Juliana Nunes Santos

Habilidades auditivas e desenvolvimento de linguagem em crianças

BACKGROUND: the relationship between anemia and development. AIM: to compare the auditory and language development in anemic and non-anemic children, with ages ranging from three to six years, of a public daycare center in Belo Horizonte city. METHOD: a transversal study; blind case and control format. A digital puncture was performed in all children to detect iron-deficiency anemia (hemoglobin = 11.3g/dL). The research group was composed of 19 anemic children and the control group of 38 healthy children, selected through randomized paired sampling. The childrens hearing was evaluated through otoacoustic emissions, tympanometry and a simplified evaluation of the central auditory processing was performed. The language development of each child was observed using the behavior observation guidelines for children with ages from zero to six years. Performance indexes were created in order to classify the language responses of the children. RESULTS: the groups did not differ in terms of age, gender, breast-feeding and mothers literacy. The following variables presented statistically significant differences: hemoglobin values (10.6g/dL, 12.6g/dL); presence of the acoustic reflex (63%, 92%); reception performance indexes (72.8, 90.1); emission (50.6, 80.6) and cognitive aspects of language (47.8, 76.0) in anemic and non-anemic children respectively. The hearing abilities in the verbal and non-verbal sequential memory and the sonorous localization were inadequate in most of the children, especially in those with anemia. CONCLUSION: anemic children differed statically from non-anemic children in terms of alterations in the acoustic reflex and language development and also presented a higher prevalence of alterations in the hearing evaluation.

Efeito da manobra de Epley na qualidade de vida dos pacientes com vertigem posicional paroxística benigna

A vertigem produz impactos significativos na qualidade de vida (QV). E necessario mensurar os efeitos das terapeuticas antivertiginosas na QV. OBJETIVO: Investigar o efeito da manobra de reposicionamento na qualidade de vida de pacientes com vertigem posicional paroxistica benigna (VPPB). MATERIAL E METODOS: Estudo retrospectivo, atraves da revisao dos prontuarios de 21 pacientes com VPPB atendidos no servico de Reabilitacao Vestibular (RV) de uma clinica escola de Belo Horizonte atendidos em 2007-2008. Foram analisados os escores fisicos, funcionais e emocionais, pre e pos-terapia de RV com realizacao de manobras de reposicionamento de Epley, por meio do questionario Dizziness Handicap Inventory (DHI), especifico para avaliacao da interferencia da tontura na QV. RESULTADOS: O intervalo mediano entre as avaliacoes foi de 21 dias. O numero medio de manobras foi 2,3±1,1. A aplicacao do DHI mostrou um significante impacto da VPPB na QV dos pacientes em todas as dimensoes da vida diaria, com os seguintes escores medios pre e pos-terapia: fisico (17,5/3,7), funcional (17,3/3,9), emocional (13,2/3,2) e total (48,1/10,9), respectivamente (p<0.001). CONCLUSAO: Na amostra estudada a manobra de Epley teve impacto positivo na QV, seja nas dimensoes fisica, funcional e emocional do DHI dos pacientes com VPPB antes e depois do reposicionamento.

Anemia em crianças de uma creche pública e as repercussões sobre o desenvolvimento de linguagem

OBJECTIVE: To compare language development in anemic and non-anemic children from a public day care center in Belo Horizonte, Minas Gerais, Brazil. METHODS: Cross-sectional study with evaluation of language development of anemic (cases) and non-anemic children (controls) between two and six years old. All children had a digital puncture to detect anemia (hemoglobin <11.3g/dL). Cases were 22 anemic children and controls, 44 children selected by randomized paired sampling. The language development of each participant was observed and classified according to two main fields: communicative aspects (reception and emission) and cognitive aspects, based on the Child Behavior Observation Guide for children from zero to six years old. Performance rates were created in order to qualify childrens answers. RESULTS: The hemoglobin values observed in case and control groups were 10.6 and 12.5g/dL, respectively. The groups did not differ regarding age, gender, breastfeeding and mothers schooling. Significant differences were observed in the language evaluation in all examined fields: levels of reception (p=0,02) and emission (p<0.001) and cognitive aspects (p <0.001), with worse performance of anemic children. CONCLUSIONS: Anemic children presented worse language development when compared to non-anemic ones. In the public health context, childhood anemia should be considered as a relevant problem due to language development alterations with possible consequences on learning abilities and future social and professional performance.

