Schooling and children with hearing impairment and deafness

A história da educação para surdos no Brasil iniciou-se em 1857 com o Imperial Instituto de Surdos-Mudos e a chegada de Hernest Huet, ex-diretor do Instituto de Surdos em Paris. Huet influenciou o desenvolvimento da Língua Brasileira de Sinais (Libras) ao introduzir uma metodologia baseada em sua experiência na França. Apenas na década de 1970, a língua de sinais foi efetivamente ensinada, junto com o método oral. A filosofia bilíngue ganhou destaque, recomendando que a Libras seja a primeira língua e o português, a segunda. Em 2015, a Comissão de Defesa dos Direitos das Pessoas com Deficiência Auditiva apresentou o projeto de Lei 1.361/15 para garantir direitos aos deficientes auditivos unilaterais, retomando destaque em 2022. A Lei de Libras (10.436/2002) garante direitos, mas a pesquisa destaca a necessidade de implementar efetivamente o ensino em Libras e promover mudanças sociais para uma inclusão plena. Apesar de avanços, persiste um longo caminho para garantir a educação bilíngue e transformações na interação e participação da comunidade surda. Esta pesquisa empregou a metodologia de pesquisa bibliográfica e documental, centrada em uma análise sócio-histórica. Conclui-se que, apesar dos avanços significativos alcançados na melhoria da qualidade de vida e na construção de um sistema educacional para pessoas surdas ou com deficiência auditiva, persiste um extenso caminho a ser percorrido. Isso se evidencia na urgência de uma implementação mais efetiva do ensino em Língua Brasileira de Sinais (LIBRAS) e na integração dessa língua no quotidiano dos brasileiros.The history of education for the deaf in Brazil began in 1857 with the Imperial Institute for Deaf-Mutes and the arrival of Hernest Huet, former director of the Institute for the Deaf in Paris. Huet influenced the development of Brazilian Sign Language (Libras) by introducing a methodology based on his experience in France. It was only in the 1970s that sign language was effectively taught, along with the oral method. The bilingual philosophy gained prominence, recommending that Libras be the first language and Portuguese the second. In 2015, the Commission for the Defense of the Rights of People with Hearing Impairments presented bill 1,361/15 to guarantee unilateral rights for hearing impaired people, resuming prominence in 2022. The Libras Law (10,436/2002) guarantees rights, but research highlights the need to effectively implement teaching in Libras and promote social changes for full inclusion. Despite advances, there remains a long way to go to guarantee bilingual education and transformations in the interaction and participation of the deaf community. This research used bibliographic and documentary research methodology, centered on a socio-historical analysis. It is concluded that, despite the significant advances made in improving the quality of life and building an educational system for people who are deaf or hard of hearing, there is still a long way to go. This is evident in the urgency of more effective implementation of teaching in Brazilian Sign Language (LIBRAS) and the integration of this language into the daily lives of Brazilians

Survival and quality of life of patients with oral and oropharyngeal cancer at 1-year follow-up of tumor resection

OBJECTIVE: This study aimed to assess the survival and life quality evolution of patients subjected to surgical excision of oral and oropharyngeal squamous cell carcinoma. MATERIAL AND METHODS: Forty-seven patients treated at a Brazilian healthcare unit specialized in head and neck surgery between 2006 and 2007 were enrolled in the study. The gathering of data comprised reviewing hospital files and applying the University of Washington Quality of Life (UW-QOL) questionnaire previously and 1 year after the surgery. Comparative analysis used Poisson regression to assess factors associated with survival and a paired t-test to compare preoperative and 1-year postoperative QOL ratings. RESULTS: 1 year after surgery, 7 patients were not found (dropout of the cohort); 15 had died and 25 fulfilled the UW-QOL again. The risk of death was associated with having regional metastasis previously to surgery (relative risk=2.18; 95% confidence interval=1.09-5.17) and tumor size T3 or T4 (RR=2.30; 95%CI=1.05-5.04). Survivors presented significantly (p<0.05) poorer overall and domain-specific ratings of quality of life. Chewing presented the largest reduction: from 74.0 before surgery to 34.0 one year later. Anxiety was the only domain whose average rating increased (from 36.0 to 70.7). CONCLUSIONS: The prospective assessment of survival and quality of life may contribute to anticipate interventions aimed at reducing the incidence of functional limitations in patients with oral and oropharyngeal cancer.(FAPESP) São Paulo Research Foundation(CNPq) Brazilian Council for the Scientific and Technological Developmen

