento sustancial del área de estudio: número de investigaciones, diversidad y alcance de los temas abordados, grupos de profesores/as estudiados/as, así como de las experiencias de aplicación del conocimiento (programas e intervenciones). A pesar de esos avances, las investigaciones y prácticas todavía mantienen el énfasis en el individuo y en la enfermedad, con ausencia o un enfoque limitado sobre los factores del trabajo (proceso y gestión del trabajo) en el proceso salud/enfermedad. Las cuestiones relacionadas con los diferenciales de género (en el trabajo y situación de salud) también permanecen invisibles. Se observa poca coordinación de investigadores/as y movimientos docentes (una característica relevante de las primeras iniciativas en el área de estudio). Se constata la ausencia de políticas públicas de regulación en entornos y gestión laborales. Los aspectos planteados proporcionan una base de reflexión, con el fin de que ayuden en la identificación de problemas clave y escenarios analíticos con potencial para avanzar en este campo de investigación y de intervención.

Seeking the recognition of voice disorder as work-related disease: historical-political movement. / Em busca do reconhecimento do distúrbio de voz como doença relacionada ao trabalho: movimento histórico-político.

The high prevalence of voice disorders among professionals who use their voice as a working tool, signals the existence of a collective illness caused by voice wear through poor working conditions and lack of social protection. This article describes the construction of a political movement seeking recognition of voice disorder as a work-related disease in Brazil. This is a narrative review on the historical processes, including social subjects, production of knowledge and the proposals for a strategic agenda, in view of the urgency of including voice disorder in the Brazilian Ministry of Health's list of work-related diseases. The analysis comprises three strands: a) technical and scientific, on advances in characterization of voice disorder and establishment of its connection with work; b) juridical and institutional, on legal recognition of this linkage; c) political and professional, on mobilization of social actors to advocate recognition of work-related voice disorders (WRVDs). The key role of the Pontifical Catholic University of São Paulo in fomenting discussions about WRVDs over the course of this movement lasting nearly two decades is highlighted, along with the main difficulties in achieving formal recognition of WRVDs .

A elevada prevalência de alteração vocal no exercício do trabalho sinaliza um adoecimento coletivo, determinado pelo desgaste da voz sob precárias condições ocupacionais. Este artigo descreve a construção, no Brasil, do movimento histórico-político em busca do reconhecimento do distúrbio de voz como doença relacionada ao trabalho (DVRT). Trata-se de uma revisão narrativa, com relato dos processos históricos, incluindo os sujeitos sociais, a produção de conhecimento, os fatos que marcaram a trajetória do movimento e as proposições de uma agenda estratégica, tendo em vista a urgência da inclusão do DVRT na lista de doenças relacionadas ao trabalho do Ministério da Saúde. Foram adotados três eixos de análise: a) técnico-científico, sobre os avanços na caracterização do distúrbio de voz e do nexo com o trabalho; b) jurídico-institucional, relativo às formas institucionais de reconhecimento jurídico deste nexo; e c) político-profissional, no qual se discute a articulação dos atores sociais na defesa do reconhecimento do DVRT. Durante quase duas décadas destacam-se o importante papel da Pontifícia Universidade Católica de São Paulo no fomento às discussões e as principais dificuldades para o reconhecimento formal do DVRT.

Em busca do reconhecimento do distúrbio de voz como doença relacionada ao trabalho: movimento histórico-político / Seeking the recognition of voice disorder as work-related disease: historical-political movement

Resumo A elevada prevalência de alteração vocal no exercício do trabalho sinaliza um adoecimento coletivo, determinado pelo desgaste da voz sob precárias condições ocupacionais. Este artigo descreve a construção, no Brasil, do movimento histórico-político em busca do reconhecimento do distúrbio de voz como doença relacionada ao trabalho (DVRT). Trata-se de uma revisão narrativa, com relato dos processos históricos, incluindo os sujeitos sociais, a produção de conhecimento, os fatos que marcaram a trajetória do movimento e as proposições de uma agenda estratégica, tendo em vista a urgência da inclusão do DVRT na lista de doenças relacionadas ao trabalho do Ministério da Saúde. Foram adotados três eixos de análise: a) técnico-científico, sobre os avanços na caracterização do distúrbio de voz e do nexo com o trabalho; b) jurídico-institucional, relativo às formas institucionais de reconhecimento jurídico deste nexo; e c) político-profissional, no qual se discute a articulação dos atores sociais na defesa do reconhecimento do DVRT. Durante quase duas décadas destacam-se o importante papel da Pontifícia Universidade Católica de São Paulo no fomento às discussões e as principais dificuldades para o reconhecimento formal do DVRT.