Anemia entre pré-escolares - um problema de saúde pública em Belo Horizonte, Brasil

O artigo tem por objetivo determinar a prevalencia de anemia em criancas matriculadas em creches da regional Centro-Sul de Belo Horizonte (MG), identificando fatores biologicos e socioeconomicos associados. Estudo transversal descritivo realizado em 18 creches. Foram avaliadas 373 criancas com base em amostragem estratificada por instituicao participante. A hemoglobina (Hb) serica foi determinada por puncao capilar e leitura em β-hemoglobinometro, adotando-se pontos de corte para anemia de Hb < 11,0g/dL para criancas de seis a 60 meses e Hb < 11,5g/dL para aquelas com idade superior, preconizados pela OMS. O estado nutricional foi definido por afericao do peso e altura e confeccao dos indices Peso/Idade (P/I), Estatura/Idade (E/I) e IMC/Idade (IMC/I). Entre os participantes 54% eram meninas. A media de idade foi de 38,1 ± 6,2 meses. A prevalencia global de anemia foi de 38,3%, sendo superior nas criancas com idade inferior ou igual a 24 meses (56,1%). Encontrou-se associacao significativa entre anemia e os fatores menor idade da crianca, menor idade materna e baixa renda familiar. O estudo mostrou que anemia em criancas de creches de Belo Horizonte constitui relevante problema de saude publica, sinalizando a necessidade de se implantar acoes especificas para mitigacao dos riscos por ele apontados.

Inserção dos fonoaudiólogos no SUS/MG e sua distribuição no território do estado de Minas Gerais

PURPOSE: to investigate the distribution of speech therapists in the state of Minas Gerais, their inclusion in SUS (Unique Health System) and analyze the geographical variations of this distribution and its inequalities. METHOD: analyzing Reports in Health Information of 853 municipalities in Minas Gerais, in the year of 2009, which are available at the Health Information System in Brazil, called DATASUS. The indicators: municipal population, total number of speech therapists in SUS and in the private network and the average number of speech therapists (SUS and private network) per thousand inhabitants were examined. RESULTS: data analysis revealed the presence of 1733 speech therapists acting in the state in 2009. Of these, 67.8% attended the SUS system. Of the 853 municipalities, 505 (59%) lacked the professional speech therapist in the investigated period. It was observed that among the 13 state geographical regions, the Centre-South and South regions had the best average of speech therapists per 10,000 inhabitants (1/10.000) and the North of Minas Gerais and Northeast regions, the worst, 0.16 and 0.05 / 10,000, respectively. IWe observed the presence of 0.58 speech therapists/10.000 inhabitants available in SUS and 0.86 speech pathologist/10.000 in the private network and health care system in Brazil. CONCLUSION: the inclusion of speech therapists in the state health care is poor, being observed a great disparity in the distribution of professionals. The bottleneck in the speech therapy care in SUS in Minas Gerais is notorious, since that for every 17 000 Minas residents there was only one speech therapist in SUS in the state in 2009. It is important to highlight the need for mobilization of professionals and health managers to ensure health care integrity in the state.

Estado nutricional e desenvolvimento da linguagem em crianças de uma creche pública

PURPOSE: To investigate the association between nutritional status and child language development. METHODS: The study included 34 children from four to six years and 11 months of age, enrolled in day care centers of Belo Horizonte, Minas Gerais, Brazil. Children were assessed for receptive and expressive language development using the tasks of the instrument Language Development Evaluation (ADL). Nutritional screening used the weight-for-age and length/height-for-age indexes, according to the WHOs Child Growth Standards. RESULTS: Regarding language, 13 (38%) children presented alterations; and, regarding nutritional status, 26 (76%) were well-nourished, six (18%) were at nutritional risk, one (3%) was malnourished, and one (3%) was overweight. When the means for the height/age and the weight/age indexes were compared between children with and without language development impairments, no difference was found. CONCLUSION: No association was observed between nutritional status and language development in the studied children. However, the indexes height-for-age and weight-for-age tended to be lower in children with language impairment.

