Resumo A maior parte dos distúrbios ocupacionais da voz são de natureza funcional. O esforço vocal excessivo e prolongado pode levar ao desenvolvimento de alterações crônicas. A grande quantidade de informações científicas produzidas e veiculadas na área da saúde vocal requer dos especialistas um olhar atento às melhores evidências que auxiliam na resolubilidade ou amenização do problema. Objetivos: Investigar os principais temas e abordagens metodológicas dos estudos qualitativos sobre saúde vocal do professor. Métodos: Revisão integrativa realizada nas principais bases e portais de dados da saúde, seguindo as etapas: escolha do tema e elaboração da pergunta norteadora; critérios de elegibilidade dos artigos para inclusão e exclusão; estratégia de busca, seleção de estudos e extração de dados; análise dos dados coletados. A pergunta norteadora foi: “Quais os principais assuntos abordados e características metodológicas das pesquisas qualitativas que versam sobre a saúde vocal dos professores publicadas de janeiro de 2012 a dezembro de 2022?” Resultados: Identificaram-se 364 estudos, com a inclusão de 21 para análise. Os principais objetivos das investigações selecionadas referem-se a percepções de professores ou profissionais de saúde sobre: propostas de intervenção e promoção da saúde vocal; fatores que interferem na saúde vocal; associação entre saúde vocal e trabalho; associação entre saúde vocal e qualidade de vida; avaliação de tecnologia voltada à saúde vocal; e atuação do fonoaudiólogo na saúde vocal do professor. Entrevistas semiestruturadas foram as estratégias mais utilizadas para a coleta, e a análise de conteúdo, para a análise e organização dos dados. Observaram-se alguns artigos com abordagem mista. Conclusões: Este artigo auxilia na ampliação do conhecimento sobre estudos qualitativos na área de saúde vocal do professor, evidenciando suas características e fortalecendo a associação entre teoria e prática, o que contribui para a tomada de decisão e a aplicação das melhores práticas no cuidado à saúde.

Abstract Most occupational voice disorders are functional in nature. Excessive and prolonged vocal effort can lead to the development of chronic alterations. The large amount of scientific information produced and disseminated in the field of vocal health requires specialists to pay close attention to the best evidence that helps solve or alleviate the problem. Objectives: Investigate the main themes and methodological approaches of qualitative studies on teachers' vocal health. Methods: Integrative review carried out in the main health data bases and portals, following the steps: choice of theme and elaboration of the guiding question; eligibility criteria of articles for inclusion and exclusion; search strategy, study selection and data extraction; analysis of collected data. The guiding question was: “What are the main issues addressed and methodological characteristics of the qualitative research that deals with the vocal health of teachers published from January 2012 to December 2022?” Results: There were identified 364 studies, with the inclusion of 21 for analysis. The main objectives of the selected investigations refer to the perceptions of teachers or health professionals about: proposals for intervention and promotion of vocal health; factors that interfere with vocal health; association between vocal health and work; association between vocal health and quality of life; evaluation of technology focused on vocal health; and the speech therapist's role in the teacher's vocal health. Semi-structured interviews were the most used strategies for data collection, and content analysis for data analysis and organization. Some articles with a mixed approach were observed. Conclusions: This article helps to expand knowledge about qualitative studies in the area of teachers' vocal health, highlighting its characteristics and strengthening the association between theory and practice, which contributes to decision-making and the application of best practices in health care.

Résumé En nous appuyant sur l’instrument théorique de la grammaire tensive développée par Claude Zilberberg, nous prétendons démontrer que la notion générale de l’indicible peut se définir, sémiotiquement parlant, comme le corrélat expressif d’un “excédent de sens” généré par un dépassement aspectuel —opération tensive d’expansion paradigmatique qui, en établissant grâce à la force d’un événement de nouvelles limites dans un univers discursif quelconque, transforme les limites préétablies en seuils (degrés) d’une échelle marquée par l’instabilité. Le contenu d’un dépassement se définira en termes intensifs par l’incommensurabilité ; en termes extensifs, par l’absence de précédents ; et, en termes jonctifs, par la concessivité radicale, c’est-à-dire par le caractère inconcevable de l’expérience. Voici donc les trois paramètres sémantico-aspectuels véhiculés par l’indicible à travers la variété des ressources discursives qui le mettent en évidence.

