A disfonia limita o trabalho docente e compromete a qualidade de vida do professor. O presente trabalho investigou fatores associados à pior qualidade de vida relacionada à voz em 2.133 professoras da rede municipal de ensino fundamental de Belo Horizonte, Minas Gerais, Brasil. A qualidade de vida foi mensurada pelo Protocolo de Qualidade de Vida e Voz, um questionário internacional padronizado com dois domínios: sócio-emocional e físico. As professoras foram agrupadas segundo o escore final dos domínios, sendo o menor quartil definido como ponto de corte para uma pior qualidade de vida relacionada à voz. Menor criatividade no trabalho e relacionamento ruim com alunos estiveram associados com a pior qualidade de vida relacionada à voz em ambos os domínios. Transtorno mental (GHQ12 > 4) esteve associado somente ao domínio sócio-emocional, e ruído na sala de aula apenas ao componente físico. Os resultados indicam que a qualidade de vida é uma dimensão fundamental para analisar a disfonia no trabalho docente e que condições ruins de trabalho estão associadas a uma pior qualidade de vida relacionada à voz.

Several studies have shown a high prevalence of voice disorders among teachers. However, it is difficult to establish comparisons among the results found given the great variability among criteria and symptoms used to define the presence of vocal alteration, in addition to the variations in the composition of the populations studied (age, gender, origin, working schedule, profession, among others). This study aims to discuss the need for a standard definition of functional voice disorder and possible implications of the lack of such a standard definition on estimating the prevalence of functional voice disorders among teachers. A systematic bibliographic review on voice disorders in teachers was carried out as of 1990 in the Medline, Scielo, Ovid, Pubmed and Lilacs databases. Of the 3,186 citations, 15 fulfilled the inclusion criteria to discuss prevalence of vocal disorder in teachers. Nine articles defined vocal disorder based solely on the presence of vocal symptoms, which varied in relation to type, number, frequency, and reference period. Hoarseness and vocal tiredness were mentioned in all studies that evaluated vocal symptoms. Only three studies reported prevalence based on professional examination. Prevalence rates varied according to reference period and frequency of symptoms. The results ratified the importance of standardizing the case definition of voice disorder in order to better study and understand its occurrence and to compare prevalence obtained from different populations and along time in the same population. Standardized definitions should include laryngeal alterations observed in later phases of voice disorder as well as signs and symptoms present in phases previous to organic alterations, when they are potentially reversible.

IntroduçãoErros na medida da exposição são uma das maiores fontes de viés em estudos epidemiológicos, os quais podem levar a conclusões espúrias sobre a relação entre a exposição e a doença. Do ponto de vista do indivíduo, esses erros podem ser definidos como a diferença entre a medida da exposição e a exposição verdadeira 1 . Nesse prisma, o uso do informante secundário pode ser uma importante fonte de viés na mensuração de exposições e eventos em saúde.Os informantes secundários são usados em estudos epidemiológicos quando a população estudada, por alguma razão (morte, demência, debilidade física, desconhecimento), é incapaz de informar os dados requeridos. Seu uso também pode ocorrer para aumentar o número de indivíduos avaliados em um estudo, provendo assim maior representatividade ao grupo estudado, como no caso de muitos inquéritos populacionais de saúde 2,3 .Apesar da importância dos informantes secundários, alguns estudos têm mostrado que a concordância entre o indivíduo e seu informante é melhor para os componentes físicos e pior para os componentes emocionais relacionados à qualidade de vida 4,5,6 . Os indivíduos que fornecem a informação no lugar do sujeito pesquisado tendem a subestimar ou superestimar os escores de qualidade de vida do informante primário 7 . Similarmente, Fayers & Machin (2000, ARTIGO ARTICLE

Our findings showed a relationship between inflammation and LBP by establishing that low IL-6 plasma levels preceded outcome (LBP recovery), supporting the concept that proinflammatory cytokines promote pain.

OBJECTIVE:To analyze whether the explanatory model for health assessments among elderly people based on self-reporting is comparable with the model based on secondary informant reporting, and whether the secondary informant's selfassessed health infl uences the health assessment among these elderly people. METHODS:This was a cross-sectional study on 230 pairs consisting of one elderly individual and one secondary informant, conducted in Belo Horizonte, Southeastern Brazil, in 2007. The sociodemographic and health variables of the elderly people were investigated by means of a structured interview. Multiple logistic regression was used to analyze associations with self-assessed poor health among the elderly individuals and with the information provided by the secondary informants. RESULTS:In the model based on self-reporting, the variable most strongly associated with poor health assessment among these elderly individuals was the presence of limitations or disabilities relating to performing activities of daily living and/or mobility. In the model based on the secondary informant, the most important explanatory variable was the number of chronic diseases presented by the elderly individual. Furthermore, the chance that the secondary informant would assess the elderly individual's health as poor was three times greater when this informant assessed his own health as poor. CONCLUSIONS:The results showed signifi cant differences between the health assessment model for elderly people based on the individual's own responses and the model based on a secondary informant's responses. The elderly individuals tended to place value on their limitations or disabilities relating to performing activities of daily living and mobility, while secondary informants tended to place value on the diagnoses of chronic diseases. Secondary informants with poor self-assessed health presented almost three times greater chance of reporting elderly individuals' health as the same as their own. Thus, self-reported information better refl ects individuals' health conditions than do reports from secondary informants.

