Summary Herbal remedies have been used for many years to alleviate various symptoms. They were used in ritual acts to reassure the Gods and as medication. Plants as rhubarb and ginseng were used in China long time ago. The Egyptians had knowledge of herbal medicine such as aloe, myrrh and henbane, 1550 BC. The father of medicine Hippocrates used a large number of herbal medicines, and had many theories on the subject. Different parts of the plant can be used to extract the active ingredients. The active ingredient is made up of essential oils, tanning substances etc. The parts that are used may be the root, stem, leaves, and flowers. In order to extract the active ingredients, you can use various strategies such as making tinctures or extracts. Echinacea has been used against various diseases, the plant now used to alleviate cold symptoms. St John's worth can be used for depression. Valerian can be used as a sedative. Ginkgo can be used for poor cerebral blood flow in the brain. The mental and physical performance can be increased with the help of ginseng. These are approved herbal medicine and the interest in them is increasing. But do they work and how safe are they? Use and safety of Echinacea and Ginkgo where reviewed in the present study. Three scientific articles on the echinacea effect were studied, as were two articles about ginkgo. The aim of the Echinacea articles was to examine whether the plant was effective against the common or not. The other two articles examined ginkgo’s effect on memory problem and on tinnitus, respectively. Echinacea studies showed no significant difference therapeutically compared to placebo. The side effects were few, and not serious. The studies on ginkgo did not demonstrate any therapeutic difference compared to placebo. The side effects were few and not serious. These are approved herbal remedies. Do they really work, or could this effect rather be referred to as placebo? The use of herbal remedies as medicines could potentially be useful as complementary to traditional medicine. To read the instructions and follow the dosage, however, is an important part of the safety. More studies are also needed on the safety of herbal remedies. / Abstrakt I många år har man använt sig av naturläkemedel för att lindra olika sjukdomssymtom. Dels användes förr dels i rituella handlingar för att blidka gudarna, och dels i medicineringssyfte. Växter som rabarber och ginseng användes i Kina. Egyptierna hade kunskaper om läkeväxter som aloe, myrra och bolmört, redan 1550 f.kr. Medicinens fader Hippokrates använde sig av ett stort antal läkeväxter och hade många teorier angående ämnet. Olika delar av växten kan utnyttjas för att utvinna de aktiva substanserna. Delarna som används kan vara t ex roten, stammen, bladen, blomman. De aktiva substanserna består av eteriska oljor, garvämnen, slemämnen, bitterämnen m.m.. För att utvinna de aktiva substanserna använder man sig av olika bredningsformer som tinktur, extrakt eller annat. Echinacea har använts mot flera olika sjukdomar. Nu används växten för att lindra förkylningssymtom. Johannesört ges mot depression. Som lugnande medel kan valeriana användas. Ginkgo kan användas vid dålig genomblödning, t ex i hjärnan. Den psykiska och fysiska prestationsförmågan kan höjas med hjälp av ginseng. Dessa är godkända naturläkemedel. Och intresset för dem ökar. Men fungerar de, och hur säkra är de? I detta arbete granskades artiklar om Echinacea och Ginkgo, deras användning och säkerhet. Tre vetenskapliga artiklar, angående echinaceas effekt studerades, samt två artiklar om ginkgo. Echinacea-artiklarnas syfte var att undersöka om växten hade effekt mot förkylning. De andra två artiklarna undersökte ginkgos effekt dels mot minnesproblem, och dels mot tinnitus. Echinaceastudierna visade ingen signifikant terapeutisk skillnad jämfört med placebo. De biverkningar som fanns var få och inte allvarliga. Studierna om ginkgo visade inte heller någon terapeutisk skillnad jämfört med placebo. Biverkningarna var även här få och inte allvarliga. Dessa godkända naturläkemedel, har i andra studier visat vetenskapligt bevisad effekt, men kan denna effekt möjligen framför allt vara en placeboeffekt? Användningen av naturläkemedel kan vara ett bra komplement till traditionell medicinering. Att läsa anvisningarna och följa doseringen är dock en viktig del av säkerheten. Flera studier behövs även kring säkerheten med naturläkemedel. 2008:F26

