Obtaining measurements of Maximum Phonation Time (MPT) and Vital Capacity (VC) are fundamental in a speech-therapy evaluation since they provide information about neuromuscular and aerodynamic control of a subject s vocal production. Such variables may be altered in subjects who have vocal nodules, a pathology which alters the glottic closure and the pneumo-phono-articulatory coordination. Aim: verify the MPT of vowels, the VC and the possible relationship between them in adult women with vocal nodules. Materials and Methods: database records from a speech therapy school-clinic were used, making up a total of 38 subjects. The inclusion criteria were female adults and otorhinolaryngology diagnosis of vocal nodules. The exclusion criteria were: to have another laryngeal pathology other than the vocal nodules; hearing loss; oral breathing; history of neurological, psychiatric, endocrine or gastric disorders; flu or allergy history; drinking and/or smoking habits; previous speech therapy and/or otorhinolaryngology treatments. Anamnesis data, the otorhinolaryngology diagnosis, and the MPT measurements of vowels /a, i, u/ were collected from the database, as well as the value of the highest vital capacity from all subjects in the sample. MPT evaluation is given by the duration measurement of three emissions of each vowel. The patient is asked to stand and produce such sounds in habitual tone and intensity until the end of exhalation. The highest value of each vowel is then considered. Regarding VC values, the patient is asked to perform six exhalations in the spirometer, after maximal inhalation. Three exhalations are performed with nasal occlusion and three without occlusion, including a rest between them. Finally, the highest out of the six values collected is considered. The results were statiscally analysed at a 5% significance level. The analysis was carried out through descriptive statistics, Mann-Whitney U Test, Variables Normality Tests (Lilliefors), Spearman Correlation, Kruskal-Wallis Test. Results: representative age range; representative and within normality VC; less homogeneous MPT and mean, below normality and with a strong positive and meaningful correlation; moderate, positive and meaningful correlation between VC and MPT and the mean. Conclusion: in the presence of vocal nodules in an adult group of women, the Maximum Phonation Times were reduced, the vowel /a/ presented a lower value when compared to the other vowels, and the VC remained within normality, having a moderately positive correlation between both of them. / A obtenção de medidas de Tempos Máximos de Fonação (TMF) e da Capacidade Vital (CV) são fundamentais na avaliação fonoaudiológica, pois revelam informações sobre o controle neuromuscular e aerodinâmico da produção vocal de um indivíduo. Tais variáveis podem estar alteradas em indivíduos com nódulos vocais, patologia que altera o fechamento glótico e a coordenação pneumofonoarticulatória. Objetivo: verificar os TMF de vogais, a CV e a relação entre ambos em mulheres adultas com presença de nódulos vocais. Materiais e Métodos: utilizaram-se os registros do Banco de dados de uma clínica-escola de Fonoaudiologia, totalizando um grupo de estudo constituído de 38 sujeitos. Os critérios de inclusão foram: adultos do sexo feminino e diagnóstico otorrinolaringológico de nódulos vocais. Os critérios de exclusão foram: apresentar outra patologia laríngea além dos nódulos vocais; comprometimento auditivo; respiração oral; histórico de doenças neurológicas, psiquiátricas, endocrinológicas ou gástricas; gripe ou quadros de alergias; hábitos de etilismo e/ou tabagismo; tratamento fonoaudiológico e/ou otorrinolaringológico prévios. Foram coletados do Banco de Dados os dados de anamnese, o diagnóstico otorrinolaringológico, e as medidas de TMF das vogais /a, i, u/, bem como o valor da maior CV de todos os sujeitos da amostra. A avaliação dos TMF se dá pela medida da duração de três emissões de cada uma das vogais, sendo que o paciente é orientado a ficar em pé e realizar tais emissões em tom e intensidade habituais, até o final da expiração, considerando-se o maior valor de cada vogal. Em relação aos valores de CV, o paciente é solicitado a realizar um total de seis expirações no espirômetro, após inspiração máxima, sendo três delas com presença de oclusão nasal e três sem oclusão, com descanso entre elas. Por fim, é considerado o maior dos seis valores coletados. Os resultados foram analisados estatisticamente ao nível de significância de 5%, sendo a análise realizada por meio da estatística descritiva, Teste U de Mann-Whitney, Teste de Normalidade das Variáveis (Lilliefords), Correlação de Spearman, Teste de Kruskal-Wallis. Resultados: faixa de idade homogênea; CV representativa e dentro da normalidade; TMF e média menos representativos, abaixo da normalidade e com forte correlação positiva e significativa entre si; correlação moderada, positiva e significativa entre CV e TMF e sua média. Conclusão: na presença de nódulos vocais em um grupo de mulheres adultas, os TMF encontraram-se reduzidos, a vogal /a/ apresentou menor valor quando comparada às demais vogais, e a CV permaneceu dentro da normalidade, havendo correlação moderadamente positiva entre ambos.