Determinantes sociais de alterações fonoaudiológicas Social determinants of speech-language disorders

OBJETIVO: Verificar a associação entre fatores sócio-econômicos e alterações fonoaudiológicas auto-referidas. MÉTODOS: Este estudo foi realizado por meio de entrevistas domiciliares com 543 adultos residentes na cidade de Salvador (BA). RESULTADOS: Os resultados mostraram associações positivas e estatisticamente significantes entre escolaridade e queixas de alterações auditivas (RP=1,48 com IC95% 1,22-1,81) e de escolaridade e queixas de linguagem (RP=1,69 com IC95% 1,36-2,11). Também foram encontradas associações entre renda e queixas de alterações de motricidade oral (RP=1,34 com IC95% 1,13-1,60) e renda com queixas vocais (RP=1,24 com IC95% 1,08-1,44). CONCLUSÃO: Conclui-se que condições adversas de vida relacionam-se a alta prevalência de distúrbios fonoaudiológicos em comunidades.<br>PURPOSE: To verify the association between socioeconomic factors and self-referred speech-language disorders. METHODS: This study was carried out through home interviews with 543 adults who lived in the city of Salvador (BA), Brazil. RESULTS: Results showed positive statistically significant associations between level of education and hearing loss complaints (RP=1.48 with IC95% 1.22-1.81), and between level of education and language complaints (RP=1.69 with IC95% 1.36-2.11). Associations between income and oral motricity (RP=1.34 with IC95% 1.13-1.60) and between income and vocal complaints (RP=1.24 with IC95% 1.08-1.44) were also found. CONCLUSION: Adverse life conditions were related to high prevalence of speech-language disorders in communities

Riscos ocupacionais na legislação trabalhista brasileira: destaque para aqueles relativos à saúde e à voz do professor Occupational risks in the Brazilian labor legislation: highlight on those related to teacher's health and voice

OBJETIVO: Analisar a legislação a respeito de riscos ocupacionais, com destaque para aqueles relacionados à saúde e à voz do professor. MÉTODOS: Trata-se de pesquisa bibliográfica, de caráter qualitativo, que considerou as políticas públicas sobre Saúde e Segurança no Trabalho. As Normas Regulamentadoras foram lidas e seus conteúdos analisados e organizados por categorias, com recorte para aqueles referentes ao ambiente escolar. RESULTADOS: As 33 normas focalizam os fatores de risco, níveis de tolerância e controle para saúde e segurança no trabalho. Os agentes ambientais nocivos são múltiplos e suas especificidades, como concentração e frequência, determinam o nível de tolerância à exposição. Na escola, os riscos ambientais como ruído, poeira, temperatura e iluminação inadequadas, dentre outros, estão presentes, porém em grau leve. O tratamento acústico, de iluminação e de ventilação é indicado para controle desses riscos. Os documentos mostram situações de agravos à saúde dos trabalhadores em graus de risco muito maiores do que aqueles da docência. Não há explicitação de fatores inerentes à organização do trabalho e os cuidados com a voz limitam-se à profissão de teleoperador, o que pode servir de referência para o professor. CONCLUSÃO: A legislação trabalhista é ampla ao abarcar a diversidade de condições de trabalho e garantir a saúde dos trabalhadores. A docência apresenta riscos ocupacionais à saúde mais leves do que outras profissões; contudo, os fatores organizacionais do trabalho, assim como os distúrbios de voz, muito frequentes na docência, carecem de maior atenção da legislação no Brasil.<br>PURPOSE: To analyze the legislation regarding occupational risks, highlighting those related to teacher's health and voice. METHODS: A bibliographic search of qualitative nature regarding the public policies about Health and Security at Work was carried out. The Regulatory Standards were read and their contents analyzed and organized into categories, detaching those from the scholar environment. RESULTS: The 33 regulatory standards focus the risk factors, tolerance levels, and control for health and security at work. The harmful environmental agents are multiple and their specificities, such as concentration and frequency, determine the level of tolerance to exposition. At school, the environmental risks like noise, dust, temperature and inadequate lighting, among others, are present, however in a mild degree. The acoustic, lighting and exhaust ventilation treatments are indicated for the control of such risks. The documents show situations of worsening of the workers' health in much higher degrees of risk than those from teaching activities. There is no explicitation of factors inherent to the work organization, and the care with the voice is limited to the profession of telesales workers, which can serve as a reference to the teacher's work. CONCLUSION: Labor legislation is ample to cover the diversity of work conditions and to ensure the workers' health. Teaching presents milder occupational risks to health than other professions; nevertheless, the organizational factors of work, as well as voice disorders, very frequent in this activity, demand greater attention from Brazilian legislation

Paracoccidioidomycosis in the state of Maranhão, Brazil: geographical and clinical aspects

INTRODUCTION: The study aimed to show the situation of paracoccidioidomycosis in the state of Maranhão, Brazil. METHODS: This study is a descriptive case series developed in two stages. First, a survey of cases originating from the state of Maranhão at the Instituto de Doenças Tropicais Natan Portela, Piauí (IDTNP) from 1997 to 2007, and second, the clinical description of 29 cases diagnosed in the Centro de Referências em Doenças Infecciosas e Parasitárias, Maranhão (CREDIP) from 2004 to 2010. RESULTS: Two hundred and sixteen cases have been cataloged at the IDTNP. West, east, and central regions of the state of Maranhão recorded 90.3% of cases proving to be important areas for study. The western region, with a prevalence of 10.8/100,000 inhabitants, has a significantly higher proportion of cases than the northern, southern, and eastern regions (p < 0.05). The occurrence was higher in men with 89.3% of cases, and the male-to-female ratio was 8.4:1. The majority of patients were older than 20 years, lived in rural areas, and had farming or soil management as main occupation (73.8%). At CREDIP, 29 cases were diagnosed, of which 26 (89.6%) had multifocal manifestations. Mucous tissues were involved more (75.8%) frequently, followed by lymph nodes, skin, and lungs with 65.5%, 39% and 37.9 %, respectively. The diagnosis was made by combining direct examination, culture, and histopathology. CONCLUSIONS: The study shows the geographical distribution and the epidemiological and clinical aspects of paracoccidioidomycosis, revealing the significance of the disease to the state of Maranhão