<p>Summary</p><p>Herbal remedies have been used for many years to alleviate various symptoms. They were used in ritual acts to reassure the Gods and as medication. Plants as rhubarb and ginseng were used in China long time ago. The Egyptians had knowledge of herbal medicine such as aloe, myrrh and henbane, 1550 BC. The father of medicine Hippocrates used a large number of herbal medicines, and had many theories on the subject.</p><p>Different parts of the plant can be used to extract the active ingredients. The active ingredient is made up of essential oils, tanning substances etc. The parts that are used may be the root, stem, leaves, and flowers. In order to extract the active ingredients, you can use various strategies such as making tinctures or extracts. Echinacea has been used against various diseases, the plant now used to alleviate cold symptoms. St John's worth can be used for depression. Valerian can be used as a sedative. Ginkgo can be used for poor cerebral blood flow in the brain. The mental and physical performance can be increased with the help of ginseng. These are approved herbal medicine and the interest in them is increasing. But do they work and how safe are they?</p><p>Use and safety of Echinacea and Ginkgo where reviewed in the present study. Three scientific articles on the echinacea effect were studied, as were two articles about ginkgo. The aim of the Echinacea articles was to examine whether the plant was effective against the common or not. The other two articles examined ginkgo’s effect on memory problem and on tinnitus, respectively. Echinacea studies showed no significant difference therapeutically compared to placebo. The side effects were few, and not serious. The studies on ginkgo did not demonstrate any therapeutic difference compared to placebo. The side effects were few and not serious. These are approved herbal remedies. Do they really work, or could this effect rather be referred to as placebo? The use of herbal remedies as medicines could potentially be useful as complementary to traditional medicine. To read the instructions and follow the dosage, however, is an important part of the safety. More studies are also needed on the safety of herbal remedies.</p> / <p>Abstrakt</p><p>I många år har man använt sig av naturläkemedel för att lindra olika sjukdomssymtom. Dels användes förr dels i rituella handlingar för att blidka gudarna, och dels i medicineringssyfte. Växter som rabarber och ginseng användes i Kina. Egyptierna hade kunskaper om läkeväxter som aloe, myrra och bolmört, redan 1550 f.kr. Medicinens fader Hippokrates använde sig av ett stort antal läkeväxter och hade många teorier angående ämnet.</p><p>Olika delar av växten kan utnyttjas för att utvinna de aktiva substanserna. Delarna som används kan vara t ex roten, stammen, bladen, blomman. De aktiva substanserna består av eteriska oljor, garvämnen, slemämnen, bitterämnen m.m.. För att utvinna de aktiva substanserna använder man sig av olika bredningsformer som tinktur, extrakt eller annat.</p><p>Echinacea har använts mot flera olika sjukdomar. Nu används växten för att lindra förkylningssymtom. Johannesört ges mot depression. Som lugnande medel kan valeriana användas. Ginkgo kan användas vid dålig genomblödning, t ex i hjärnan. Den psykiska och fysiska prestationsförmågan kan höjas med hjälp av ginseng. Dessa är godkända naturläkemedel. Och intresset för dem ökar. Men fungerar de, och hur säkra är de?</p><p>I detta arbete granskades artiklar om Echinacea och Ginkgo, deras användning och säkerhet. Tre vetenskapliga artiklar, angående echinaceas effekt studerades, samt två artiklar om ginkgo. Echinacea-artiklarnas syfte var att undersöka om växten hade effekt mot förkylning. De andra två artiklarna undersökte ginkgos effekt dels mot minnesproblem, och dels mot tinnitus. Echinaceastudierna visade ingen signifikant terapeutisk skillnad jämfört med placebo. De biverkningar som fanns var få och inte allvarliga. Studierna om ginkgo visade inte heller någon terapeutisk skillnad jämfört med placebo. Biverkningarna var även här få och inte allvarliga. Dessa godkända naturläkemedel, har i andra studier visat vetenskapligt bevisad effekt, men kan denna effekt möjligen framför allt vara en placeboeffekt?</p><p>Användningen av naturläkemedel kan vara ett bra komplement till traditionell medicinering. Att läsa anvisningarna och följa doseringen är dock en viktig del av säkerheten. Flera studier behövs även kring säkerheten med naturläkemedel.</p><p>2008:F26</p>

Bakgrund: Buller kan beskrivas som icke önskvärt ljud. Det anses vara ett stort hälsoproblem internationellt och i kombination med komplexa arbetsuppgifter kan buller leda till flera negativa konsekvenser. Ljudtrötthet innebär att ljud upplevs som störande och det kan uppstå när individer exponeras för starkt buller eller vistas i en påfrestande ljudmiljö. Vissa frisörsalonger uppnår ljudnivåerna på 71–76 dB (A). Frisörer spenderar cirka 29 % av dagen med att klippa hår, 17 % med att färga hår, 10 % med att föna hår och 8 % av dagen med att tvätta hår och fönar kan producera ljudnivåer på 60–95 dB (A). Syfte: Syftet med denna studie är att utforska potentiellt samband mellan bullerexponering och ljudtrötthet bland yrkesverksamma frisörer. Studien ämnar också att undersöka relaterade symptom till ljudtrötthet såsom ljudkänslighet, svårighet att höra i samtal, försämrad hörsel, stress, koncentrationssvårigheter samt tinnitus. Detta för att få en djupare förståelse av hur ljudmiljön påverkar frisörers hörselhälsa och välmående. Metod: En kvantitativ enkätstudie genomfördes. 