Abstract Based on the theoretical framework of Tensive Grammar, as developed by Claude Zilberberg, we aim to demonstrate that the general notion of unspeakable can be defined, in semiotic terms, as the expressive correlate of a “sense surplus” generated by an aspectual overflow —tensive operation of paradigmatic expansion that, by establishing new limits in a given universe of discourse as the result of an event, transforms the pre-established limits into thresholds (degrees) in a scale marked by instability. The content of an aspectual overflow will be defined, in terms of intensity, by immeasurability; in terms of extent, by the lack of precedents; and in terms of junction, by a radical concession, that is, by the inconceivable nature of the experience. These will therefore be the three semantic-aspectual parameters conveyed by the notion of unspeakable through the vast array of discursive resources that can be employed to manifest it.

Resumen Tomando como base el instrumental teórico de la gramática tensiva desarrollada por Claude Zilberberg, esta contribución se propone demostrar que la noción general de indecible puede ser definida semióticamente como el correlato expresivo de un “excedente de sentido” generado por un rebasamiento aspectual —operación tensiva de expansión paradigmática, que, al establecer, por la fuerza de un evento, nuevos límites dentro de un universo discursivo cualquiera, transforma los límites prestablecidos en umbrales (grados) de una escala marcada por la inestabilidad. El contenido de un rebasamiento será definido en términos intensivos por la inconmensurabilidad; en términos extensivos, por la ausencia de precedentes; y, en términos juntivos, por la concesividad radical, es decir, por el carácter inconcebible de la experiencia. Serán estos, por tanto, los tres parámetros semántico-aspectuales vehiculados por lo indecible a través de la variedad de recursos discursivos que lo ponen de manifiesto.

Abstract Geometric morphometric methods are powerful tools to discriminate between closely related ostracods taxa as well as to study the relationship between their morphological variations, taxonomy and paleoecology. In this study, valve outline analysis allows the discrimination between the non-marine ostracod C. silvestrii and R. whatleyi juveniles, pointing out differences in the posterior valve area and surface ornamentation. Modern female specimens of C. silvestrii from 23 sites located in a spatial transect (41 to 51 °S) exhibited extensive morphological variability, on the basis of which three morphotypes (acuminated, transitional, subtruncated) were determined. Multivariate analyses showed that acuminated and transitional shapes are not arranged in groups but the subtruncated morphotype, previously described as E. cecryphalium, seems to be associated with low water conductivity (372 µS cm-1), dominant cold (5 ºC) and windy (8.6 m s-1) climatic conditions. The fossil cluster which included nine cores spanning the last 15.6 kyr, only covered acuminated and transitional shapes, which may indicate that these lineages might be older than the subtruncated morphotype. In addition, morphological differences between reproduction modes suggested that parthenogenetic females exhibit de posterior margin more acuminate than sexual females. These results set the ground for more precise ecological and paleoenvironmental studies in Patagonia.

Abstract In order to characterize Patagonian (Argentina) ecoregions using non-marine ostracods, their associations in 69 environments were assessed. Twenty eight taxa were recorded, including 12 endemic of the Neotropical region. Our results indicate that Patagonian ostracods are mainly influenced by electrical conductivity (EC), altitude, pH, and temperature; and shows a correlation with Argentinian ecoregions. Assemblage I is composed of sites located at high altitude in the Andean Patagonian forest ecoregion. Host waters have low temperature, EC and pH, and support as representative species Cypris pubera, Eucypris virens, Bradleystrandesia fuscata, Tonacypris lutaria and Amphicypris nobilis. Assemblage II, related to mid-altitude environments in the Patagonian Steppe ecoregion, thrived in waters with moderate to high EC, and alkaline pH values. Dominant species includes Limnocythere rionegroensis, L. patagonica, E. virgata, Riocypris whatleyi, Riocypris sarsi, Newnhamia patagonica, Kapcypridopsis megapodus, Ilyocypris ramirezi and Penthesinelula incae. Assemblage III inhabited environments within Monte and Espinal ecoregions, situated in the eastern part of the study area at low altitude, EC moderate and temperate waters, supporting Heterocypris hyalinus, Amphicypris argentinensis, Sarscypridopsis aculeata, Cypridopsis vidua, Herpetocypris intermedia and Chlamidotheca incisa. Our results indicates that Argentinian Patagonia hosts a diverse ostracod fauna and highlights their capacity as proxies in ecological and palaeoenvironmental studies.