Perfil auditivo de trabalhadores de um entreposto de carnes

PURPOSE: to characterize the auditory profile of workers at a Meat and Derivative Warehouse of the metropolitan region of Belo Horizonte. METHODS: it is a transversal study where 53 workers of this warehouse had been evaluated, with application of questionnaire and analysis of audiometric examinations. RESULTS: from the evaluated employees, 5.66% showed induced auditory loss for noise. The exposition time did not relate with induced auditory loss for noise. The most common auditory symptoms had been difficulty to understand words (13.2%) and difficulty to bear the intense sounds (11.3%) and the not auditory symptoms had been headache (16.9%) and irritability (11.3%). Significant difference was observed (p < 0.05) when correlating the individuals with normal and modified hearing with the presence of humming, complaint about listening abilities and difficulty to talk in noisy environments. CONCLUSION: the results reveled that individuals with audiometries suggesting induced auditory loss for noise were more vulnerable to humming, also showing more difficulty to talk in noisy environments. However, the others auditory and non-auditory complaints were raised in both groups, regardless of the existence of auditory loss.

Distribuição dos fonoaudiólogos na atenção à saúde no estado de Minas Gerais entre 2005 e 2010

PURPOSE: to analyze trends in the distribution of speech therapists in Minas Gerais from 2005 to 2010. METHOD: it is a retrospective study, in which a secondary database of public domain - Reports in Health Information of Brazilian Health Information System, called DATASUS was analysed. It was considered data from 853 municipalities in Minas Gerais, highlighting the resource indicators related to the number of speech therapist, the number of professionals in the Minas Gerais macro regions, the population of these spaces, the binding of the speech therapists to the Public Health System (SUS) and the trends distribution of these professionals from 2005 to 2010. RESULTS: from 2005 to 2010, there was a significant increasing in the number of speech therapists. The number of municipalities with speech therapist raised from 32,8% to 54,5%. Since 2008, marked as the peak of professional growth, there was an increase about 25%. The number of speech therapist per 10.000 inhabitants increased from 0,61 in 2005 to 1,30 in 2010. CONCLUSION: there was a considerable increase in the distribution of speech therapists in the searched state, rising from 1237 professionals in 2005 to 2555 professionals in 2010. In 2005, 278 of the municipalities had a speech therapist in the health care. Five years later, there was an increase of 186 municipalities with speech therapist, indicating greater availability of this professional for the mining population. Although the data from this study reinforce the accessibility and professional presence in Minas Gerais, it was notable regional discrepancy in the state.

Effect of classroom acoustics on the speech intelligibility of students

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

Percepção de agentes comunitários de saúde sobre os riscos à saúde fonoaudiológica

OBJETIVO: Investigar a percepcao dos agentes comunitarios sobre os aspectos relacionados a saude fonoaudiologica da populacao usuaria de um programa de saude da familia. METODOS: Trata-se de estudo observacional transversal com aplicacao de questionario a 85 agentes comunitarios. Foram investigadas 20 situacoes hipoteticas abordando os temas fonoaudiologicos na rotina de trabalho dos agentes. As variaveis analisadas foram: idade, tempo de atuacao, escolaridade, percepcao dos riscos a saude da populacao nas areas de voz, motricidade orofacial, linguagem e audiologia. RESULTADOS: A media de idade dos agentes foi de 38 anos (±9,1), e o tempo de medio de atuacao no programa 5,0 anos (±2,9). Observou-se que 80 profissionais (94%) possuiam pelo menos o Ensino Medio completo, e todos eram do genero feminino. Entre as situacoes hipoteticas investigadas, os agentes demonstraram ter a percepcao do risco e atitude de leva-lo para discussao da equipe em 49% das situacoes envolvendo o risco a saude auditiva, 53% saude vocal, 60% e 62% os riscos relacionados a motricidade orofacial e linguagem, respectivamente. Nao foi encontrada relacao entre o tempo de atuacao e a percepcao do risco a saude fonoaudiologica. CONCLUSAO: Os agentes comunitarios mostraram ter percepcao de muitas situacoes de risco a saude fonoaudiologica dos usuarios, especialmente no que se refere a saude vocal e das estruturas e funcoes orofaciais. E necessario ao agente comunitario ir alem das habilidades e competencias conceituais e procedimentais no que se refere a saude da comunicacao humana, pois se almeja um profissional com habilidades atitudinais.