31 frisörer inkluderades i studien, varav 22 var från Örebro, 9 från Karlstad och ingen var från Sunne. Fyra av salongerna hade en arbetare medan de resterande salongerna hade minst två arbetare. Resultat: Ett positivt, statistiskt signifikant samband sågs gällande buller i korrelation till ljudtrötthet, ljudkänslighet, svårighet att höra i samtal, stress och koncentrationssvårigheter men sambandet gällande ljudkänslighet bör tas med försiktighet. Gällande ljudtrötthet uppvisades ett positivt, statistiskt signifikant samband med ljudkänslighet, svårighet att höra i samtal, stress och koncentrationssvårigheter men sambandet gällande ljudkänslighet bör tas med försiktighet. Detta indikerar att ju mer ljudtrötthet frisörerna hade, desto mer ljudkänslighet men även mer svårighet att höra i samtal, stress och koncentrationssvårigheter rapporterades. Det fanns inte någon statistiskt signifikant skillnad i upplevelsen av ljudtrötthet mellan olika åldersgrupper. Dessutom påverkade antal år som yrkesverksam frisör inte rapporteringen av ljudtrötthet. Slutsatser: Det är viktigt att arbeta preventivt för att motverka buller på frisörsalonger. Vidare forskning är viktigt för att lyfta fram problemet. Denna studie är menad att vara ett bidragande startskott till detta ämne och bidra till ökad förståelse kring forskningsfrågan. / Background: Noise can be described as unwanted sound. It is considered a major health problem internationally, and in combination with complex work tasks, noise can lead to several negative consequences. Noise fatigue means that sound is experienced as disturbing, and it can occur when individuals are exposed to loud noise or reside in a stressful sound environment. Some hairdressing salons reach noise levels at 71–76 dB (A). Hairdressers spend approximately 29% of their day cutting hair, 17% coloring hair, 10% blow drying hair and 8% of their day washing hair and blow dryers can produce noise levels at 60-95 dB (A). Aim: The aim of this study is to explore potential relationship between noise exposure and noise fatigue among professional hairdressers. The study also intends to investigate related symptoms to noise fatigue such as sound sensitivity, difficulty hearing in conversation, impaired hearing, stress, concentration difficulties and tinnitus. This is to gain a deeper understanding of how the sound environment affects hairdressers hearing-health and well-being.Methods: A quantitative survey study was conducted. 31 hairdressers were included in the study, of which 22 were from Örebro, 9 from Karlstad and none was from Sunne. Four of the salons had one worker while the remaining salons had at least two workers. Results: A positive, statistically significant relationship was seen regarding noise in correlation to sound fatigue, sound sensitivity, difficulty hearing in conversation, stress and concentration difficulties but the connection regarding sound sensitivity should be taken with caution. Regarding sound fatigue, a positive, statistically significant relationship was shown with sound sensitivity, difficulty hearing in conversation, stress and concentration difficulties but the connection regarding sound sensitivity should be taken with caution. This indicates that the more sound fatigue the hairdressers had, the more sound sensitivity but also more difficulty hearing in conversations, stress and concentration difficulties were reported. There was no statistically significant difference in the experience of noise fatigue between different age groups. In addition, number of years as a working hairdresser did not influence the reporting of noise fatigue. Conclusions: It is important to work preventively to counteract noise in hairdressing salons. Further research is important to highlight the problem. This study is meant to be a contributing starting point to this subject and contribute to increased understanding of the research question.

Bakgrund: Hörselnedsättning är ett vanligt hälsoproblem som kan ha en rad psykosociala följder. För att utvärdera dessa används vanligen frågeformulär. I nuläget saknas det en kartläggning över vilka frågeformulär som används, om de är validerade och hur de är översatta. Syfte: Studien syftade till att kartlägga frågeformulär som mäter psykosociala aspekter i svensk hörselvård och se ifall de har utvärderats gällande validitet och reliabilitet samt hur de har översatts till svenska. Metod: En enkätundersökning sammanställdes från redan insamlade data från olika verksamheter i Sverige och en litteratursökning gjordes där sammanlagt sju artiklar granskades. Resultat: Endast 14 verksamheter (41%) av 34 använde frågeformulär som mäter psykosociala aspekter. För många verksamheter saknades klinikbeslut om att använda frågeformulär och majoriteten av verksamheterna fick välja själva vilka som skulle användas. Det fanns en betydande variation av frågeformulär mellan verksamheterna, men Hospital Anxiety and Depression Scale (HADS), Karolinska Exhaustion Disorder Scale (KEDS) och Montgomery-Asberg Depression Rating Scale (MADRS) var mest förekommande. Formulären användes