Health care workers (HCWs) are at an increased risk of being exposed to COVID-19. This study aimed to characterize flu-like syndrome cases (FS) in HCWs notified in Brazil and compare them with FS cases in the general community (GC). In the Brazilian protocol, FS corresponds to a suspected case of COVID-19. The manuscript analyzed cases of FS in five Brazilian states, estimating the incidence rates of cases of FS and clinical and epidemiological characteristics. Registered cases (March to June 2020) totaled about 1,100,000 cases of FS. HCWs represented 17% of the registers, whose incidence was 20.41/100 vs. 2.15/100 in the GC. FS cases in HCWs concentrated the highest percentages in the age group of 30 to 49 years (65.15%) and among the nursing staff (46.86%). This study was the first interstate evaluation in Brazil to estimate suspected cases of FS by COVID-19 in HCWs. In order to control the spread of viral respiratory infections in HCWs, including COVID-19, it is necessary to review the management of health information to identify who they are, how many they are, and to what situations these workers are most frequently exposed, as well as in what professions they have. This information can guide specific, practical, and far-reaching actions.

Objective: To investigate the prevalence of voice complaints among bus transport workers in a metropolitan area in Brazil and examine whether sociodemographic and occupational factors were associated with this outcome. This study is part of a larger study that investigated the working conditions and health of drivers and conductors of urban transportation. Methods: The sample size (1,607 participants) was calculated by means of quotas and was stratified according to occupation (drivers and conductors) in the bus companies of Belo Horizonte, Betim and Contagem. Face-to-face interviews were facilitated by means of a digital questionnaire, applied by the interviewer using a netbook. The outcome variable was constructed from combining the responses to the following two questions: (1) Over the last two weeks, have you felt tired when speaking? (no/sometimes/every day). (2) Over the last two weeks, have you noticed any worsening of your voice quality? (no/sometimes/every day). Sociodemographic, lifestyle, occupational characteristic and health situation data were gathered. Results: The prevalence found was 29% overall: 24% for drivers and 34% for conductors. Attention was drawn to positive associations with the function of conductor and with reports of exposure to vibration and thermal discomfort. Among the individual factors, only female gender reached statistical significance. Conclusion: Risk factors exist that justify interventions to promote voice health within the urban transport sector under study. It would be appropriate to investigate whether vibration of the whole body would influence the functioning and morphology of the larynx.

Objetivou-se investigar o tema da Integração Ensino-Serviço-Comunidade na percepção de discentes da Universidade Federal de Sergipe, campus Lagarto, e o perfil sociodemográfico dos estudantes. Trata-se de uma pesquisa aplicada, observacional, transversal, de abordagem por métodos mistos e caráter descritivo, realizada por meio de questionários semiestruturados autoaplicáveis. Os participantes deste estudo foram discentes de graduação matriculados nos oito cursos da área de ciências da saúde oferecidos pelo campus Lagarto. Os dados quantitativos foram analisados de forma descritiva por meio do software Excel (Microsoft®). O software WebQDA® foi utilizado nas análises qualitativas para a descrição das categorias de análise. Participaram deste estudo 412 estudantes, correspondente a 25% da média de alunos matriculados dentro do período da pesquisa [2018-2019; (n=1639)] sendo prevalentes: estudantes do sexo feminino (72,7%; n=298), heterossexuais (91%; n=372), negros (76%; n=312), com idade entre 16 a 24 anos (91%; n=344), solteiros (92,7%; n=295), que possuíam ao menos um filho (62,5%; n=256). A frequência de atividades de Integração Ensino-Serviço-Comunidade, referidas por discentes, foi variável de acordo com o módulo curricular: maior dentro da Universidade nas disciplinas de Tutorial/Equivalente (62,4%; n=234) e Habilidades/Equivalente (63,5%; n=237) e, nos espaços coletivos do território (57,5%; n=215), no módulo de Prática de Ensino na Comunidade/Equivalente. Dentre os discentes, 20% (n=71) não possuíam nenhuma compreensão sobre o tema da Integração Ensino-Serviço-Comunidade. As concepções identificadas estavam alinhadas principalmente a Associação da teoria com a prática (35%; n=127), Prestação de Serviços (15,5%; n=56) e Estratégia para aperfeiçoamento da formação para o Sistema Único de Saúde (12%; n=44). Os dados indicam que, com o avançar dos ciclos, as atividades de Integração Ensino-Serviço-Comunidade do módulo de Prática de Ensino e Comunidade acontecem cada vez menos nos espaços coletivos do território, e se tornam mais habituais nas dependências ou nos consultórios das unidades de saúde municipais, nos diferentes níveis de atenção.Palavras-chave: Relações Comunidade-Instituição. Sistema de Aprendizagem em Saúde. Educação em Saúde.