Relationship between methods of training load quantification based on perception of effort and heart rate in young futsal players

The aims of this study were to verify the association between the methods of training load quantification session-RPE and training impulse -proposed by Lucia (LuciaTRIMP) -and to describe the training intensity distribution in under-18 semi-professional futsal. Fifteen male players (mean and SD; age: 17 ± 1 years; body mass: 70.4 ± 6.5 kg; height: 175 ± 4 cm and BMI 23 ± 2 kg.m²) performed an incremental treadmill test to determine the ventilatory threshold (VT), respiratory compensation point (RCP), and maximal oxygen consumption (VO2max). Only eight athletes had their training loads quantified by means of session-RPE and Lucia methods over a total of 78 training sessions before the main competition of the season. High to almost perfect correlations (r = 0.64 - 0.91) were found between session-RPE and LuciaTRIMP methods. The distribution of the training intensity was, respectively, 76, 18 e 6% of training duration below VT (zone 1), between VT and RCP (zone 2), and above RCP (zone 3). The session-RPE method was highly associated with an objective method of training load quantification. Furthermore, the training sessions of a semi-professional under-18 futsal team showed a decreasing training intensity distribution.Os objetivos do estudo foram verificar a associação entre os métodos de quantificação da carga de treinamento, PSE da sessão e impulso de treinamento proposto por Lucía (LuciaTRIMP) e descrever a distribuição da intensidade de treinamento no futsal semiprofissional da categoria sub 18. Quinze jogadores (média e DP; idade: 17 ± 1 ano; massa corporal: 70,4 ± 6,5 kg; estatura: 175 ± 4 cm e IMC 23 ± 2 kg.m-2) foram submetidos a um teste de corrida incremental para determinar o limiar ventilatório (LVmax), o ponto de compensação respiratória (PCR) e o consumo máximo de oxigênio (VO2max). Apenas oito atletas foram monitorados por meio dos métodos PSE da sessão e LuciaTRIMP durante 78 sessões de treinamento antes da principal competição da temporada. Foram encontradas correlações individuais de magnitudes alta a quase perfeita (r = 0,64 - 0,91) entre os métodos PSE da sessão e LuciaTRIMP. O padrão de distribuição da intensidade de treinamento foi 76, 18 e 6% do tempo abaixo do LV (zona 1), entre LV e PCR (zona 2) e acima do PCR (zona 3), respectivamente. O método PSE da sessão se mostrou altamente relacionado com um método objetivo de quantificação da carga de treinamento. Além disso, as sessões de treinamento de uma equipe de futsal semiprofissional da categoria sub 18 apresentaram um padrão decrescente de distribuição das intensidades de treinamento

Phylogenetic origin of primary and secondary metabolic pathway genes revealed by C. maxima and C. reticulata diagnostic SNPs