främst vid behovsutredningsbesök. De professioner som använde frågeformulären i högst utsträckning var kuratorer och psykologer. Frågeformulären användes främst för vuxna i yrkesverksam ålder, pensionärer och personer med depression, ångest och utmattning. Majoriteten av verksamheterna har inte gjort några förändringar av frågeformulären. Samtliga verksamheter använde svenska versioner av formulär. Sju artiklar hittades som behandlade följande frågeformulär: Beck Depression Inventory (BDI), MADRS, HADS, Tinnitus Handicap Inventory (THI), Insomnia Severity Index (ISI), (KEDS) och Mental Fatigue Scale (MFS). Samtliga visade på god validitet men HADS, ISI, KEDS och MFS saknade adekvat intern konsistens. Samtliga saknade information om hur översättningsprocessen gått till. Slutsatser: Studien har kartlagt de frågeformulär som mäter psykosociala aspekter och som används inom svensk hörselvård. Hälften av frågeformulären som användes (BDI, HADS, ISI, KEDS, MADRS, MFS och THI) var utvärderade och visade sig vara validerade, men alla var inte reliabla. Det saknades psykometriska utvärderingar för resterande frågeformulär. Studien identifierar flera områden för förbättring, som att fler verksamheter behöver använda frågeformulär som mäter psykosociala aspekter, samt att många av dessa verktyg behöver genomgå en psykometrisk utvärdering och dokumentera översättningsprocessen. / Background: Hearing impairment is a common health issue that can have various psychosocial consequences. To assess these, questionnaires are commonly used. However, there is a lack of mapping regarding which questionnaires are used, whether they are validated, and how they are translated. Aim: The study aimed to map questionnaires measuring psychosocial aspects in Swedish audiological care and to examine whether they have been evaluated for validity and reliability, as well as how they have been translated into Swedish. Methods: The method consisted of a survey gathering data from various facilities in Sweden, and a literature search where a total of seven articles were reviewed. Results: Only 14 (41%) out of 34 facilities used questionnaires measuring psychosocial aspects. For many facilities, there was no clinical decision regarding the use of questionnaires and most facilities had to choose which ones to use themselves. There was significant variation in the questionnaires used between facilities, but Hospital Anxiety and Depression Scale (HADS), Karolinska Exhaustion Disorder Scale (KEDS) and Montgomery-Asberg Depression Rating Scale (MADRS) were the most common. The questionnaires were mainly used during needs assessment visits. The professions that used the questionnaires the most were counselors and psychologists. The questionnaires were primarily used for adults of working age, retirees, and individuals suffering from depression, anxiety, and exhaustion. Most facilities have not made any changes to the questionnaires. All facilities used Swedish versions of the questionnaires. Seven articles were found that addressed the following questionnaires: Beck Depression Inventory (BDI), MADRS, HADS, Tinnitus Handicap Inventory (THI), Insomnia Severity Index (ISI), KEDS and Mental Fatigue Scale (MFS), showing good validity but HADS, ISI, KEDS and MFS were lacking sufficient internal consistency. All lacked information about the translation process. Conclusions: The study has mapped the questionnaires measuring psychosocial aspects used within Swedish audiology. Half of the questionnaires utilized (BDI, HADS, ISI, KEDS, MADRS, MFS och THI) were validated, but not all were reliable. There is a lack of psychometric evaluations of the remaining questionnaires. The study identifies several areas for improvement, such as the need for more facilities to use questionnaires measuring psychosocial aspects, and many of these tools need to undergo psychometric examination and documentation of the translation process.

Made available in DSpace on 2016-04-27T18:12:15Z (GMT). No. of bitstreams: 1 LucianeFigueiredo.pdf: 1388145 bytes, checksum: a12378e7490ffe48ea1021025b84918a (MD5) Previous issue date: 2006-07-31 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Scope: To describe the vestibular complaints and/or symptoms found in otoneurological clinical practice and investigate the relationship between these and vestibulometry. Method: A study was performed by retrospective analysis of the medical records of 116 individuals examined in the otoneurological sector of the Institute of Advanced Studies in Audition during the period from January 2004 through November 2005. Results: The findings showed that the sample was comprised of 86 (74.1%) females and 30 (25.9%) males. The age bracket ranged from 18 to 82 years (50 years average). The vestibular evaluation revealed normal results in 66 individuals and altered results in 50. The otoneurological complaints and/or symptoms reported by the individuals were: dizziness, vertigo, tinnitus, perspiration, headaches, heaviness in the head and walking disturbances. Among