Abstract The high prevalence of voice disorders among professionals who use their voice as a working tool, signals the existence of a collective illness caused by voice wear through poor working conditions and lack of social protection. This article describes the construction of a political movement seeking recognition of voice disorder as a work-related disease in Brazil. This is a narrative review on the historical processes, including social subjects, production of knowledge and the proposals for a strategic agenda, in view of the urgency of including voice disorder in the Brazilian Ministry of Health's list of work-related diseases. The analysis comprises three strands: a) technical and scientific, on advances in characterization of voice disorder and establishment of its connection with work; b) juridical and institutional, on legal recognition of this linkage; c) political and professional, on mobilization of social actors to advocate recognition of work-related voice disorders (WRVDs). The key role of the Pontifical Catholic University of São Paulo in fomenting discussions about WRVDs over the course of this movement lasting nearly two decades is highlighted, along with the main difficulties in achieving formal recognition of WRVDs .

Relationship Between Parameters of Development and Functional Compounds of Yacon Leaves

Abstract Yacon is a tuberous root from the Andean region being increasingly grown across the world due to the low caloric values of their roots and the functional properties of extractions of its leaves. However, there is still a gap in the knowledge of how the plant develops, and if physical and chemical changes are noticed regarding maturity. The subject of this work was to investigate the dynamics of a group of parameters and to establish correlations across them. To achieve this goal, leaves collected from three different parts of the plant in three months were assessed regarding size (plant height and leaf area), color and the presence of sesquiterpene lactones. Different methods of extraction were also studied and the total phenolic content was analyzed. The analysis of the results revealed different patterns in the quantity, size and leaf distribution according to the age of the plant. From three different methods of extraction studied, decoction seems to be the most appropriate one to obtain phenolic compounds with greater yield and safety. Besides, the greenness of yacon leaves showed a linear correlation to the total phenolic content, being a simple and promising estimator of the corresponding bioactive group. Sesquiterpene lactones were identified in all extracts, indicating the ease of their extractability even in simple procedures of tea-making.

Trabalho e saúde de professoras e professores no Brasil: reflexões sobre trajetórias das investigações, avanços e desafios / Trabajo y salud de profesoras y profesores en Brasil: reflexiones sobre trayectorias de investigaciones, avances y desafíos / Teachers' work and health in Brazil: thoughts on the history of research, strides, and challenges

Este Ensaio discute a temática de trabalho e saúde docente no Brasil. Tem como objetivos: descrever trajetórias iniciais das investigações de saúde do/a professor/a no contexto brasileiro; discutir elementos que consolidaram consenso com relação à caracterização do trabalho e os principais problemas de saúde neste grupo; e sistematizar seus principais avanços e desafios. O Ensaio é organizado com base na experiência de mais de duas décadas em investigações e práticas nessa temática. Valendo-se dessa experiência identificam-se seus movimentos, as evidências acumuladas e perspectivas potenciais de desenvolvimento futuro. Com base nos elementos trazidos à discussão observa-se o crescimento substantivo do campo: do número de investigações, da diversidade e abrangência dos temas abordados, dos grupos de professores/as estudados/as e das experiências de aplicação do conhecimento (programas e intervenções). Apesar desses avanços, as investigações e práticas ainda mantêm a ênfase no indivíduo e na doença, com ausência ou abordagem limitada dos fatores do trabalho (processo e gestão do trabalho) no processo saúde/doença. Questões relativas aos diferenciais de gênero (no trabalho e na situação de saúde) também permanecem invisíveis. Observa-se pouca articulação de pesquisadores/as e movimentos docentes (uma característica relevante das primeiras iniciativas no campo). Registra-se ausência de políticas públicas de regulação dos ambientes e gestão do trabalho. Os aspectos trazidos à discussão fornecem uma base de reflexão, de modo a auxiliar na identificação de nós críticos e de cenários analíticos com potencial para avançar nesse campo de investigação e de intervenção.