Resumo Introdução O Sistema Único de Saúde considera o cuidado hospitalar como importante eixo para a construção da integralidade. Os residentes do Programa de Residência Multiprofissional, do Hospital Universitário da Universidade de São Paulo, identificaram dificuldades da equipe médica e de enfermagem em detectar demandas em reabilitação na alta hospitalar, levando residentes a criarem um grupo de apoio à alta. Objetivo Verificar o perfil sociodemográfico e de saúde dos usuários acompanhados pelo grupo de apoio, identificar os desafios para inserção dos usuários na rede de serviços de reabilitação e as estratégias do grupo de apoio para enfrentamento desses desafios. Método Estudo retrospectivo, exploratório e descritivo, baseado em análise documental. Resultados Foram analisados formulários de 251 usuários, 83 (33%) receberam encaminhamento para reabilitação por ocasião na alta hospitalar e 17 (6,7%), a partir das orientações do grupo de apoio à alta; 95 (37,8%) procuraram serviços de reabilitação. Desses, 60 foram efetivamente inseridos em serviços, sendo 46 (18,3%) extra-hospitalares, como centros de reabilitação e unidades básicas de saúde, e 14 (5,6%) no Programa de Atendimento Domiciliar do hospital. Quanto às áreas profissionais, 34 (13,5%) iniciaram tratamento fisioterápico, 29 (11,6%), fonoaudiológico e 11 (4,9%), terapêutico-ocupacional. Identificaram-se insuficiência de encaminhamentos profissionais e dificuldades dos usuários quanto ao acesso e continuidade de atenção. Conclusão O grupo de apoio tem reforçado encaminhamentos prescritos ou sua obtenção em consultas médicas na rede, acolhido demandas por área profissional, orientado usuários para acessar serviços e inserir-se em tratamentos. Os usuários valorizaram a escuta e o acolhimento do grupo de apoio, no qual se configuram estratégias para promoção do cuidado integral em saúde.

Abstract Introduction The Unified Health System considers that hospital care is important for the construction of integrality. Residents in a Multi-professional Residency Program to the Hospital Universitário da Universidade de São Paulo indicated, difficulties of the medical and nursing staff were identified to detecting demands for rehabilitation at hospital discharge, which encouraged residents to create a support group to hospital discharge. Objective To verify the sociodemographic and health profile of users accompanied by the support group, identify challenges for insertion of these users in the rehabilitation care network and identify strategies of the support group to face these challenges. Method Retrospective, exploratory and descriptive study, based on the documentary analysis. Results We analyzed forms of 251 users, 83 (33%) received a referral for rehabilitation at discharge and 17 (6.7%) received referral after guidelines of the discharge support group; 95 (37.8%) sought rehabilitation services. Of these, 60 were effectively included in the services, of which 46 (18.3%) were extra-hospital, such as rehabilitation centers, basic health units and 14 (5.6%) in the Hospital Home Care Program. Concerning professional areas, 34 (13.5%) started physical therapy treatment, 29 (11.6%), speech therapy and 11 (4.9%), therapeutic-occupational. It was identified insufficiency of professional referrals and difficulties of users regarding access and continuity of care. To cope with challenges, the support group has reinforced prescribed referrals or directed obtaining referrals in medical consultations on the network. Conclusion The group has tried to understand user demands by professional area, oriented users to access services and to get treatments. The users have valued the receptiveness of the support group, being a strategy to promote integral health care.

Le présent article prétend réaliser une approximation de la notion d'ironie romantique à partir du point de vue de ses implications littéraires. En tant que processus discursif, l'ironie romantique établit un paradigme qui renferme une interruption du fonctionnement logique du langage au profit d'une conception paradoxale du sens qui se base sur une vision du monde comme devenir.