the neurovegetative symptoms, nausea proved to be significant (p=0.004). The analysis of the isolated dizziness/vertigo complaint, in comparison with the variable vestibular exam (normal/altered) did not produce any statistically significant association. On the other hand, when the complaint of vertigo appeared in association with tinnitus, a considerable number of altered exam results were observed. Conclusion: Based on the data gathered, it can be seen that the fact that a patient records a complaint of isolated dizziness/vertigo does not signify that the vestibular exam will necessarily be altered. However, the association of vertigo + tinnitus reveals itself to be indicative of altered exam results. Therefore, a comparison of the clinical history of patients with vestibulometric symptoms is fundamental for establishing the diagnostic hypothesis / Objetivo: Descrever a queixa e/ou os sintomas vestibulares encontrados na clínica otoneurológica e investigar a relação destes com a vestibulometria. Método: Efetuou-se um estudo por meio da análise retrospectiva dos prontuários de 116 sujeitos examinados no setor de otoneurologia do Instituto de Estudos Avançados da Audição no período de janeiro de 2004 a novembro de 2005. Resultados: Os achados mostraram que a amostra foi constituída por 86 (74,1%) sujeitos do sexo feminino e 30 (25,9%) do sexo masculino. A faixa etária variou de 18 e 82 anos (média 50 anos). A avaliação vestibular mostrou resultados normais em 66 sujeitos e resultados alterados em 50. As queixas e/ou sintomas otoneurológicos referidos pelos sujeitos foram: tontura, vertigem, zumbido, náusea, sudorese, cefaléia, peso na cabeça e distúrbios à marcha. Dentre os sintomas neurovegetativos, a náusea apresentou-se bastante significativa (p=0,004). A análise da queixa de tontura/vertigem isolada, em comparação com a variável exame vestibular (normal/alterado), não apresentou associação estatisticamente significante. Por outro lado, quando a queixa de vertigem apareceu associada a zumbido, observou-se um número considerável de exames alterados. Conclusão: Com base nos dados encontrados, verifica-se que o fato de o paciente apresentar queixa de tontura/vertigem isolada não significa que o resultado do exame vestibular estará necessariamente alterado. Todavia, a associação vertigem + zumbido mostra-se sugestiva de exame alterado. Sendo assim, comparar a história clínica dos pacientes com os achados vestibulométricos é fundamental para o estabelecimento da hipótese diagnóstica

The objective of this study was to evaluate the use of omega 3 in association with folic acid for the treatment of sensorineural hearing loss. For this purpose, 15 patients aged between 18 and 75 years were included in the study. The participating patients received orally a single daily dose of 5 mg of folic acid and 2 g dose of omega 3 (eicosapentaenoic fatty acid (EPA) - 360 mg and docosahexaenoic acid (DHA) - 240 mg), three times a day for a period of 3 months (Rexall Sundown, Inc. ) and were followed over 16 weeks. The Tinnitus Handicap Inventory (THI), and The Clinical Global Impression Scale-Improvement (CGI-I) were used as a method of assessing results. Of the 15 patients included in the study, none withdrew consent or were excluded during the process. No patient reported any adverse event. There was a reduction, on average, of 14.2 units in THI, which corresponds to a 35% drop from baseline value (p- value <0.001). Considering the results obtained by the CGI-I, improvements were observed in 80% of the patients and no worsening were reported. It was concluded that the experimental treatment is safe, highly tolerable and with considerable improvement rates, opening doors to new possibilities in managing patients with tinnitus. / O objetivo deste trabalho foi avaliar o uso do ômega 3 em associação ao ácido fólico, para o tratamento do zumbido neurossensorial. Para tanto, 15 pacientes com idades variando entre 18 e 75 anos foram incluídos no estudo. Os pacientes participantes receberam, por via oral, dose única diária de 5 mg de ácido fólico e doses de 2 g de ômega 3 (ácido graxo eicosapentaenoico - EPA - 360 mg e ácido docosahexaenoico - DHA - 240 mg), três vezes ao dia, pelo período de três meses (Rexall Sundown, Inc.®), e foram acompanhados ao longo de 16 semanas. Como método de avaliação de resultados foram utilizados o Tinnitus Handicap Inventory (THI) e o Clinical Global Impression- Scale-Improvement (CGI-I). Dos 15 pacientes incluídos no estudo, nenhum retirou seu consentimento ou foi excluído durante o processo e nenhum referiu qualquer evento adverso. Observou-se redução de, em média, 14,2 unidades no THI, o que corresponde à queda de 35% do valor inicial (valor-p <0,001). Considerando-se os resultados aferidos pelo CGI-I, verificou-se melhora em 80% dos pacientes e nenhuma piora. Concluiu-se que o tratamento avaliado mostrou-se seguro, altamente tolerável e com índices de resposta que merecem ser confirmados por estudos mais amplos, randomizados, duplo-cego e contraplacebo.