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A dissertação comenta criticamente as interpretações recentes referentes ao vitalismo no século XVIII, dedicando atenção especial aos Nouveuax Éléments de la Science de lHomme (publicado primeiramente em 1778), de Paul-Joseph Barthez (1734-1806). Até a segunda metade do século XX, como é primeiramente argumentado nesta dissertação, intérpretes do iluminismo entendiam a doutrina mecanicista como a herdeira direta da Revolução Científica, bem como a corrente dominante no mundo das ciências da vida ao longo de todo o século XVIII. Assim, na historiografia do século passado, o vitalismo era ou escassamente mencionado, ou visto como uma retrógrada corrente anti-iluminista. Mais recentemente, vários historiadores e pesquisadores da história das ciências no século XVIII (sobretudo Williams e Reill) entendem o iluminismo de um modo mais amplo e plural, considerando o vitalismo iluminista (um termo proposto por Reill) como parte integrante de um conceito mais dinâmico de iluminismo. A seguir, são apresentados a doutrina mecanicista e seus conceitos centrais, bem como as ideias de alguns dos principais representantes do mecanicismo no século XVII e início do XVIII, no caso, mais especificamente, do mecanicismo newtoniano. Em seguida, são expostos e comentados a doutrina vitalista e seus conceitos, no que é dado destaque ao vitalismo na Universidade de Montpellier. Nesse contexto, são comentados conceitos vitalistas, tal como apresentados nos Nouveuax Éléments de la Science de lHomme, no qual Barthez propõe uma nova fisiologia baseada no princípio vital; nisso são apresentados sua metodologia de pesquisa, o conceito de princípio vital, as forças sensitivas e motrizes do princípio da vida, além dos conceitos de simpatia, sinergia e, por fim, o conceito de temperamento. Esses conceitos ou essa terminologia , tal como é mostrado, não são originalmente concebidos por Barthez, mas foram por ele reapropriados e reformulados em debate com o newtonianismo e demais correntes filosóficas médicas desde a Antiguidade até o século XVIII, assim como com observações e experimentos próprios às investigações médico-científicas da época. Como resultado, é alcançada uma compreensão da doutrina vitalista como um esforço intelectual inovador tanto interagindo quanto integrado com o debate científico contemporâneo, ou seja, os médicos vitalistas se viam e, em geral, eram vistos como atuando segundo os padrões de cientificidade exigidos por seus pares. / On the thesis critical comments are made on the recent interpretations of Vitalism on the XVIII century, paying special attention on the Nouveaux Éléments de la Science de lHomme (first published in 1778), by Paul-Joseph Barthez (1734 1806). Since the second half of the XX century, as it is firstly discussed on this thesis, the Enlightenment interpreters understood the mechanist doctrine as the heiress of Scientific Revolution as well as the dominant strain in the sciences of life throughout the XVIII century. This way, on the historiographical of the last century Vitalism was scarcely mentioned or seen as a backward anti-Enlightenment school of thought. Recently, historians and researchers on history of Science of the XVIII century (above all Williams and Reill) understand Enlightenment in a more plural way, considering Enlightenment Vitalism (a name proposed by Reill) an integral part of a more dynamic Enlightenment concept. Next, the mechanist doctrine and its main concepts are shown, as well as the thoughts of some of the mechanist main followers on the XVII century and the beginning of the XVIII century, more specifically the Newtonian Mechanist. Afterwards, the vitalist doctrine and its concepts are exposed and commented with special attention to the Vitalism at the Montpellier University. Within this context, the vitalist concept are commented as they are presented on the Nouveaux Éléments de la Science de lHomme, where Barthez proposes a new physiology based on vital principles; on this way, his researching methodology is presented as well as the vital principle concept, the sensitive forces and the principle of life motive forces, besides the concepts of sympathy, synergy and at last, the concept of temperament. Those concepts or this terminology , as it is shown, are not originally conceived by Barthez, but they were taken and reformed by him on debating with Newtonianism and others Medical Schools strain of thoughts since Antiquity until the XVIII century as well as with experiments and observations of the medical-scientific researches by his own and of his own time. As a result, understanding of the Vitalist doctrine is reached as an in the 18th Century largely well-accepted intellectual effort, fittingly interacting with the contemporaneous scientific debate, that is, vitalist physicians had seen themselves and were also seen by his peers as following the scientific standards of their own time.

