Browsing by Author "Amaro, Joana"
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- Voice health of teachers in the north of Portugal: epidemiological indicatorsPublication . Santos, Marisa; Araújo, André; Andrade, Ana; Amaro, JoanaEffective communication is a fundamental requisite for teachers and other professionals in the education field. Teachers are considered professional voice users, as voice quality is central to their speech and communicative profile. In the last decades, teachers have been shown to be a risk group concerning voice disorders. Several studies have already identified specific risk factors within this population, and proposed voice health promotion measures, including prevention actions, and labour policy changes. The intervention of teachers as active advocates of their own interests is crucial to ensure improvements in their working conditions and in their labour rights. This study is the first conducted in Portugal by the initiative of a teachers’ syndicate and was included in a Voice Prevention Program implemented in northern Portugal. Thus, the aims of this study were to determine a) the prevalence of voice disorders self-reported by teachers of this region, b) the most frequent voice symptoms, and c) the risk and protection factors associated with voice disorders in this group. An observational analytic case-control study was conducted for epidemiologic and correlation analysis purposes. The population of teachers in northern Portugal is estimated to be more than 60.000 professionals. Our sample was composed by 405 teachers which participated in a voice health promotion initiative. A self-directed questionnaire, previously developed and validated in other similar Portuguese studies, was used. This instrument included questions exploring demographic information, teaching experience and specialty, individual and environmental factors, health information, voice problems, and vocal symptoms, among others. The discrete variables were compared with chi-square test and a logistic regression model was used in order to calculate the adjusted odds ratios and their confidence intervals at 95%. Significance level was determined at the 5% level. The prevalence of self-reported voice disorders in the last year was 57%. Most relevant symptoms were: loss of voice control, dry throat, tired and weak voice, roughness, tightness or pressure, and voice breaks in speech. Several risk factors were identified, namely: being a female teacher, teaching in the 1st cycle, teaching non-specific disciplines, working in stuffy classrooms, having difficult access to water, and anxious personal profile, suffering of depressive disorder, sinusitis and gastro-oesophageal reflux disease, and yelling. Protection factors were: teaching in secondary level (high school), teaching physicochemical sciences, and working in a classroom with natural ventilation. Voice disorders’ prevalence was high, although in line with other regions and countries previously described. Considering existing literature, symptoms were also similar, but some risk factors where different. As this was a pilot study, future work will expand the number and geographical distribution of the sample, reinforcing its statistical relevance, in order to contribute to better labour policies in Portugal.
- Water quality supply in a Portuguese teaching hospital: monitoring and studies on detection of critical pointsPublication . Norton, Pedro; Amaro, Joana; Martins, Natália; Vieira Da Silva, ManuelaSurveillance of drinking water quality is extremely important to human health, assuming greater relevance in hospital environments, especially to those individuals who are immunocompromised. This study is aimed to determine the effect of increasing free chlorine (Cl) concentration in a hospital water network in regard to water quality monitoring and microbial growth control, between 2010 and 2013 in Porto. The average of free Cl concentration in the period under analysis showed some heterogeneity per floor, varying between 0.84 and 1.25 mg/L. In addition, there was a rise in proportion of samples that exceeded WHO guidelines (free Cl 0.5 mg/L), particularly in the last two years of the same period. With respect to microbial analysis, 22.4% of the samples were positive for Legionella spp., 6.4% for Pseudomonas aeruginosa, 15% and 30.4% for aerobic plate counts at 36 and 22 C, respectively. The proportion of positive samples decreased throughout the period under analysis, in particular for Legionella spp. (41.7% in 2010 vs. non-detectable in 2013) and P. aeruginosa (10.8% in 2010 vs. 3.3% in 2013). These results are in accordance with the gradual rise in free Cl concentration (0.78 § 0.94 mg/L in 2010 vs. 1.16 § 0.51 mg/L in 2013). In conclusion, a suitable plan for drinking water quality was instituted which resulted in reducing microbiological growth in the waterwork network, improving public health protection. However, the detection of critical points associated with lower levels of free Cl were found on certain floors/points-of-use, requiring the need to improve the monitoring water treatment system and/or implementation of additional technologies.