Submitted by Ana Paula Lisboa Monteiro (monteiro@univates.br) on 2010-11-22T16:52:02Z No. of bitstreams: 1 SandraWeber.pdf: 930166 bytes, checksum: f4661254f487fa3ecc7cef6d1feedf94 (MD5) / Made available in DSpace on 2010-11-22T16:52:02Z (GMT). No. of bitstreams: 1 SandraWeber.pdf: 930166 bytes, checksum: f4661254f487fa3ecc7cef6d1feedf94 (MD5) / Tradicionalmente, zumbido no trabalhador exposto ao ruído tem sido relacionado à perda auditiva. Entretanto, as inúmeras possibilidades etiológicas e a interação do sistema auditivo com outros sistemas, como o sistema somatossensorial, somada ao impacto negativo que o zumbido pode causar, ampliam esta dimensão. Nesta perspectiva, o presente trabalho visa contribuir para o entendimento do zumbido e a correlação com perda auditiva, modulação somática do zumbido e repercussão na qualidade de vida de trabalhadores expostos ao ruído. Foi realizado estudo transversal e descritivo de trabalhadores expostos ao ruído e com percepção de zumbido, envolvendo entrevista, audiometria tonal, questionário Tinnitus Handicap Inventory e manobras somáticas para pesquisa da modulação do zumbido. De um total de 585 trabalhadores expostos ao ruído, em uma empresa do ramo alimentício, foi encontrada uma prevalência de zumbido de 7,2% (n=42), na faixa etária de 20 a 60 anos, tempo médio de exposição ao ruído de três anos e oito meses e tempo médio de percepção do zumbido de três anos e sete meses. Verificou-se predomínio da percepção de zumbido intermitente (88%), bilateral (53,4%), com início progressivo (66,7%), descrito como som único (85,7%). Um total de 50% dos trabalhadores com zumbido não apresentaram perda auditiva. Estresse, silêncio e barulho foram os fatores de piora mais citados. O zumbido interfere principalmente na concentração. Foi encontrada modulação somática do zumbido em 69% dos indivíduos. A Correlação de Spearman mostrou diferença significativa (p=0,0094) entre o tempo de exposição ao ruído e o tempo de percepção do zumbido nos indivíduos sem perda auditiva.

A tontura é considerada pela área médica, como um problema de saúde pública. Entender os distúrbios do equilíbrio corporal, como a limitação de um dos sistemas fundamentais para a sobrevivência do indivíduo, ajuda a compreender a importância e a necessidade de uma abordagem diagnóstica rápida e precisa. A valorização de sinais encontrados na avaliação vestibular, e da queixa do paciente, é fundamental para o diagnóstico, sendo de extrema importância o encaminhamento para avaliação exploratória do sistema vestibular, para que medidas terapêuticas personalizadas sejam adotadas. A reabilitação vestibular (RV) é um recurso terapêutico realizado por meio de exercícios que visam melhorar a interação vestíbulo-visual durante a movimentação cefálica, e ampliar a estabilidade postural estática e dinâmica nas condições que produzem informações sensoriais conflitantes. Objetivo: Verificar a eficácia de um protocolo de procedimentos terapêuticos de RV em grupo, aplicado em indivíduos com queixas vestibulares, considerando as variáveis: gênero, idade, presença de zumbido e influência da localização do comprometimento do sistema vestibular. Material e métodos: Estudo descritivo e retrospectivo, realizado a partir da análise de prontuários de 151 pacientes atendidos na DSA do HRAC-USP. A casuística foi delimitada a partir da análise de prontuários de pacientes de ambos os gêneros, com idade entre 10 a 88 anos. Os critérios de inclusão foram: queixas vestibulares, ter realizado a VENG pré RV em grupo, ter respondido ao Dizziness Handicap Inventory (DHI) e a Escala Visual Analógica (EVA), para os sintomas de tontura e zumbido, nas etapas pré e pós intervenção. A RV foi composta por 13 sessões de aproximadamente 60 minutos, seguindo protocolo especifico elaborado para a RV em grupo. O tratamento estatístico foi composto pelos testes Teste T, McNemar, Friedmann, Qui-Quadrado, Fisher, Binominal, Kolmogorov-Smirnov e Testes Wilcoxon. Foi adotado valor de significância (p) igual ou menor que 0,05. Resultados: Na comparação entre os resultados do DHI obtidos nas etapas pré e pós RV houve diferença para todos os aspectos, tanto a pontuação total como para a classificação por grau (p=0,001). Na análise do EVA houve diferença quanto ao desconforto da tontura (valor de p variou de 0,000 a 0,092), quanto ao desconforto relacionado ao zumbido (p=0,001). Houve diferença na comparação da avaliação vestibular por meio da VENG antes e depois da RV (p=0,003). Não houve correlação entre idade (p=0,610) e efetividade da RV porém houve correlação com o gênero (p=0,028). Houve diferença entre os resultados da VENG na comparação entre as etapas pré e pós RV em grupo (p=0,001). Na correlação da EVA com as variáveis, houve correlação com o gênero feminino (p=0,000), com todas as faixas etárias, exceto a de 10 a 20 anos (p=0,125) de 21 a 90 anos, e com o comprometimento vestibular periférico (p=0,000). Conclusão: O protocolo de RV em grupo, aplicados em pacientes com queixas vestibulares foi eficaz para a queixa de tontura e zumbido, independente da idade. O gênero feminino apresentou mais benefícios com a RV do que o gênero masculino. A RV foi eficaz para todos os tipos de comprometimento vestibular, inclusive nos achados identificados como normais. / Dizziness is considered by the medical field as a public health problem. Understanding body balance disorders, such as limiting