Este Ensayo discute la temática de trabajo y salud docente en Brasil. Tiene como objetivos: describir trayectorias iniciales de investigaciones de salud del/a profesor/a en el contexto brasileño; discutir elementos que consolidaron el consenso referente a la caracterización del trabajo y los principales problemas de salud en este grupo; además de sistematizar sus principales avances y desafíos. El estudio está organizado en base a la experiencia de más de dos décadas en investigaciones y prácticas en esta temática. Valiéndose de esta experiencia se identifican sus movimientos, las evidencias acumuladas y perspectivas potenciales de su desarrollo futuro. En base a los elementos en liza se observa un crecimiento sustancial del área de estudio: número de investigaciones, diversidad y alcance de los temas abordados, grupos de profesores/as estudiados/as, así como de las experiencias de aplicación del conocimiento (programas e intervenciones). A pesar de esos avances, las investigaciones y prácticas todavía mantienen el énfasis en el individuo y en la enfermedad, con ausencia o un enfoque limitado sobre los factores del trabajo (proceso y gestión del trabajo) en el proceso salud/enfermedad. Las cuestiones relacionadas con los diferenciales de género (en el trabajo y situación de salud) también permanecen invisibles. Se observa poca coordinación de investigadores/as y movimientos docentes (una característica relevante de las primeras iniciativas en el área de estudio). Se constata la ausencia de políticas públicas de regulación en entornos y gestión laborales. Los aspectos planteados proporcionan una base de reflexión, con el fin de que ayuden en la identificación de problemas clave y escenarios analíticos con potencial para avanzar en este campo de investigación y de intervención.

This Essay discusses the theme of teachers' work and health in Brazil. The objectives are to describe the initial history of research on teachers' health, discuss elements leading to a consensus on the characterization of the group's work and principal health problems, and systematize the main strides and challenges. The Essay draws on more than two decades of research and practice in this field. Based on this experience, the authors identify the movements, the accumulated evidence, and prospects for future development. The elements brought to the discussion point to substantial growth in the field: the number of studies, the diversity and scope of topics, the groups of men and women teachers studied, and the experiences with application of the knowledge (programs and interventions). Despite these strides, the studies and practices still emphasize the individual and the disease, with little or no attention to work factors (work process and management) in the health/disease process. Issues pertaining to gender differences (in work and in health status) also remain invisible. There is little linkage between researchers and teachers' movements (a relevant characteristic of the first initiatives in the field). There are no public policies to regulate the workplace and work management. The contributions to the discussion provide insight for thought to assist the identification of critical nodes and analytical scenarios with the potential for progress in this field of research and intervention.

Self-perception of surface hydration effect on teachers' voice quality: an intervention study / Autopercepção do efeito da hidratação direta na qualidade vocal de professores: um estudo de intervenção

ABSTRACT Objective: to assess the effects of surface hydration on vocal quality according to teachers' self-perception. Methods: an examiner-blinded pre-test and post-test intervention study carried out with a single group of 27 teachers. Sociodemographic characteristics and work questionnaire, Screening Index for Voice Disorder, Vocal Severity Rating Scale, Expected Effects Pre-intervention, Perceived Effects Post-intervention and Post-intervention Perception instruments, were applied. The intervention lasted 4 weeks and consisted of 5 minutes of nebulization with saline solution (sodium chloride 0.9%), after 10 minutes of mouth dehydration, prior to teaching. Results: screening Index for Voice Disorder scores demonstrated a statistically significant reduction (p=0.001). Frequency of voice disorders in the Vocal Severity Rating Scale was reduced without a statistical significance (p= 0.172). Expected Effects, Pre-intervention, and Perceived Effects, Post-intervention, showed improvement in vocal quality (40.7%), vocal comfort (40.7%) and vocal folds hydration (37%). Post-intervention perception form showed moderate improvement of the symptoms (59.3%), cleared voice (55.6%) and ease speaking (48.1%) as well as intense belief in the intervention (74.1%) and intense compliance to the intervention (74.1%). Conclusion: surface hydration with saline solution promoted self-perceived improvement in vocal quality.