This article attempts an approach to the notion of romantic irony from the point of view of its literary implications. As discursive procedure, romantic irony establishes a paradigm that involves a disruption of the logical functioning of language in favor of a paradoxical conception of sense that is grounded in a worldview as becoming.

El presente artículo pretende una aproximación a la noción de ironía romántica desde el punto de vista de sus implicaciones literarias. Como procedimiento discursivo, la ironía romántica establece un paradigma que entraña una interrupción del funcionamiento lógico del lenguaje en provecho de una concepción paradójica del sentido que tiene su fundamento en una visión del mundo como devenir.

OBJECTIVES:The aim of the present study was to determine the Chlamydia trachomatis prevalence and to identify the demographic, behavioural and clinical factors associated with C. trachomatis in human immunodeficiency virus infected men.STUDY:This was a cross-sectional study of C. trachomatis prevalence among human immunodeficiency virus-infected men enrolled at the Outpatient clinic of acquired immunodeficiency syndrome of the Fundação de Medicina Tropical Dr. Heitor Vieira Dourado in Manaus, Amazonas, Brazil. C. trachomatis deoxyribonucleic acid from urethral samples was purified and submitted to real time polymerase chain reaction to identify the presence of C. trachomatis.RESULTS:A total of 276 human immunodeficiency virus-infected men were included in the study. The prevalence of C. trachomatis infection was 12% (95% confidence interval 8.1%-15.7%). The mean age of the participants was 34.63 (standard deviation 10.80) years. Of the 276 human immunodeficiency virus-infected men, 93 (56.2%) had more than one sexual partner in the past year and 105 (38.0%) reported having their first sexual intercourse under the age of 15 years. Men having sex with men and bisexuals amounted to 61.2% of the studied population. A total of 71.7% had received human immunodeficiency virus diagnosis in the last three years and 55.1% were using antiretroviral therapy. Factors associated with C. trachomatis infection in the logistic model were being single (p<0.034), men having sex with men (p<0.021), and having previous sexually transmitted diseases (p<0.001).CONCLUSION:The high prevalence of C. trachomatis infection among human immunodeficiency virus-infected men highlights that screening human immunodeficiency virus-infected men for C. trachomatis, especially among men having sex with men, is paramount to control the spread of C. trachomatis infection.

OBJETIVO: avaliar de forma objetiva e subjetiva a voz de pacientes com disfonia espasmódica nos momentos pré e pós aplicação de toxina botulínica A. MÉTODO: as emissões vocais de onze pacientes do sexo feminino foram registradas antes e após (15 dias) o tratamento. As amostras vocais foram analisadas por duas fonoaudiólogas com experiência em voz por meio da análise perceptivo-auditiva (escala GRBASI) e da análise espectrográfica. RESULTADOS: na análise perceptivo-auditiva com vogal sustentada os parâmetros que alteraram após o tratamento foram o grau de severidade, tensão e instabilidade, enquanto na fala encadeada foram o grau de severidade e a tensão. Na análise espectrográfica ocorreu melhora do traçado após o tratamento sem significância estatística entre os parâmetros. CONCLUSÃO: ocorreu melhora significante dos aspectos perceptivo-auditivos após o tratamento e, portanto, as injeções de toxina botulínica A mostraram-se eficazes no tratamento da disfonia espasmódica no grupo estudado.

PURPOSE: to analyze in an objective and subjective manner the voice of patients with spasmodic dysphonia in the moments before and after botulinum toxin A. METHOD: the vocal emissions of eleven women patients were recorded before and after (15 days) treatment. The vocal samples were analyzed by two experienced speech therapists through the perceptual analysis (GRBASI scale) and spectrographic analysis. RESULTS: in the perceptual analysis with subtended vowel, the altered parameters were degree of severity, strain and instability, while in connected speech only degree of severity and strain changed after treatment. In the perceptual analysis with sustained vowel, the parameters that have changed, were the degree of severity, strain and instability, while in connected speech only degree of severity and strain changed after treatment. The spectrographic analysis was improved after treatment with no statistical significance found among the parameters. CONCLUSION: there was significant improvement of the vocal analysis after treatment and, therefore, injections of botulinum toxin A were effective in the treatment of spasmodic dysphonia in this group.