one of the fundamental systems for individual survival, helps to understand the importance and necessity of a quick and accurate diagnostic approach. The evaluation of signs found in the vestibular evaluation, and the patient\'s complaint, is fundamental for the diagnosis, being extremely important the exploratory evaluation of the vestibular system, so that therapeutic therapeutic measures are adopted. Vestibular Rehabilitation (VR) is a therapeutic resource performed through exercises that aim to improve vestibulovisual interaction during head movement and to increase static and dynamic postural stability in conditions that produce conflicting sensory information. Aim: To verify the efficacy of a group VR therapeutic protocol, applied to individuals with vestibular complaints, considering the following variables: gender, age, tinnitus and influence of the location of vestibular system impairment identified by vectoelectronystagmography (VENG). Methods: Descriptive and retrospective study, based on the analysis of medical records of 151 patients seen in the DSA of HRACUSP. The casuistry was delimited from the analysis of medical records of patients of both genders, aged between 10 and 88 years. Inclusion criteria were: vestibular complaints, VENG pre VR in group, response to Dizziness Handicap Inventory (DHI) and Visual Analogue Scale (VAS) for the symptoms of dizziness and tinnitus, in the pre- and post-intervention stages. The VR was composed of 13 sessions of approximately 60 minutes, following a specific protocol elaborated for VR in a group. The statistical treatment was composed by the Test T, McNemar, Friedmann, Chi- Square, Fisher, Binominal and Kolmogorov-Smirnov tests. Significance (p) value was adopted equal to or less than 0.05. Results: The results obtained were compared with the results obtained for each classification level (p=0,001). In the analysis of VAS, there was a difference between the discount of dizziness (variance value = 0,000 to 0,092), or discomfort related to tinnitus (p=0,001). There was a difference in the evaluation of vestibular evaluation through VENG before and after VR (p=0,003). There was no correlation between age (p=0,610) and VR efficacy, with correlation with gender (p=0,028). There was a difference between the VENG results between the previous phases of the group (p=0,001). In the correlation between the VAS and the variables, there was a correlation with the female gender (p=0,000), with all age groups, except for 10 to 20 years (p=0,125) from 21 to 90 years and with peripheral vestibular impairment (p=0,000). Conclusion: The group VR protocol applied to patients with vestibular complaints was effective for complaint of dizziness and tinnitus, regardless of age. The female had more benefits with an VR than the male sex. VR was effective for all types of vestibular compromise, including findings identified as normal.

A tontura é considerada pela área médica, como um problema de saúde pública. Entender os distúrbios do equilíbrio corporal, como a limitação de um dos sistemas fundamentais para a sobrevivência do indivíduo, ajuda a compreender a importância e a necessidade de uma abordagem diagnóstica rápida e precisa. A valorização de sinais encontrados na avaliação vestibular, e da queixa do paciente, é fundamental para o diagnóstico, sendo de extrema importância o encaminhamento para avaliação exploratória do sistema vestibular, para que medidas terapêuticas personalizadas sejam adotadas. A reabilitação vestibular (RV) é um recurso terapêutico realizado por meio de exercícios que visam melhorar a interação vestíbulo-visual durante a movimentação cefálica, e ampliar a estabilidade postural estática e dinâmica nas condições que produzem informações sensoriais conflitantes. Objetivo: Verificar a eficácia de um protocolo de procedimentos terapêuticos de RV em grupo, aplicado em indivíduos com queixas vestibulares, considerando as variáveis: gênero, idade, presença de zumbido e influência da localização do comprometimento do sistema vestibular. Material e métodos: Estudo descritivo e retrospectivo, realizado a partir da análise de prontuários de 151 pacientes atendidos na DSA do HRAC-USP. A casuística foi delimitada a partir da análise de prontuários de pacientes de ambos os gêneros, com idade entre 10 a 88 anos. Os critérios de inclusão foram: queixas vestibulares, ter realizado a VENG pré RV em grupo, ter respondido ao Dizziness Handicap Inventory (DHI) e a Escala Visual Analógica (EVA), para os sintomas de tontura e zumbido, nas etapas pré e pós intervenção. A RV foi composta por 13 sessões de aproximadamente 60 minutos, seguindo protocolo especifico elaborado para a RV em grupo. O tratamento estatístico foi composto pelos testes Teste T, McNemar, Friedmann, Qui-Quadrado, Fisher, Binominal, Kolmogorov-Smirnov e Testes Wilcoxon. Foi adotado valor de significância (p) igual ou menor que 0,05. Resultados: Na comparação entre os resultados do DHI obtidos nas etapas pré e pós RV houve diferença para todos os aspectos, tanto a pontuação total como para a classificação por grau (p=0,001). Na análise do EVA houve diferença quanto ao desconforto da tontura (valor de p variou de 0,000 a 0,092), quanto ao desconforto relacionado ao zumbido (p=0,001). Houve diferença na comparação da avaliação vestibular por meio da VENG antes e depois da RV (p=0,003). Não houve correlação entre idade (p=0,610) e