Introdução: As complicações respiratórias, somadas a baixos volumes pulmonares e tosse ineficiente, decorrentes da fraqueza da musculatura respiratória nas doenças neuromusculares (DNM), são as principais causas de morbidade e mortalidade. Objetivo: Verificar os efeitos do treinamento de empilhamento de ar na função respiratória de pacientes com DNM. Métodos: Estudo prospectivo em 21 pacientes com DNM, idade entre 7 e 23 anos. Todos foram submetidos a avaliações respiratórias a cada 4 e 6 meses. Realizou-se espirometria e medida do pico de fluxo de tosse não assistido e assistido (PFTNA e PFTASS) com insuflações e empilhamento de ar com ressuscitador manual. Os pacientes e cuidadores foram treinados e orientados a realizar o treinamento das manobras de empilhamento de ar diariamente no domicílio. A análise estatística utilizou o pacote estatístico como médias ± desvios-padrão, foram submetidas ao teste de normalidade de D\'Agostino-Pearson. Utilizou-se ANOVA para medidas repetidas, seguidas do teste Post Hoc de Tukey. O pico de fluxo expiratório (PFE) não exibiu distribuição normal e, por isso, foi submetido ao teste de Friedman seguido do teste Post Hoc de Dunn. Os coeficientes de correlação de Pearson foram calculados e nível de significância estabelecido foi p < 0,05. Resultados: Houve aumento na estatura média dos pacientes de 2,5 cm (p < 0,0001). A média da capacidade de insuflação máxima (CIM) foi maior que a capacidade vital forçada (CVF) basal em todas as avaliações (p < 0,0001). Houve aumento na média da CVF e CIM (p < 0,01), PFTNA (p < 0,05) e no PFTASS após período de treinamento nos pacientes com escoliose não estruturada ou ausente. Conclusão: O treinamento domiciliar com insuflações e empilhamento de ar deve ser enfatizado nas DNM, pois aumenta o PFT. Tal treinamento aumenta a CVF basal e o PFTNA nos pacientes sem deformidades torácicas. / Introduction: Respiratory complications, low lung volumes and inefficient cough, resulting from weakness of respiratory muscles are the major causes of morbidity and mortality in neuromuscular patients (NMD). Objective: To assess the effects of air stacking training on lung function in patients with NMD. Methods: Prospective study in 21 patients with NMD aged 7 to 23 years. Al patients underwent respiratory evaluations every 4 to 6 months. Was performed spirometry and measurement of unassisted peak cough flow (UPCF) and assisted peak cough flow (APCF) with insufflations and air stacking with manual resuscitator. The patients and caregivers were trained and were prescribed lung insufflations by air stacking three times each day at home. The statistical analysis used the statistical package GraphPad Prism 5.0 for Windows. Spirometric variables were expressed as means ± standard deviations, were subject to normality test D\'Agostino-Pearson. We used ANOVA for repeated measures followed by post hoc Tukey test. The peak expiratory flow (PEF) did not exhibit normal distribution and therefore was subjected to the Friedman test followed by Dunn´s post hoc test. The Pearson correlation coefficients were calculated and significance level was set at p < 0.05. Results: There was in increase in the average height of 2.5 cm, of the patients (p < 0.0001). The mean maximum insufflation capacity (MIC) was greater than forced vital capacity (FVC) baseline for all evaluations (p < 0.0001). There was increase in mean FVC and MIC (p < 0.001), UPCF (p < 0.05) and APCF (p < 0.01) after air stacking training period in patients without scoliosis or unstructured. Conclusion: The air stacking training home should be emphasized in NMD. This training increases the FVC and UPCF in patients without scoliosis or unstructured.