Modern cultivated Citrus species and varieties result from interspecific hybridization between four ancestral taxa. Among them, Citrus maxima and Citrus reticulata, closely associated with the pummelo and mandarin horticultural groups, respectively, were particularly important as the progenitors of sour and sweet oranges (Citrus aurantium and Citrus sinensis), grapefruits (Citrus paradisi), and hybrid types resulting from modern breeding programs (tangors, tangelos, and orangelos). The differentiation between the four ancestral taxa and the phylogenomic structure of modern varieties widely drive the phenotypic diversity's organization. In particular, strong phenotypic differences exist in the coloration and sweetness and represent important criteria for breeders. In this context, focusing on the genes of the sugar, carotenoid, and chlorophyll biosynthesis pathways, the aim of this work was to develop a set of diagnostic single-nucleotide polymorphism (SNP) markers to distinguish the ancestral haplotypes of C. maxima and C. reticulata and to provide information at the intraspecific diversity level (within C. reticulata or C. maxima). In silico analysis allowed the identification of 3,347 SNPs from selected genes. Among them, 1,024 were detected as potential differentiation markers between C. reticulata and C. maxima. A total of 115 SNPs were successfully developed using a competitive PCR technology. Their transferability among all Citrus species and the true citrus genera was very good, with only 0.87% of missing data. The ancestral alleles of the SNPs were identified, and we validated the usefulness of the developed markers for tracing the ancestral haplotype in large germplasm collections and sexually recombined progeny issued from the C. reticulata/C. maxima admixture gene pool. These markers will pave the way for targeted association studies based on ancestral haplotypes

Combination of an analgesic and anti-inflammatory to avoid bleaching-induced tooth sensitivity: a randomized, triple-blind clinical trial / Combinação de um analgésico e antiinflamatório para evitar a sensibilidade dental induzida pelo clareamento: um ensaio clínico randomizado triplo-cego

induced tooth sensitivity (TS). This trial assed if the combination of an analgesic and an anti-inflammatory could reduce bleaching-induced TS. A parallel, placebo-controlled, triple-blind, randomized trial was conducted on 115 healthy adults. The patients received the association of acetaminophen 750 mg/ ketorolac tromethamine 10 mg or placebo, 1 h before the in-office bleaching (35% hydrogen peroxide), and extra doses every 8 h for 48 h. The TS was recorded on VAS 0-10 and NRS 0-4 scales, during bleaching and 1 to 48 h post-bleaching. The color was measured before and one month after dental bleaching using two visual shade guides and spectrophotometer. An intent-to-treat analysis was used to analyze data from all patients who were randomly assigned. No significant difference (p=0.41) in the absolute risk of TS between the acetaminophen/ketorolac group (72%; 95% CI 60 to 82) and placebo (79%; 95% CI 68 to 89) with a relative risk of 0.92; 95% CI 0.7 to 1.1. The mean difference in intensity of TS for VAS was lower in the acetaminophen/ketorolac group in the periods 12 to 24 h (-0.7) and 24 to 48 h (-0.4). A whitening effect was observed in both groups with no statistically significant difference (p&gt;0.05). The administration of the association ketorolac/acetaminophen prior to in-office bleaching did not reduce the risk of TS but reduced the intensity of TS after 12 h in a very small magnitude. clinicaltrial.gov NCT03343392.

Efeito da aplicação prolongada do sistema adesivo convencional de 2 passos na qualidade de restaurações de resina composta em lesões cervicais não cariosas: Ensaio clínico controlado, randomizado, duplo cego / Effect of the extended time of application of the conventional two-step adhesive system on the longevity of composite resin restorations in non-carious cervical lesions: a double-blind randomized clinical trial

Objetivo: Este ensaio clínico randomizado duplo-cego avalia a influência do aumento do tempo de aplicação em dois sistemas adesivos de duas etapas de etch-and-rinse (Peak® Universal Bond (P); Ultradent Products Ind e Single Link (SL); Angelus Dental Products Industry) aplicados em lesões cervicais não cariocas (NCCLs). Métodos: Um total de 119 restaurações foram colocadas aleatoriamente em 35 pacientes, de acordo com os seguintes grupos: P1 - aplicado de acordo com o fabricante; P2X - aplicado pelo tempo duplo; SL1 e SL2X (o mesmo modo de aplicação). O composto de resina Amelogen (Ultradent) foi colocado de forma incremental. As restaurações foram avaliadas imediatamente (linha de base) e 6 meses, usando os critérios FDI e USPHS. As análises estatísticas foram realizadas utilizando testes apropriados (=0,05). Resultados: Vinte e quatro restaurações foram perdidas aos 6 meses (4 para P1, 2 para P2X, 9 para SL1 e 9 para SL2X) (p &lt; 0,05 entre grupos). A sensibilidade pós-operatória não foi observada em nenhum dos períodos de recall. Foram consideradas cinco restaurações com pequenas discrepâncias na adaptação marginal no recall de 6 meses usando os critérios de IDE (8 para P1, 7 para P2X, 12 para SL1 e 8 para SL2X; p &gt; 0,05 entre os grupos). Dez restaurações foram consideradas como tendo pequenas discrepâncias na descoloração marginal no recall de 6 meses (2 para P1, 1 para P2X, 3 para SL1 e 2 para SL2X; p &gt; 0,05 entre os grupos). Conclusão: O aumento do tempo de aplicação do sistema adesivo em duas etapas não melhorou o comportamento clínico das restaurações compostas colocadas nos NCCLs. Entretanto, o comportamento clínico pode ser influenciado pela composição dos sistemas adesivos