RESUMO Objetivo: avaliar os efeitos da hidratação da superfície na qualidade vocal, segundo a autopercepção dos professores. Métodos: estudo de intervenção pré-teste e pós-teste, cego ao examinador, com grupo único de 27 professores. Foram avaliadas características sociodemográficas e do trabalho, por meio de questionário estruturado, e aplicados os instrumentos Índice de Triagem para Distúrbio de Voz, Escala de Classificação da Severidade Vocal, Efeitos Esperados Pré-intervenção, Efeitos Percebidos Pós-intervenção e Percepção Pós-Intervenção. A intervenção durou quatro semanas e consistiu em cinco minutos de nebulização com soro fisiológico (cloreto de sódio a 0,9%), após 10 minutos de desidratação, antes de lecionar. Resultados: Índice de Triagem para Distúrbio de Voz demonstrou redução estatisticamente significativa (p = 0,001). A frequência de distúrbios da voz no Escala de Classificação da Severidade Vocal foi reduzida sem significância estatística (p = 0,172). Efeitos Esperados Pré-intervenção e Efeitos Percebidos Pós-intervenção mostraram melhora na qualidade vocal (40,7%), conforto vocal (40,7%) e hidratação das pregas vocais (37%). Percepção Pós-intervenção demonstrou melhora moderada dos sintomas vocais (59,3%), voz mais clara (55,6%) e facilidade ao falar (48,1%), intensa credibilidade na intervenção (74,1%) e intensa adesão a intervenção (74,1%). Conclusão: a hidratação de superfície com soro fisiológico, promoveu melhora autorreferida da qualidade vocal dos professores.

Protective Strategies Against Dysphonia in Teachers: Preliminary Results Comparing Voice Amplification and 0.9% NaCl Nebulization.

OBJECTIVE: This study aimed to compare the effects of two protective strategies, voice amplification (VA) and 0.9% NaCl nebulization (NEB), on teachers' voice in the work setting. METHODS: An interventional evaluator-blind study was conducted, assigning 53 teachers from two public high schools to one of the two protective strategy groups (VA or NEB). Vocal function was assessed in a sound-treated booth before and after a 4-week period. Assessment included the severity of voice impairment (Consensus Auditory-Perceptual Evaluation of Voice [CAPE-V]), acoustic analysis of fundamental frequency (f0), sound pressure level (SPL), jitter, shimmer, glottal-to-noise excitation ratio (GNE), noise (VoxMetria), and the self-rated Screening Index for Voice Disorder (SIVD). Data were statistically analyzed using SPSS Statistics (version 22) with a significance level of P ≤ 0.05. Effect size was calculated using Cohen's d coefficient. RESULTS: There were no statistical differences between groups at baseline in terms of age, sex, time of teaching, teaching workload, and voice outcomes, except for SPL. During postintervention between groups, NEB displayed lower SIVD scores (VA = 3; NEB = 0; P = 0.018) and VA had lower acoustic irregularity (VA = 3.19; NEB = 3.69; P = 0.027), with moderate to large effect size. Postintervention within-groups decreased CAPE-V for VA (pretest = 31.97; posttest = 28.24; P = 0.021) and SIVD for NEB (pretest = 3; posttest = 0; P = 0.001). SPL decreased in both groups, NEB decreased in men only, and VA decreased in both men and women. NEB increased f0 for female participants (P ≤ 0.001). CONCLUSION: Both VA and NEB may help mitigate dysphonia in different pathways, being potential interventions for protecting teachers' voices in the work setting. An ongoing study with a control group will further support these preliminary results.

Self-Ratings of Vocal Status in Daily Life: Reliability and Validity for Patients With Vocal Hyperfunction and a Normative Group.

PURPOSE: The aim of this study was to establish reliability and validity for self-ratings of vocal status obtained during the daily activities of patients with vocal hyperfunction (VH) and matched controls. METHOD: Eight-four patients with VH and 74 participants with normal voices answered 3 vocal status questions-difficulty producing soft, high-pitched phonation (D-SHP); discomfort; and fatigue-on an ambulatory voice monitor at the beginning, 5-hr intervals, and the end of each day (7 total days). Two subsets of the patient group answered the questions during a 2nd week after voice therapy (29 patients) or laryngeal surgery (16 patients). RESULTS: High reliability resulted for patients (Cronbach's α = .88) and controls (α = .95). Patients reported higher D-SHP, discomfort, and fatigue (Cohen's d = 1.62-1.92) compared with controls. Patients posttherapy and postsurgery reported significantly improved self-ratings of vocal status relative to their pretreatment ratings (d = 0.70-1.13). Within-subject changes in self-ratings greater than 20 points were considered clinically meaningful. CONCLUSIONS: Ratings of D-SHP, discomfort, and fatigue have adequate reliability and validity for tracking vocal status throughout daily life in patients with VH and vocally healthy individuals. These questions could help investigate the relationship between vocal symptom variability and putative contributing factors (e.g., voice use/rest, emotions).