efetividade da RV porém houve correlação com o gênero (p=0,028). Houve diferença entre os resultados da VENG na comparação entre as etapas pré e pós RV em grupo (p=0,001). Na correlação da EVA com as variáveis, houve correlação com o gênero feminino (p=0,000), com todas as faixas etárias, exceto a de 10 a 20 anos (p=0,125) de 21 a 90 anos, e com o comprometimento vestibular periférico (p=0,000). Conclusão: O protocolo de RV em grupo, aplicados em pacientes com queixas vestibulares foi eficaz para a queixa de tontura e zumbido, independente da idade. O gênero feminino apresentou mais benefícios com a RV do que o gênero masculino. A RV foi eficaz para todos os tipos de comprometimento vestibular, inclusive nos achados identificados como normais. / Dizziness is considered by the medical field as a public health problem. Understanding body balance disorders, such as limiting one of the fundamental systems for individual survival, helps to understand the importance and necessity of a quick and accurate diagnostic approach. The evaluation of signs found in the vestibular evaluation, and the patient\'s complaint, is fundamental for the diagnosis, being extremely important the exploratory evaluation of the vestibular system, so that therapeutic therapeutic measures are adopted. Vestibular Rehabilitation (VR) is a therapeutic resource performed through exercises that aim to improve vestibulovisual interaction during head movement and to increase static and dynamic postural stability in conditions that produce conflicting sensory information. Aim: To verify the efficacy of a group VR therapeutic protocol, applied to individuals with vestibular complaints, considering the following variables: gender, age, tinnitus and influence of the location of vestibular system impairment identified by vectoelectronystagmography (VENG). Methods: Descriptive and retrospective study, based on the analysis of medical records of 151 patients seen in the DSA of HRACUSP. The casuistry was delimited from the analysis of medical records of patients of both genders, aged between 10 and 88 years. Inclusion criteria were: vestibular complaints, VENG pre VR in group, response to Dizziness Handicap Inventory (DHI) and Visual Analogue Scale (VAS) for the symptoms of dizziness and tinnitus, in the pre- and post-intervention stages. The VR was composed of 13 sessions of approximately 60 minutes, following a specific protocol elaborated for VR in a group. The statistical treatment was composed by the Test T, McNemar, Friedmann, Chi- Square, Fisher, Binominal and Kolmogorov-Smirnov tests. Significance (p) value was adopted equal to or less than 0.05. Results: The results obtained were compared with the results obtained for each classification level (p=0,001). In the analysis of VAS, there was a difference between the discount of dizziness (variance value = 0,000 to 0,092), or discomfort related to tinnitus (p=0,001). There was a difference in the evaluation of vestibular evaluation through VENG before and after VR (p=0,003). There was no correlation between age (p=0,610) and VR efficacy, with correlation with gender (p=0,028). There was a difference between the VENG results between the previous phases of the group (p=0,001). In the correlation between the VAS and the variables, there was a correlation with the female gender (p=0,000), with all age groups, except for 10 to 20 years (p=0,125) from 21 to 90 years and with peripheral vestibular impairment (p=0,000). Conclusion: The group VR protocol applied to patients with vestibular complaints was effective for complaint of dizziness and tinnitus, regardless of age. The female had more benefits with an VR than the male sex. VR was effective for all types of vestibular compromise, including findings identified as normal.

In this thesis I offer a philosophy and a performance practice of the ear. It is a theoretical reflection as well as a discussion on my hearing/listening and performance practice, research and workshops. Here is where sound and the body move and perform by relating to the constantly changing acoustic environment. It is an enquiry into and a corporeal experience of sound as the ear body, a bodied experience of sound and listening where the whole body becomes an ear. This is explored through my experience of chronic tinnitus, a criticism of over-determined technology and through a discussion on the trance-dance therapy of Tarantism. With a focus on environmental awareness, this thesis is an ecophenomenological investigation in my theory of site contingency, where I connect my ecophenomenological approach to contingency – contingency intended as a necessary experience of the world – and to acoustic ecology. It offers a methodology for performance-making, also through workshops. They are a ground for shared mutual experience and contribution, with participants from different backgrounds and abilities, and are also a pedagogical instrument, for students and others, in the form of a ‘training’ practice of the ear. This methodology becomes a basis for what I call site-contingent performance, where sound is intended and experienced as relation and as contingency. The kinaesthetics of sound is exemplified in ‘aural choreography,’ a moving by following environmental sounds, and where the experience of contingency is also in the practice of ‘earlines’ drawing; a form of performance and of acoustic documentation.