The objective was to determine the prevalence of vital teeth requiring non-surgical root canal therapy (NSRCT) that present with radiolucencies in mature permanent teeth in a pediatric population. A retrospective electronic dental chart review of children treated with NSRCT at VCU’s School of Dentistry between November 30, 2009 and March 1, 2013 was conducted. The presence or absence of a periapical radiolucency was determined from digital radiographs by three calibrated dentists. Specific characteristics of each tooth were collected. Statistical analysis using logistic regression was completed on all teeth with radiolucencies and vital teeth with radiolucencies. NSRCT was completed on 551 teeth. Radiolucencies were present in 246 teeth. Vitality data on access was only available in 184 teeth. In these, the prevalence of vital teeth with radiolucencies was 45.1% (n=83). Significant differences were noted for tooth type, gender, and puberty. Post-pubertal subjects had more vital teeth with radiolucencies than pubertal subjects.

Purpose: The purpose of this retrospective chart review was to determine how primary molars needing vital pulp therapy have been treated in the past four years at Virginia Commonwealth University (VCU) and to determine which treatments: indirect pulp therapy (IPT), formocresol pulpotomy, and ferric sulfate pulpotomy have been successful. Methods: AxiUm records that contained the procedure codes D3120 (Pulp Cap – Indirect) or D3220 (Therapeutic Pulpotomy) were totaled by year. Visit records were queried again to identify treatment failures i.e. extractions or pulpectomy. Results: In 2010, 52% of vital pulp therapies were ferric sulfate pulpotomies and in 2014 over 90% were indirect pulp therapy. Indirect pulp therapy had a 96.2% success rate, formocresol pulpotomy had a 65.8% success rate and ferric sulfate had a 62.9% success rate at three years (PConclusions:Indirect pulp therapy is a successful treatment option for the primary tooth with deep caries approaching the pulp

Civil registration (CR) is a continuous recording of births, deaths, causes of death, marriages, divorces, and migrations, and is fundamental to the socioeconomic development in every country. It establishes the legal identity of individuals and produces vital statistics (VS) of a population. Identity documents, including a birth certificate, signifies an individual's citizenship. They preset access to basic services, legal protection, and economic opportunities. Statistics produced from the civil registry are key to inform the planning and monitoring of development programs, including health. Birth registration is fundamental to the CRVS system because at-birth records provide the basic information needed by other sectors in order to plan and deliver their services. Also, they create a documentation path over individuals’ lifecycle. Poor birth registration performance, therefore, epitomizes a weak CRVS system. This study focuses on birth registration in Indonesia, one of the countries with the largest number of unregistered under-five years old children. It aims to identify factors that generate stronger birth registration in other lower middle-income countries and to examine the current state of birth registration in Indonesia. Based on the review of the global and regional practices and the analysis of the empirical evidence, this study proposes comprehensive solutions to engender an effective birth registration system in Indonesia. This study is presented in three papers, each of which addresses specific aims and research questions and together offer conceptual coherence on birth registration system in Indonesia. Paper 1 titled “Enablers to Stronger Birth Registration Systems in Developing Countries: A Qualitative Systematic Review” synthesizes experiences from birth registration strengthening programs. Paper 2 titled “Barriers and Opportunities of Birth Registration: Evidence from Indonesia” quantitatively analyzes the current state and the factors that affect the access to birth registration services in Indonesia. Paper 3 titled “Ending Invisibility Since Birth: Solutions for Birth Registration Policy in Indonesia and the Global Practice” discusses strategic changes that are required to improve the birth registration performance in Indonesia and potentially beyond. It is hoped that this study can contribute to the literature about Indonesia and birth registration systems while offering applicable ways to improve the situation.