Babesia spp. and Ehrlichia chaffeensis infection in Dogs from Southeastern Bahia, Brazil

Background: Tickborne diseases are frequent in tropical countries such as Brazil. Protozoa of the Babesia genus and bacteria of the Ehrlichia genus spread throughout the country with high prevalences in urban and rural areas, causing clinical or subclinical diseases in dogs. This study aimed to investigate the prevalence of infection from Babesia spp. and Ehrlichia chaffeensis in the dog population in the municipality of Ituberá, Bahia, Brazil, and to verify the risk factors associated with the infections.Materials, Methods &amp; Results: A cross-sectional study was conducted, consisting of the following procedures: clinical examination and blood samples collection from 380 dogs and application of a structure questionnaire to dog owners to collect epidemiological data. All dogs were evaluated for the presence of ticks and clinical signs associated with the infections. Blood samples were collected and tested for Babesia spp. through capillary blood smears, indirect immunofluorescence assays (IFAT), and polymerase chain reaction (PCR); all the samples were also tested for E. chaffeensis through nested PCR. Intra-erythrocyte piroplasms were visualized in the blood smears of two animals (2/380; 0.5%) in the cytology exams. Anti-B. canis antibodies were detected in 140/380 (36.8%) dogs, at 1:40 dilution. By PCR, 147/380 (38.7%) dogs tested positive for infection by Babesia sp., but no animal was infected by E. chaffeensis. Only 115/380 dogs (30.3%) were infested by ticks. In total, 223/380 dogs (58.7%) were found infected by Babesia spp. No clinical signs were it found to be significant for the infection. The infected (Ht = 40%) and uninfected dogs’ (Ht = 39%) hematocrit averages were not found to significantly differ (P = 0.47). No hematological changes were found to be significant for the disease. The evaluated variables sex, habitat (urban or rural), exposure to other dogs, age, and infestation by ticks were not found to be risk factors. The condition of semirestriction of 175/223 (78.4%) dogs was found as a risk factor for the infection (P = 0.01; OR = 1.75; IC 95% = 1.10-2.78).Discussion: The low detection from blood smears was inferior to the lowest prevalences found in Brazil. On the other hand, the high seroprevalence rate by IFAT observed in this study was found in other Brazilian states.  The low infection prevalence in the cytologic analysis associated with high seroprevalence are characteristics of chronic or subclinical infections. The high seroprevalence rates may also indicate chronicity and/or subclinical disease when associated with low parasitemia and may also be indicated by the low title variation observed. In this study, some dogs that tested positive for Babesia by serology tested negative in the PCR, which suggests a previously exposure to this pathogen and maintenance of detectable levels of antibodies, or that they were subclinical or chronic carriers of the infection. The equal hematocrit averages of dogs either carrying or not the disease suggests that the infected animals, especially the seemingly healthy dogs, are subclinical or chronic carriers, either asymptomatic or otherwise, that are adapted to the disease, which may contribute to the agent remaining in this population. The fact that no clinical sign of hematological change was significant for the infection may demonstrate the low pathogenicity of this agent in the evaluated population. The semi-restricted condition of the dogs as a risk factor is probably due to the increased exposure of these animals to canine babesiosis vectors during their movement through different neighborhood areas and villages in the municipality. The combination of diagnostic methods is important to identify the infection and determine its prevalence in epidemiological studies. Also, PCR was fundamental in this study, to identify the infection in asymptomatic dogs