We provide an analysis of the main sources of data used to estimate fertility schedules in developing countries, giving special attention to Brazil. In addition to the brief history of various data sources, we present several indirect demographic methods, commonly used to estimate fertility and assess the quality of data. From the methods used, the Synthetic Relational Gompertz model gives the most robust estimates of fertility, independent of the data source considered. We conclude that different demographic data sources and methods generate differing estimates of fertility and that the country should invest in quality of birth statistics.

No description available.

The notion of superdiversity demands a move beyond an ethno-focal analysis of migration related diversity and calls to analytically incorporate other aspects of diversification, including differential migration, legal status and labour market trajectories. Taking London and Toronto as field locations, this thesis investigates how a superdiversity lens can be operationalised and utilised to discuss migrant socialities in urban contexts. It methodologically explores one particular avenue for doing this - personal social network analysis - to better understand the theoretical and empirical implications of adopting a superdiversity approach. Both qualitative and quantitative analysis strategies are used and particular emphasis is on visualising complex patterns and exploring how starting with complexity as an assumption facilitates the multidimensional analysis a superdiversity lens calls for. Focusing on networks of migrants who in statistical terms are commonly categorised as 'other' - who have relatively few co-migrants in terms of place of origin but who are differentiated in terms of other superdiversity aspects - the thesis questions if and what impact small group size has on patterns of sociality. With this focus it is established that a) the numerical size of the origin group impacts on social activities differently depending on whether one small group is explicitly liked to other pan-ethnic groups or not; b) that sociality patterns of migrants emerge from the complex interplay of general socialising opportunities but are also linked to individual trajectories of migration and settlement; c) that with a superdiversity lens it is indeed possible to move beyond the ethnic network notion. To support this latter point the thesis explores four alternative ways of describing migrant networks in terms of city-cohort, long-term resident, superdiverse and migrant-peer networks. The analysis contributes to theoretical debates by proposing a rational understanding of diversity rather than one based on the enumeration of categories be they ethnic or otherwise.

In 1969, Indonesia established a national family planning programme and total fertility has declined rapidly since but there is little consensus over the relative contribution of family planning to the observed decline. The first chapter constructs a new measure of family planning exposure to examine the role of family planning in reducing fertility. The causal effects of infant mortality is also examined based on a new instrumental variable, water supply and sanitation programme exposure, and that of schooling using father's schooling as an instrument. The findings strongly indicate that family planning contributes to lower fertility together with reductions in infant deaths and improvements in women's schooling, and that the effects of family planning and decreases in infant mortality are larger than that of schooling. In 2002, nearly one-in-ten men and more than one-in-five women in Indonesia were overweight and noncommunicable diseases had become the main cause of death but there exists no evidence on the causal effect of schooling on BMI for developing countries. The second chapter assesses whether more schooling causes healthier BMI in Indonesia by using two instrumental variables to capture exogenous variation in schooling. The first instrument takes advantage of the primary school construction programme (SD INPRES) in the 1970s; the second instrument is father's schooling. Two results stand out: more schooling causes higher BMI for men and there is no causal effect of schooling on BMI for women. This chapter also provides some very preliminary evidence that the shift from blue collar to white collar and service sector occupations is one contributing factor to why more schooling increases BMI for men. The third chapter also uses the SD INPRES programme but to examine the effect of increased school supply on schooling attainment: overall, by gender, and by socioeconomic background. It also constructs a new SD INPRES programme exposure variable as an instrument for schooling to assess the causal effect of schooling on wages. The results strongly suggest that the SD INPRES programme increased schooling for men and women but that women benefited more as did individuals from less advantageous socioeconomic backgrounds. More schooling also causes higher wages and there appears to be an added positive effect for women through the additional schooling induced by the SD INPRES programme.