Uso, cessação, fumo passivo e exposição a mídia do tabaco no Brasil: resultados da Pesquisa Nacional de Saúde 2013 e 2019

Objective: To compare indicators of tobacco use, secondhand smoke, cessation and exposure to pro and anti-tobacco media in 2013 and 2019, and describe these indicators according to sociodemographic variables in 2019. Methods: Cross-sectional study with data from the National Health Survey. The indicators of use, secondhand smoke, cessation and exposure to tobacco-related media were evaluated. Prevalence and confidence intervals (95%CI) were estimated for the total population in 2013 and 2019 and according to sociodemographic variables for 2019. Poisson regression with robust variance was used to assess differences in prevalence. &nbsp;Results: There was an improvement in most of the indicators studied; an increase in ex-smokers and a reduction in secondhand smoke and the attempt to quit smoking. All pro- and anti-tobacco media exposure indicators declined. When considering the prevalence according to sociodemographic characteristics in 2019, 43.8% (95%CI: 41.6;46.0) of men tried to quit smoking, and 50.8% (95%CI: 48.5;53.2) of women. Secondhand smoke at home was higher among women (10.2%; 95%CI: 9.7;10.8). Among those who thought about quitting smoking due to warnings, the proportion was higher among women (48.0%; 95%CI: 45.3;50.6). Tobacco use was higher among men (43.8% (95%CI: 41.6;46.0), in the population aged 40 to 59 years (14.9%; 95%CI: 14.2; 15.6), with a lower level of education (17.6%; 95%CI: 16.8;18.4). Conclusion: The study showed improvement in tobacco-related indicators between the years studied. It is noteworthy that this advance was smaller in relation to the other periods previously analyzed, and, therefore, greater investments in public policies to combat and control smoking in Brazil are necessary.Objetivo: Comparar indicadores de uso do tabaco, fumo passivo, cessação e exposição a mídia pró e antitabaco, em 2013 e 2019, e descrever esses indicadores segundo variáveis sociodemográficas em 2019. Métodos: Estudo transversal com dados da Pesquisa Nacional de Saúde. Avaliou-se os indicadores de uso, fumo passivo, cessação e exposição a mídia relacionada ao tabaco. Estimou-se as prevalências e intervalos de confiança (IC95%) para população total em 2013 e 2019, e segundo variáveis sociodemográficas para 2019. Para avaliar diferenças nas prevalências usou-se a Regressão de Poisson com variância robusta. Resultados: Houve melhoria dos indicadores de uso do tabaco; aumento de ex-fumantes e redução do fumo passivo e da tentativa de parar de fumar. Todos os indicadores de exposição a mídia pró e contra o tabaco diminuíram. &nbsp;Ao considerar as prevalências segundo características sociodemográficas em 2019, 43,8% (IC95%: 41,6;46,0) dos homens tentaram parar de fumar e 50,8% (IC95%: 48,5;53,2) das mulheres. O fumo passivo no domicilio foi maior nas mulheres (10,2%; IC95%: 9,7;10,8). Entre os que pensaram em parar de fumar devido as advertências, a proporção foi maior nas mulheres (48,0%; IC95%: 45,3;50,6). O uso do tabaco foi mais elevado nos homens (43,8%; IC95%: 41,6;46,0), na população de 40 a 59 anos (14,9%; IC95%: 14,2;15,6) e com menor nível de instrução (17,6%; IC95%: 16,8;18,4). Conclusão: O estudo mostrou melhoria dos indicadores relacionados ao tabaco entre os anos estudados. Ressalta-se, que esse avanço foi menor em relação a outros períodos analisados previamente, e, portanto, torna-se necessário maiores investimentos em políticas públicas de enfrentamento e controle do tabagismo no Brasil